Xeomin vs Botox

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For patients seeking to reduce signs of aging such as wrinkles, certain drugs that interfere with the nerve signals in muscles can help in relaxing facial tensions and managing aesthetics. Xeomin and Botox are two such drugs that are used for cosmetic procedures. They each impact different aspects of muscle contractions but both have wrinkle-smoothing effects on the skin. Both Xeomin and Botox contain botulinum toxin type A, which blocks nerve activity in the muscles, causing a temporary reduction in muscle activity. However, they differ slightly in their formulations: while both toxins are derived from the same bacterium (Clostridium botulinum), Xeomin is known as a "naked injectable," meaning it does not contain any additives and only includes botulinum toxin type A. This may decrease a patient's likelihood of developing resistance to it. On the other hand, Botox contains additional proteins which could potentially lead to antibody formation over time or repeated use.

What is Xeomin?

Xeomin (incobotulinumtoxinA) and Botox (onabotulinumtoxinA) are both neurotoxic proteins derived from the bacterium Clostridium botulinum that act on neuromuscular junctions. Both have been approved by the FDA for cosmetic use, specifically to treat moderate to severe frown lines between eyebrows. Xeomin was initially approved in 2010, whereas Botox received its approval earlier in 2002. The primary difference lies in their formulation: Xeomin is a "naked" toxin, meaning it does not contain any of the accompanying proteins found with Botox. This lack of accessory proteins may reduce the likelihood of developing resistance, as these are typically what our immune system targets when forming antibodies against foreign substances. Still, both drugs work similarly by blocking nerve signals to muscles which temporarily reduces muscle activity leading to a reduction in appearance of facial wrinkles.

What conditions is Xeomin approved to treat?

Xeomin is approved for the treatment of several conditions, including:

  • Chronic sialorrhea, or excessive drooling
  • Upper limb spasticity in adults
  • Cervical dystonia (painful spasms in your neck muscles)
  • Blepharospasm (uncontrollable blinking) in adults who have previously been treated with onabotulinumtoxinA (Botox)

It's also used to temporarily improve the look of moderate to severe frown lines between the eyebrows.

How does Xeomin help with these illnesses?

Xeomin helps to manage muscle spasms and wrinkles by temporarily paralyzing muscles. It does this by blocking the release of acetylcholine, a neurotransmitter that causes muscle contraction, at the neuromuscular junctions. Acetylcholine is a chemical that acts as a messenger in the brain and throughout the body, playing an important role in muscle movement, heart rate regulation, learning, and memory among other things. When there's excessive activity or contractions like in certain muscular disorders or appearance of wrinkles due to aging skin elasticity loss, Xeomin can be extremely beneficial. By decreasing acetylcholine availability for muscle contractions, Xeomin can limit these unnecessary movements thus helping patients manage their condition and improve their physical appearance or comfort level.

What is Botox?

Botox, or botulinum toxin type A, is a neurotoxic protein produced by the bacterium Clostridium botulinum and related species. It inhibits the release of acetylcholine from nerve endings to paralyze muscles temporarily. Botox was first approved for therapeutic use by the FDA in 1989 and later gained popularity due to its cosmetic applications.

As a treatment for various conditions like chronic migraines, excessive sweating, muscle disorders, and certain eye disorders— as well as for reducing facial wrinkles—Botox has very specific uses. Its effects on muscle paralysis can be beneficial especially in patients who suffer from overactive muscles or spasms that do not respond well to typical treatments.

While Botox does have some side effects such as pain at the injection site or flu-like symptoms, these are generally mild and temporary. Unlike medicines affecting neurotransmitters like serotonin (common in many antidepressants), it doesn't lead to common side effects such as weight gain or sexual dysfunction.

What conditions is Botox approved to treat?

Botox has received approval for a variety of medical and cosmetic uses including:

  • Chronic Migraine: For those experiencing headaches on most days of the month, Botox injections can help reduce headache frequency.
  • Hyperhidrosis: This is excessive sweating which does not respond to antiperspirants. Botox can be injected into the skin to treat symptoms of severe underarm sweating.
  • Wrinkles: Botox is famously used in cosmetic procedures to temporarily reduce facial wrinkles especially on the forehead and around eyes.

How does Botox help with these illnesses?

Botulinum toxin, commonly known as Botox, is a neurotoxin that plays a significant role in the field of cosmetics and medicine. It exerts its effects by blocking the release of acetylcholine, thus impairing muscle contractions and providing temporary relief for certain muscular conditions and reduction of wrinkles. Not unlike norepinephrine's essential role in numerous bodily processes such as wakefulness and focus, acetylcholine is crucial for muscle movement. Low levels of this neurotransmitter can lead to conditions like myasthenia gravis and certain types of dementia.

