During Botox consultations, there is a question I hear more often than many people might expect.

 

“Are Korean Botox products effective enough?”

“Isn’t imported Botox better?”

These are common questions.

 

What we usually call “Botox” actually refers to botulinum toxin type A injections.

 

There are several botulinum toxin products developed in Korea, and some of them have clinical research data in aesthetic areas such as glabellar lines and crow’s feet.

 

So today, I would like to explain, based on study findings, whether Korean botulinum toxin products really show meaningful effects :)

 

How does botulinum toxin reduce wrinkles?

Expression wrinkles are not caused simply because the skin folds.

 

Repeated muscle movements, such as raising the forehead, frowning between the eyebrows, or forming wrinkles around the eyes when smiling, gradually create lines in the skin.

 

Botulinum toxin type A works by temporarily reducing muscle contraction through inhibition of acetylcholine release, a neurotransmitter between nerves and muscles.

 

As a result, wrinkles that used to fold excessively during facial expression can become softened.

 

To put it simply, it is not a treatment that “irons out” the skin.

 

It is closer to a treatment that helps prevent a piece of paper, which has been repeatedly folded, from being folded as strongly again.

 

So the effect of Botox is more accurately understood as controlling muscle movement so that expression lines do not deepen as much, rather than regenerating the skin itself.

 

Then how did Korean botulinum toxin products perform in studies?

First, we can look at research on Nabota, also known as prabotulinumtoxinA.

 

In a study published in Archives of Craniofacial Surgery in 2018, 42 patients with glabellar frown lines received 20U of Nabota, and changes were observed at 2, 3, 4, 5, and 14 days after injection.

 

The study reported that improvement in glabellar lines at maximum frown was observed in 85.4% of patients 2 days after injection.

 

It also reported that glabellar lines at rest improved in 51.2% of patients after 2 days.

To explain this simply, we can understand it as:

“There is research showing that a Korean botulinum toxin product demonstrated a relatively fast response in glabellar lines.”

 

Of course, the important point here is that this does not mean everyone will improve in the exact same way within 2 days.

 

The timing and degree of perceived effect can vary depending on muscle volume, facial expression habits, wrinkle depth, skin thickness, treatment area, dose, and injection depth.

 

There are also larger-scale studies.

 

Two identical phase III clinical studies evaluated prabotulinumtoxinA in adults with moderate to severe glabellar lines.

 

Participants received 20U and were compared with a placebo group.

 

In the EV-001 study, the response rate at day 30 was 67.5% in the prabotulinumtoxinA group and 1.2% in the placebo group.

 

In the EV-002 study, the response rate was 70.4% in the prabotulinumtoxinA group and 1.3% in the placebo group.

If you look at the graph above, the key point is that the study did not simply evaluate whether the wrinkles “seemed a little better.”

 

The response rate was defined as an improvement of at least 2 points based on both investigator and patient assessments.

 

In other words, this study used a relatively strict standard to evaluate whether there was a clinically meaningful improvement in glabellar lines.

 

There is also data comparing Korean products with imported Botox products.

A multicenter, randomized, double-blind, active-controlled study compared DWP450 botulinum toxin type A with onabotulinumtoxinA in 268 patients with moderate to severe glabellar lines.

 

Each group received 20U.

 

The study reported that DWP450 and onabotulinumtoxinA were comparable in terms of efficacy and safety for improving glabellar lines.

 

This is one of the references that can help answer the question many patients ask:

“Does Korean Botox have weaker effects?”

 

However, this does not mean that Korean and imported products are always completely identical.

 

Each product may differ in diffusion range, protein composition, manufacturing method, storage conditions, dilution method, and injection habits of the clinician.

 

So in actual treatment, both the product characteristics and the treatment area need to be considered together.

 

There are also studies on crow’s feet.

 

A study published in the Journal of Clinical Medicine in 2023 compared prabotulinumtoxinA with placebo in Korean patients with moderate to severe crow’s feet.

 

At week 4, the proportion of patients whose crow’s feet at maximum smile improved to a minimal level was 69.64% in the prabotulinumtoxinA group and 0% in the placebo group.

 

At week 12, the rates were 30.36% and 6.90%, respectively.

 

Crow’s feet are more delicate than glabellar lines.

 

If the treatment is too strong, the smile may look unnatural.

 

If it is too weak, patients may feel that the effect is insufficient.

 

That is why, for crow’s feet Botox, the product itself is not the only important factor.

 

It is crucial to observe how the outer corner of the eye, cheekbone area, and lower eyelid move together when smiling, and then adjust the dose and injection points accordingly.

 

Based on published studies, Korean Botox products, or Korean botulinum toxin products, have shown meaningful improvement in areas such as glabellar lines and crow’s feet.

 

However, the important point is not to simply compare Korean products and imported products.

 

What matters more is identifying which muscles are causing the issue in your face, how much muscle activity should be reduced to maintain a natural look, and how facial expression and facial structure should be preserved.

Botox is not a treatment that “removes” muscles.

 

It is closer to a treatment that adjusts the strength of muscles that are being used excessively, only as much as needed.

 

So a good result does not come from the product name alone.

 

It comes from accurate diagnosis and proper design of dose, location, and injection depth :)

 

This was Director Won Dae-han.

 

Thank you for reading.

 

References:
Song S, Lee YH, Hong JP, Oh TS. Safety, efficacy, and onset of a novel botulinum toxin type A (Nabota) for the treatment of glabellar frown lines: a single-arm, prospective, phase 4 clinical study. Archives of Craniofacial Surgery. 2018.

Beer KR, Shamban AT, Avelar RL, Gross JE, Jonker A. Efficacy and Safety of PrabotulinumtoxinA for the Treatment of Glabellar Lines in Adult Subjects: Results From 2 Identical Phase III Studies. Dermatologic Surgery. 2019.

Won CH, Kim HK, Kim BJ, et al. Comparative trial of a novel botulinum neurotoxin type A versus onabotulinumtoxinA in the treatment of glabellar lines. International Journal of Dermatology. 2015.

Lee SK, et al. Efficacy, Safety, and Subject Satisfaction of PrabotulinumtoxinA for Crow’s Feet in Korean Patients. Journal of Clinical Medicine. 2023.

 

※ This article is intended to provide general medical information. The choice of botulinum toxin product and treatment method may vary depending on each individual’s muscle volume, facial structure, expression habits, and previous treatment history. An accurate diagnosis and treatment plan should be determined through consultation.