Botox was the first neurotoxin on the market and became quickly branded as a “liquid wrinkle eraser.” Similar to Botox cosmetics, Xeomin is an FDA approved botulinum toxin to treat frown lines, and other facial wrinkles, on the face. Botox and Xeomin are both cosmetic injectable treatments, and work by the same chemical pathways to block the signals from news to muscles, allowing them to relax, and wrinkles to disappear. The main difference between Botox and Xeomin is that Xeomin has been referred to as “naked Botox” since it has no additives or accessory proteins, which makes it essentially a purer form of toxin. This purity of Xeomin makes it less likely for one to develop an allergic reaction to the toxin and may be best for patients who have stopped responding to Botox injections.
Xeomin has the same cosmetic benefits of Botox injectable, such as smoothing out fine lines around the forehead, eyes (crow’s feet), and glabella area. Xeomin, like Botox, is botulinum toxin A, and attaches to the same receptor in the muscle to “freeze” and soften wrinkles. The results, with an experienced injector, such as Dr. Michele Green, should appear natural and “unfrozen.” Dr. Green has over 25 years in cosmetic dermatology injections in NYC, and her “less is more” philosophy has voted one of the best cosmetic injectors in New York.
Xeomin, like Botox, can be combined with other dermal fillers, laser treatments, skin tightening lasers, chemical peels, and microneedling, to have an increased rejuvenating effect. Cosmetic injections of neurotoxin are the number one cosmetic procedure currently performed in the United States. Neurotoxin injections are painless, quick, and highly effective. Botox and other cosmetic injections of Xeomin, Dysport, Juvederm, and Restylane and the most popular procedure at Dr. Michele Green’s private boutique NY office. If you are considering non-invasive cosmetic treatment for your fine lines and wrinkles, Xeomin may be a great option for you.
Botox, distributed by Allergan, is the most popular and well known brand of neurotoxin on the market today. When it comes to younger looking, rejuvenated skin, there are a variety of skincare options available, but injectable treatments have quickly become a go-to cosmetic procedure for a youthful glow that lasts. Whether you’re considering consistent use of injectables for skincare maintenance, or you’re interested in trying injectable cosmetic treatments for the first time Botox alternatives, such as Xeomin treatment, may be perfect for you.
Xeomin is an injectable cosmetic treatment similar to Botox, Dysport, Jeuveau, and Revance, that encourages the muscles around an injection site to relax, reducing the appearance of fine lines and wrinkles. Like all neuromodulators, Xeomin works on treating “dynamic wrinkles,” wrinkles which are caused by muscle contractions. “Static wrinkles” are wrinkles which do not move, and they are generally caused by aging, sun damage, and volume loss. The most common areas of dynamic which are treated by neurotoxins are:
- Frown lines between the eyebrows
- Laugh lines
- Crow’s feet
- Forehead lines
- Neck lines
- Dao’s or oral commissure
What is Xeomin?
If you’re wondering what is a Xeomin injection?, you’re not alone. Xeomin, created by Merz Pharmaceuticals, is a new, cutting-edge product available for both cosmetic and medical use, though it is inspired by innovations throughout the last several decades from Botox cosmetics. Unlike Botox, Xeomin is free of additives. The accessory proteins are removed from Xeomin during the manufacturing process. The active ingredient in Xeomin is botulinum toxin type A and in the inactive ingredients are human albumin and sucrose.
Xeomin (IncobotulinumtoxinA) actually uses the same key ingredient as Botox® (onabotulinumtoxinA) and Dysport (abobotulinumtoxinA): botulinum toxin type A. This is a neurotoxin created by the same bacterial species that creates botulism. The success of these products, in reducing the appearance of dynamic wrinkles and fine lines, have made them more popular than traditional cosmetic plastic surgery procedures. Neurotoxin injections are now the number one cosmetic procedure in the United States.
Botulinum toxin products–including Myobloc (rimabotulinumtoxinB)–use this neurotoxin in order to block neuromuscular signals, which in turn relaxes targeted muscles at or near the planned injection site. The relaxation of these muscles can reduce the appearance of wrinkles or fine lines caused by commonly used muscles, known as dynamic wrinkles. The result? A refreshed, relaxed, younger looking you!
Though botulinum toxin products or neuromodulators rely on a shared active ingredient, the method and formulation for these different injectables is distinct. Xeomin is unique in that it uses a “naked” version of botulinum toxin, meaning that it is not combined with accessory proteins or protein additives. The purity of Xeomin, is that is contains only pure 150kD neurotoxin, and will not result in the production of neutralizing antibodies, and affect the immune system. Xeomin is a leading treatment for those who have developed antibody resistance with other products such as Botox, which unfortunately can occur with continued use over time.