Botox has been widely recognized for its cosmetic use but also shows effectiveness in treating other medical issues such as excessive sweating (hyperhidrosis), migraines, bladder dysfunction and strabismus. While Xeomin shares similar applications with Botox due to their same active ingredient - Botulinum toxin type A, Botox sets itself apart due to additional complexing proteins present within it which may influence how it behaves in the body compared to Xeomin. Just like Wellbutrin being sometimes prescribed when patients don't respond well to typical SSRI antidepressants like Prozac due to individual variability; some patients might prefer or experience better results with one product over another between Botox and Xeomin despite their similarities.

How effective are both Xeomin and Botox?

Both incobotulinumtoxinA (Xeomin) and onabotulinumtoxinA (Botox) have established histories of success in treating patients with a range of conditions, including muscle spasticity, chronic migraines, excessive sweating as well as cosmetic applications like wrinkle reduction. Both medications were initially approved by the FDA only three years apart and act by blocking nerve signals to muscles or sweat glands.

The effectiveness of Xeomin and Botox was directly studied in several double-blind clinical trials; both drugs exhibited similar efficacy in managing symptoms across various conditions along with comparable safety profiles. In these studies, none of the different metrics used to measure efficacy differed significantly between patients receiving Xeomin versus those receiving Botox.

A 2015 review demonstrated that Xeomin is effective starting from the first week after injection, with its effect peaking at around 4 weeks post-injection before gradually wearing off over approximately 3 months - a timeline very similar to that seen with Botox treatments. The same study reports that Xeomin’s side effects are mild and transient when administered correctly.

In terms of usage, while both toxins are widely recognized for their efficacy across multiple indications (both therapeutic and aesthetic), physicians may choose one over another based on patient preference or perceived advantages related to formulation characteristics. For instance, due to its lack of complexing proteins compared to Botox which could theoretically reduce antibody formation resulting in treatment failure over time – some clinicians might prefer using Xeomin particularly for long term treatment plans.

abstract image of a researcher studying a bottle of drug.

At what dose is Xeomin typically prescribed?

Dosages of Xeomin range from 10-50 units per session for cosmetic use, depending on the treatment area and individual patient characteristics. The same is true for Botox, but studies have suggested that in most cases 20 units are sufficient to treat frown lines between the eyebrows. Pediatric usage hasn't been established for either medication due to their cosmetic nature. For both Xeomin and Botox, treatment can be repeated every three months if there is no response or as directed by a healthcare provider. It's important not to exceed the maximum dosage recommended by your doctor as it varies based on individual needs and responses.

At what dose is Botox typically prescribed?

Botox treatment is generally initiated with a varying dosage depending upon the individual's condition and response to therapy. The dose can then be adjusted according to medical evaluation, normally ranging between 10-50 units per session for cosmetic purposes, and up to 200 units for certain medical conditions, divided into multiple injections at specific points. These sessions are usually spaced three months apart. A higher dose may be considered if there is no adequate response to initial treatment after a few weeks. However, this should only be performed under the supervision of an experienced healthcare provider due to potential side effects and complications.

What are the most common side effects for Xeomin?

Side effects of Xeomin may include:

  • Headache
  • Neck pain
  • Dry eyes and visual disturbances
  • Drooping or swelling of the eyelids
  • Fatigue, general weakness
  • Dry mouth
  • Breathing difficulties
  • Nausea -Diarrhea or constipation -Skin rash, itching, or hives. -Pain, bruising or redness at the injection site

Please note that these side effects are usually temporary but if they persist for an extended period, seek medical attention.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Xeomin?

Like Botox, Xeomin is generally well-tolerated. However, in some rare cases, serious side effects can occur:

  • Signs of an allergic reaction like rash; hives; itching; red, swollen, blistered or peeling skin with or without fever; wheezing; tightness in the chest or throat; difficulty breathing or talking.
  • Muscle weakness near where Xeomin was used
  • Vision problems - blurred vision and/or decreased eyesight
  • Dizziness / feeling faint
  • Fast irregular heartbeat (heart palpitations)
  • Difficulty swallowing
  • Respiratory issues such as shortness of breath

In very unusual circumstances these symptoms might indicate a condition known as botulism. If you experience any of these potentially dangerous side effects stop using Xeomin and seek immediate medical attention.

What are the most common side effects for Botox?

Botox, like any medication, can sometimes result in side effects. These may include:

  • Temporary bruising or swelling at the injection site
  • Headache or flu-like symptoms
  • Droopy eyelid or cockeyed eyebrows
  • Dry eyes or excessive tearing
  • Difficulty swallowing, speaking or breathing if given in large doses (rare)

It is important to note that Botox should be administered by a certified professional to minimize these potential side effects.

