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Everything You Need to Know About Xeomin, the Trendy Botox Alternative

Two injections and a vial of clear liquid on a pink background.

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While fine lines and wrinkles are completely normal and something everyone experiences as they age, some prefer a smoother, line-free complexion. To achieve those results, many turn to at-home anti-aging ingredients, like retinol or vitamin C, or in-office options like facelifts, laser skin resurfacing, chemical peels, fillers, and botulinum toxin injectables such as Botox and Dysport. There is, however, a third neuromodulator that flies under the wrinkle-relaxing radar—Xeomin.

To answer all of your questions about Xeomin, including what it is, how it works, and how long it lasts, we spoke with board-certified plastic surgeon Norman Rowe, MD, MHA, and cosmetic dermatologist David Goldberg, MD, JD.

Keep reading to learn all about this Botox alternative, including its benefits, risks, and price tag.

Meet the Expert

  • David J. Goldberg, MD, JD, is the Director of Cosmetic Dermatology and Clinical Research at Schweiger Dermatology in New York City. He has been practicing since 1985 and has been named one of the "Top Ten Laser Surgeons in the U.S." by Self magazine.
  • Norman Rowe, MD, MHA, LLC., is a plastic surgeon and founder of Rowe Plastic Surgery in New York City. He is certified by the American Board of Plastic Surgery and a member of the American Society of Plastic Surgeons.

What Is Xeomin?

Like Botox and Dysport, Xeomin is the brand name of a botulinum toxin type A, which is approved to treat wrinkles like the "11" lines between the brows and frown lines. Botox and Xeomin work by the same mechanism, blocking the signals from nerves to muscles, causing the muscles to relax and wrinkles to smooth out.

Is Xeomin a Type of Filler?

Xeomin is a neuromodulator, not a type of filler. Xeomin is injected into your muscles to decrease movement, reducing wrinkles as a result, whereas filler is a hyaluronic acid-based gel that's injected to fill out an area. 

 Benefits of Xeomin

There are numerous benefits that Xeomin injections have, including:

  • Smoothes the appearance of wrinkles in between the eyebrows, around the eyes, on the forehead, or around the mouth
  • Blocks the signal from the nerve to muscles, causing the muscle to relax and preventing further wrinkling
  • Short treatment time, fast recovery time, and noticeable results within two weeks
  • Less likely to cause allergic reactions due to the absence of added fillers

Xeomin is often called "naked Botox" due to the purity of the product itself—but what's the benefit of a one-line ingredient list? "The concern is… years of Botox injected with the associated proteins ultimately leads to desensitization because of the other proteins, akin to getting allergy shots leading to desensitization, so that the Botox after many years may not work as well," says Goldberg. "Since 'naked' Xeomin does not have these proteins, it has been suggested such desensitization does not occur with this product."   

Xeomin vs. Botox vs. Dysport

Xeomin, Botox, and Dysport work similarly to reduce lines and wrinkles by preventing muscle contraction. "All currently available 'neuromodulators' are botulinum toxin A. They all attach to the same receptor in the same muscle to soften wrinkles," says Goldberg. "Having said that, although they share the same mechanism of action, they are different and not interchangeable."

The "primary difference between the products is that Botox has an accompanying, inactive protein, while Xeomin does not have additives," Rowe says. Xeomin is a purified form of the neurotoxin. It's manufactured so that it removes accessory proteins from the active ingredient. "Foreign accessory proteins are not necessary to the function of the drug," he adds. So, with Xeomin, you get the same results as Botox without injecting yourself with unnecessary proteins.

How to Prepare For a Xeomin Treatment

The most important thing to do when you've decided to take the injectable plunge is to do thorough research on the provider you want to see for the procedure. Goldberg recommends asking questions about what products they use and why, how many years they have been injecting, and if they have ever taught injecting techniques; teaching others leads to better injection techniques, he says.

If you're comfortable with your provider's qualifications, the chances of a botched job should be very slim. "Xeomin is a technique-sensitive treatment," Rowe says. "You should not lose the ability to show expression when you are treated by someone who is licensed, trained, and a medical expert in facial anatomy. It's important to talk to your provider about the results you want from treatment."

Schedule your treatment appointment at least two weeks before any special occasion on your calendar to ensure that any lingering aftercare or side effects don't appear at your event.

What to Expect During a Xeomin Treatment

The actual Xeomin injection process can take less than ten minutes. Your provider will numb the area beforehand, although you may feel a slight pinch from the needle itself. Again, the number of injections will vary depending upon the size of the area; for treatment of the dreaded "11" forehead lines, expect four to five different pokes. "Less is always better than more," says Goldberg. "Go to a provider who will give you a few more injections after the first injection—better not to inject too much the first time." You should be able to go on about your day as you normally would normal after your treatment.

Aftercare

Experts say the most important thing to avoid until three hours after treatment is touching your face. Additionally, avoid lying down and any vigorous activity for four to six hours afterward to keep the product where it is supposed to go and not have it migrate elsewhere.

Potential Side Effects

No matter what injectable you choose, know that there are potential risks. The most common possible side effects of a Xeomin injection are eyelid ptosis (drooping), dry eyes, visual impairment, possible onset of a cold, injection site pain, dry mouth, muscle weakness, and neck pain.

How Long Does it Take to See Results?

It can take up to a week for the full results of your treatment to show. "Results will be seen three to seven days after treatment," says Goldberg.

How Long Do Results Last?

Although the duration of Xeomin's effects depends on the individual’s metabolism rate, age, and skin quality, Rowe says results typically last three to four months.

Cost

Expect to pay at least $300 per each Xeomin injection. However, Rowe notes that the final cost will vary by geographical location, the area of the body being treated, and how many product units are being used.

Is Xeomin Cheaper Than Botox?

It can be difficult to say whether Xemoin is cheaper than Botox, as it depends on various factors, such as the number of areas being treated, the injector's expertise, and the clinic's location. However, typically, you can expect to spend a couple of hundred dollars per Xeomin treatment, which is comparable to the rates of Botox treatments.

The Final Takeaway

Xeomin is an accessible wrinkle-reversing and prevention treatment with a relatively comparable price tag to other treatments such as Botox or Dysport. The key to success is a thorough practitioner research process and clear communication about your desired results. Expect to see results within a week, that last three to four months. If side effects or adverse symptoms persist, speak with your doctor about your concerns.

Article Sources
Byrdie takes every opportunity to use high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial guidelines to learn more about how we keep our content accurate, reliable and trustworthy.
  1. Villar, L. F. Xeomin® vs. Botox® a side-by-side comparison in the same patients. Plastic and Reconstructive Surgery, 2015;136:147. doi:10.1097/01.prs.0000472470.94248.01

  2. Walker TJ, Dayan SH. Comparison and overview of currently available neurotoxinsJ Clin Aesthet Dermatol. 2014;7(2):31-39.

  3. Walker TJ, Dayan SH. Comparison and overview of currently available neurotoxinsJ Clin Aesthet Dermatol. 2014;7(2):31-39

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