What is the Difference Between Botox Cosmetic and Botox Therapeutic

Botulinum toxin is a substance that is derived from the bacteria Clostridium botulinum. In humans, it acts as a neurotoxin, effectively blocking the transmission of neurological signals between the brain and any muscle in which the toxin is injected. There are eight types of botulinum toxin, named types A through H, and two of those types—types A and B—are sold commercially and medically to be used in humans. The most well-known and popular commercially available botulinum toxin product is Botox, which is made of botulinum toxin type A. Other botulinum toxin type A products include Dysport and Xeomin, and botulinum toxin type B, which is essentially functionally identical to botulinum toxin type B, is available as Myobloc.

What is Botox Cosmetic and what can it treat?

Botox Cosmetic is a dermal injectable that must be prescribed and administered by a healthcare professional such as a plastic surgeon or a dermatologist. Botox Cosmetic is made of botulinum toxin type A and is able to help improve the appearance of a number of facial issues specifically in the face, such as diminishing the appearance of lines and wrinkles. Upon injection, Botox Cosmetic is able to temporarily paralyze muscles by blocking the chemical signals between the brain and the muscle that cause contraction. This has the effect of temporarily preventing the skin from forming wrinkles, as the underlying muscles that cause the wrinkles to appear are unable to contract.

Though Botox has been a known treatment for diminishing the appearance of lines and wrinkles, Botox Cosmetic was not introduced to the market until 2002, when it was approved by the FDA for the temporary improvement of the appearance of moderate to severe glabellar lines, the lines that appear between the eyebrows. Botox Cosmetic was also approved for the treatment of moderate to severe crow’s feet, the lines that appear at the corners of the eyes, in 2013, and was approved again in 2017 for the treatment of moderate to severe forehead lines.

Who is Botox Cosmetic suitable for?

Botox Cosmetic is suitable for treating all of the abovementioned facial skin issues temporarily in any patient between the ages of 18 and 65. Though many patients may assume Botox Cosmetic is only intended for older patients who are already showing the signs of aging, it is also suitable for younger patients who wish to prevent the further development of glabellar lines, crow’s feet, and forehead lines. 

What is Botox Therapeutic and what can it treat?

Botox Therapeutic is a prescription medicine that is the same formulation as Botox Cosmetic, but that is used as treatment for a number of medical conditions or symptoms. Botox Therapeutic is sometimes referred to as Botox Medical, and the use of Botox for therapeutic purposes actually predates its use for cosmetic treatment. In fact, the cosmetic benefits of Botox were only noticed as a side effect of other medical treatments. As Botox Therapeutic is compositionally the same as Botox Cosmetic, the mechanism of action is the same, even though its uses are very different.

Botox Therapeutic was first introduced on the market in 1989, with FDA approval for the treatment of eye muscle disorders such as strabismus (crossed eyes) and blepharospasm (eye twitching). Since its first introduction to the market, Botox Therapeutic has been discovered to help treat a number of other medical conditions and issues, including:

  • Overactive bladder, including incontinence;
  • Chronic migraines and headaches (in patients with headaches lasting 4 hours or more on 15 or more days in a month-long period);
  • Muscle stiffness in elbows, wrists, fingers, thumbs, ankles, or toes;
  • Cervical dystonia, including abnormal head position and neck pain;
  • Primary hyperhidrosis, including excessive sweating in the underarms, hands, feet, head, and face.

Who is Botox Therapeutic suitable for?

Botox Therapeutic is suitable for any patient living with the abovementioned conditions that have been prescribed the injections by a medical professional. The age requirement for Botox Therapeutic varies by condition, with the injections being suitable for patients 12 and older in cases of strabismus or blepharospasm, patients 16 and older in cases of cervical dystonia, and patients 18 and older in cases of muscle stiffness, chronic migraines, incontinent, and overactive bladder symptoms.

How is treatment different for Botox Cosmetic vs Botox Therapeutic?

The treatment process for Botox Cosmetic and Botox Therapeutic are very similar and vary only in the location in which the injections are applied. The formulation of Botox Cosmetic and Botox Therapeutic provides benefits only when it is injected into the muscles that cause or contribute to the issue or condition being treated. For treatment with Botox Cosmetic, this means injection directly into the muscles that cause the wrinkles to form. For treatment with Botox Therapeutic, the injection varies by condition. For examples, it requires injections in the bladder for overactive bladder symptoms and incontinence, and injections spread over the neck and head area for chronic migraines.

Another significant difference in treatment with Botox Cosmetic vs Botox Therapeutic is in the dosage administered, with conditions requiring Botox Therapeutic typically calling for a higher dosage. The duration of effect is similar for Botox Cosmetic and Botox Therapeutic, with the effects lasting anywhere between three to six months. The duration of results will vary slightly by location, and it is typical that optimal effects take approximately two weeks to present. Patients receiving treatment with Botox Cosmetic or Botox Therapeutic should not receive injections more often than once every three months.