Are there any potential serious side effects for Botox?

Although Botox is generally considered safe, there can be potential side effects in some cases. These may include:

  • Allergic reactions such as hives, itching, rash, wheezing or difficulty breathing
  • Difficulty swallowing or speaking due to weakening of associated muscles
  • Muscle weakness all over the body
  • Vision problems including blurred vision and/or drooping eyelids
  • Loss of bladder control or other urinary issues
  • Fast or uneven heartbeats; irregular pulse
  • Severe skin reaction – sore throat, fever, burning/painful eyes with redness and swelling

These are rare but serious side effects. If you experience any of these symptoms after a Botox treatment, it’s important to seek medical attention immediately.

Contraindications for Xeomin and Botox?

Both Xeomin and Botox, like all neurotoxin treatments, may cause side effects in some people. If you notice any symptoms such as difficulty swallowing or breathing, loss of strength or general muscle weakness, blurred vision or drooping eyelids after treatment with these products, please seek immediate medical attention.

Neither Xeomin nor Botox should be used if you have had an allergic reaction to any other botulinum toxin product (like Myobloc®, Dysport®, or a previous batch of Botox® or Xeomin®) - the proteins are similar enough that an allergy might extend to them too. Always inform your doctor about previous reactions to similar treatments; this will help prevent dangerous interactions with either Xeomin or Botox.

Additionally, patients who have been diagnosed with certain nerve disorders (such as ALS), swallowing problems (dysphagia), breathing problems (asthma), facial muscle weakness (ptosis) , bleeding issues , skin infections at planned injection sites should avoid these treatments unless recommended by their physician under close supervision.

How much do Xeomin and Botox cost?

For brand name versions of these drugs:

  • The price of 100 units of Xeomin averages around $350–$600, which works out to about $140-$240 per treatment session (assuming a typical treatment requires 20-50 units), depending on your dose and the area being treated.
  • The price for 100 units of Botox is about $600-$1200, working out to approximately $240-$480 per treatment session using the same assumptions.

Thus, if you require a higher dosage range for your treatments (i.e., closer to or exceeding 50 units), then brand-name Xeomin might be less expensive on a per-session basis. However, cost should not be the sole deciding factor in choosing between these two medications.

Note that both Botox and Xeomin are brands with no generic alternatives available currently:

  • Botox (onabotulinumtoxinA) is typically sold in vials containing 50 or 100 units; prices can vary from under $10/unit up to more than twice that amount.
  • Xeomin (incobotulinumtoxinA), like Botox, is also packaged in vials containing either 50 or 100 unit doses. Its pricing seems more consistent at roughly around $5 -6 /unit.

Remember individual needs and responses may differ significantly so always consult with a healthcare provider before making choices regarding medical treatments.

Popularity of Xeomin and Botox

Botulinum toxin A, available under brand names such as Botox, was estimated to have been administered to about 6.3 million people in the US in 2020 for cosmetic procedures alone. It accounted for over 48% of all minimally invasive cosmetic treatments performed in the U.S that year. Botox has been on a steady rise since its FDA approval for cosmetic use back in 2002.

IncobotulinumtoxinA, commercially known as Xeomin, another brand of Botulinum toxin A used both medically and cosmetically is also gaining popularity but still trails behind Botox significantly. While exact prescription numbers aren't readily available due to many variations of off-label uses and lack of specific codes tracking Xeomin injections separately from other forms of botulinum toxins; surveys suggest it's usage is increasing mainly due to its 'purer' formulation devoid of complexing proteins found in other brands like Botox.


Both Xeomin (incobotulinumtoxinA) and Botox (onabotulinumtoxinA) have been used extensively in aesthetic medicine for the treatment of wrinkles, particularly frown lines between the eyebrows. They work by temporarily paralyzing muscles to smooth out facial lines. The effectiveness of both drugs is well-documented through numerous clinical studies indicating that they are more effective than placebo treatments.

The major difference lies in their formulation: while Botox contains accompanying proteins along with the active botulinum toxin, Xeomin is a 'naked' form without these proteins. This could theoretically reduce the likelihood of developing resistance over time as there are less components to react against.

In terms of cost, both medications can be pricey but generic forms are not available due to patent restrictions. Both may require a period before noticeable effects appear post-injection, generally 3-7 days.

Side effects such as bruising or drooping eyelids occur with similar frequency for both drugs; however serious side effects like difficulty swallowing or breathing are rare but warrant immediate medical attention if experienced. As always when considering cosmetic procedures, it's important to consult with an experienced healthcare professional who can advise on which product would best suit your individual needs and circumstances.