Who Should Not Use Dysport? A Comprehensive Guide to Contraindications

October 7, 2025 •

3 min read

First approved by the FDA for cosmetic use in 2009, Dysport is a popular injectable treatment for wrinkles. However, certain medical conditions, allergies, and patient circumstances strictly determine who should not use Dysport, as serious health complications can occur.

Quick Summary

Dysport is contraindicated for individuals with specific allergies, existing neuromuscular diseases, pregnant or breastfeeding individuals, and those with active infections at the injection site.

Key Points

Allergies: Do not use Dysport if you are allergic to any of its ingredients, including cow's milk protein, or have had a prior allergic reaction to a botulinum toxin product.
Neuromuscular Disease: Patients with conditions like ALS, myasthenia gravis, or Lambert-Eaton syndrome should avoid Dysport due to the risk of exacerbated muscle weakness and swallowing or breathing difficulties.
Pregnancy and Breastfeeding: Dysport is not recommended for women who are pregnant, planning to become pregnant, or breastfeeding due to a lack of safety data.
Active Infections: The presence of a skin infection, swelling, or inflammation at the intended injection site is an absolute contraindication.
Drug Interactions: Certain medications, including aminoglycoside antibiotics and muscle relaxants, can increase the effects of Dysport and should be disclosed to a provider.
Risk of Toxin Spread: Dysport carries a black box warning for the potential spread of toxin effects beyond the injection site, which can cause life-threatening botulism-like symptoms.
Recent Botulinum Toxin Use: Do not receive Dysport if you have had another botulinum toxin product (like Botox or Xeomin) injected in the last four months.

Understanding Dysport and Its Mechanism

Dysport, also known as abobotulinumtoxinA, is a type of botulinum toxin product. It temporarily reduces muscle activity by blocking nerve signals that cause contractions. This relaxation is used cosmetically to smooth frown lines and other facial wrinkles. The effects of Dysport typically last a few months. Given its potent action, it's vital for both medical professionals and patients to understand the conditions and characteristics that make Dysport unsuitable.

Absolute Contraindications: Who Must Avoid Dysport?

Certain conditions make the use of Dysport unsafe and must be avoided to prevent severe adverse events.

Documented Allergies

Individuals with allergies to any ingredient in Dysport, other botulinum toxins, or cow's milk protein should not receive treatment. Allergic reactions can range from mild irritation to severe anaphylaxis.

Existing Skin Infections

Dysport is contraindicated if there is an active skin infection, swelling, or inflammation at the injection site, as it could spread the infection.

Pregnancy and Breastfeeding

Dysport is not recommended during pregnancy, when planning pregnancy, or while breastfeeding due to insufficient safety data on the effects of botulinum toxin on the fetus or infant. It's advisable to wait until after pregnancy and breastfeeding for this elective procedure.

Neuromuscular Disorders and Dysport

Dysport impacts neuromuscular signals, posing a risk for individuals with pre-existing muscle and nerve conditions. Patients with diseases affecting muscles and nerves, including Amyotrophic lateral sclerosis (ALS), Myasthenia gravis, or Lambert-Eaton syndrome, should avoid Dysport. Using Dysport with these conditions can intensify muscle weakness and potentially lead to serious breathing and swallowing problems.

Understanding the Black Box Warning: Risk of Toxin Spread

Dysport carries an FDA black box warning regarding the potential spread of the toxin from the injection site. This can result in serious, potentially fatal, botulism-like symptoms. Symptoms like difficulty swallowing or breathing, generalized muscle weakness, and vision problems can appear hours to weeks post-injection. This risk exists for adults, particularly those with underlying conditions. Patients should be aware of this and seek immediate medical help if symptoms occur.

Dysport and Drug Interactions

Certain medications can amplify Dysport's effects, increasing the risk of systemic side effects.

Medications that may increase Dysport's effects include:

Aminoglycoside Antibiotics: Examples include amikacin, gentamicin, neomycin, and tobramycin. It's recommended to wait at least a week after finishing antibiotics before getting Dysport.
Muscle Relaxants: Using muscle relaxants with Dysport can lead to excessive muscle weakness.
Anticholinergic Drugs: Medications for bladder control, irritable bowel, and some cold/allergy treatments can also enhance systemic effects.
Other Botulinum Toxins: Do not receive Dysport concurrently with other botulinum toxin products like Botox or Xeomin.

Comparison Table: Dysport vs. Botox for Patient Selection

Both Dysport and Botox are Type A botulinum toxins, but differences in their formulation affect their diffusion and ideal use.


Feature	Dysport (abobotulinumtoxinA)	Botox (onabotulinumtoxinA)
Diffusion	Tends to spread more widely.	Stays more localized.
Best For	Larger areas like the forehead for a broader effect.	Smaller, precise areas like crow's feet.
Onset of Action	Often visible in 2–3 days.	Generally takes 5–7 days.
Unit Conversion	More Dysport units are needed for a comparable effect to Botox.	Units are not interchangeable with Dysport.
Milk Protein	Contains cow's milk protein (contraindication for allergy).	Does not contain cow's milk protein.

Conclusion: Prioritizing Safety Through Consultation

A thorough medical consultation with a qualified provider is essential before Dysport treatment. Your provider will review your medical history, including neuromuscular conditions, allergies, and medications. If you have contraindications, delaying treatment or considering alternatives is safest. Following these guidelines helps minimize risks and achieve optimal results from treatment. For more detailed information, including the black box warning, refer to {Link: dysport.com https://dysport.com/}.

Frequently Asked Questions

Individuals with pre-existing neuromuscular disorders (such as ALS or myasthenia gravis) and those who have a known allergy to any ingredient, including cow's milk protein, are at the highest risk for serious adverse side effects.

No, Dysport should not be used if you are pregnant, trying to get pregnant, or breastfeeding. The safety of botulinum toxin products for a developing fetus is not known.

You should avoid certain injected antibiotics (like aminoglycosides), muscle relaxants, and some cold, allergy, or sleep medicines. It is crucial to inform your doctor of all current medications before receiving Dysport.

Seek immediate medical attention if you experience any symptoms of toxin spread, such as trouble swallowing, breathing, or speaking; blurred or double vision; or general muscle weakness. These symptoms can occur hours to weeks after an injection.

Yes, an allergy to cow's milk protein is a key contraindication, as it is one of the ingredients in Dysport. Allergic reactions, including anaphylaxis, can occur.

Injections should be spaced at least three months apart, and you should never receive injections from more than one botulinum toxin product at the same time. Always inform your provider of your last injection date.

You should inform your doctor if you have a history of breathing problems, such as asthma or emphysema, as you may be at higher risk for complications like breathing difficulties after a Dysport injection.