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Updated: Mar 2

girl having anti-wrinkle injection in the frown line.

What is the difference between Botox and Bocouture?

There is always the dilemma whether to go for BOTOX® or BOCOUTURE. Both contain botulinum toxin A, which is used as an anti-wrinkle injection in aesthetics and both do the same job.

There are other botulinum toxin A injections in the market, but for now we will talk about these two products only.

When someone asks for Botox, they don't necessarily mean the brand product BOTOX®, but there may be some who do specifically request for the brand.

BOTOX® has been in the market for a very long time and has established its name. The name Botox has become synonym with botulinum toxin A injection, same as hover is for vacuuming.

BOTOX® contains Botulinim Toxin A and is produced by an American company Allergan. It is now marketed as BOTOX® Cosmetic which is a prescription medicine, that is injected into muscles and used to temporarily improve the look of moderate to severe forehead lines, crow’s feet lines, and frown lines between the eyebrows in adults.

BOTOX® contains 150kD neurotoxin plus complex proteins. It also contains Albumin (human) and sodium chloride excipients. It contains the most clostridium protein 5 ng per 100 units vial.

On the other hand, BOCOUTURE® also contains 150kD neurotoxin, but without any complex proteins. It also, contains Albumin (human) and Sucrose as an excipients. It contains 0.6 ng of clostridial protein.

What does all this mean?

As BOTOX® has more protein it can stimulate a greater immune response. This increased immune response produces neutralising antibodies, which can inactivate Botox. Frequent injection can also trigger an immunological response. In addition botulinum toxin acts as an antigen in the body, thus its effect disappears progressively due to this immunological reaction, which may cause treatment failure.

BOCOUTURE® has the least amount of protein and so this makes the product "pure", but it does not contain all the properties conferred by Botox®. It does not induce a greater immune response when compared to Botox®.

The other difference is that Botox® has to be kept in the fridge at a set temperature of 4-8 °C and once reconstituted its potency lasts for 2-6 weeks. On the other hand, Bocouture does not need to be stored in the fridge before reconstituting, but once reconstituted it will need to be kept in the fridge and discarded after 2 weeks.

So, you can seen both of the products have pros and cons. Various factors need to be considered before choosing a particular brand and the results achieved.

  1. Arch Plast Surg. 2022 Jan; 49(1): 12–18. Immunogenicity of botulinum toxin Syeo Young Wee and Eun Soo Park

  2. Indian J Dermatol. 2010 Jan-Mar; 55(1): 8–14. doi: 10.4103/0019-5154.60343. BOTULINUM TOXIN

  3. Panjwani N, O’Keeffe R, Pickett A. Biochemical, functional and potency characteristics of type A botulinum toxin in clinical use. Botulinum J. 2008;1:153–166. doi: 10.1504/TBJ.2008.018956.

  4. Drugs R D. 2010 Jul; 10(2): 67–73. Content of Botulinum Neurotoxin in Botox®/Vistabel®, Dysport®/Azzalure®, and Xeomin®/Bocouture® Jürgen Frevert


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