Xeomin vs Dysport vs Botox vs Revance Daxi
Botox, Xeomin®, Dysport®, and Daxi®, consist of the same ingredient, Botulinum toxin type A. This toxin is produced by the Clostridium botulinum bacteria. This neurotoxin works by blocking the neuromuscular signals to relax targeted muscles at the injection site. Since all of these neurotoxins act in the same fashion, they each effect similar cosmetic results. There are many different treatment options now available, besides Botox, for cosmetic injection. Some physicians or patients may prefer one type over the other. They have similar duration of treatments with Revance Daxi lasting a bit longer, and similar side effect profile.
What is the cost of Xeomin?
The cost of Xeomin varies based on the amount of neurotoxin injected and the experience of the cosmetic injector. A board certified cosmetic dermatologist may be more expensive than a nurse injector in a clinic or spa. In order to have the best cosmetic results with the least amount of potential side effects, it is always best to consult an expert cosmetic injector, like Dr. Michele Green.
How long does it take for Xeomin to work?
In NYC, we understand that our patients are constantly on the go, and seek cosmetic treatments that work quickly and effectively to give them their desired look. So, how much time or how long is required for Xeomin to take effect? Results are typically apparent in just a few days, and a standard Xeomin treatment can have lasting results for up to six months.
The process for Xeomin injectable treatment is easy and painless. On average, a Xeomin treatment appointment takes around 10 minutes, and most patients experience little to no discomfort as the Xeomin is injected into the planned injection site. Patients can immediately return to normal activity after treatment, though some patients may experience slight bruising, as is a risk with any injectable treatment. Nevertheless, the majority of patients have virtually no downtime and are able to enjoy long-lasting results.
Before treatment, we recommend that patients avoid taking any anti-inflammatories (like Advil or Aleve) or aspirin, as well as certain supplements such as vitamin E or fish oil. These products can cause a higher risk of bruising or bleeding at or near the injection site. When it comes to your skincare routine, we recommend that you arrive make-up free with a fresh, clean face.
After treatment, the only recommendations are simply not to lie down on the injection site for several hours following treatment, and to avoid deep massage of the treatment area for two days. After Xeomin treatment, washing your face and applying make-up are a-ok, unlike some other cosmetic treatments.
Xeomin treatments, quite similarly to Botox and other neuromodulators, should not be administered more frequently than every three months. For optimal results, additional treatments can take place every 3-6 months, though Dr. Green will recommend a tailored skincare plan depending on your individual needs.
How much Xeomin do I need?
Before diving in to the question of how many units of Xeomin do I need?, it’s important to remember that Xeomin treatments are unique depending on the facial structure of each patient, as well as any aesthetic goals. Plus, the dosage amounts will be adjusted depending on the muscle mass and gender of the patient, as men typically require a higher dosage due to naturally larger muscle size. An experienced healthcare provider like Dr. Michele Green is your best resource to figure out how many units of Xeomin will be best for your needs.
However, there are certain unit ranges that are common when it comes to different areas or muscle groups in the face. If you’re wondering how many units of Xeomin for the forehead or other areas should be used, you can refer to this list of standard units of Botox as a comparative guide, and here is an additional Xeomin-specific guide below:
- Forehead: 10- 30 units
- Canthal Lines (“Crow’s feet”): 5-15 units
- Glabellar Lines (“11” lines): 10-20 units; Typically, 20 units is recommended for glabellar lines in a session, which is then divided into five intramuscular injections of 4 units each.
Again, when determining how many units of Xeomin is best for you, it is critical to consult with an experienced healthcare provider, like Dr. Green in NYC.
What is the difference between Botox and Xeomin?
Xeomin and Botox are similar in that they share botulinum toxin as their active ingredient, but they differ in their formula and in some of their uses. Botox, made by Allergan, has been FDA approved since 2002 and relies on accessory proteins, which are unnecessary for the function of the active ingredient. This leads to some variation in use, and a distinction in the effectiveness overall.
While Xeomin and Botox both are commonly used to treat fine lines and wrinkles, including forehead lines, “crow’s feet”, and severe frown lines, Botox can unfortunately lose effectiveness with some patients over the course of multiple applications, due to antibody resistance that can be amplified by accessory proteins. Further, Xeomin typically shows results sooner and is longer lasting than Botox, though sometimes this variation in longevity is only by a few weeks.
Xeomin is uniquely FDA approved to treat excessive drooling or salivation. Additionally, Botox can be used to prevent migraines, limit sweating, or help to treat an overactive bladder. As these injectables have some potential side effects or can cause allergic reaction in rare cases, it is imperative that both be provided by an expert, board certified cosmetic dermatologist, like Dr. Michele Green in New York.
Does Xeomin last as long as Botox?
Though the dermatology world was once thrilled by the long-lasting results of Botox — about 3-4 months — some studies have shown that Xeomin can last up to twice as long as a standard Botox treatment, giving you up to six months of relaxed, younger looking skin.
If you’re considering either Xeomin or Botox treatments, it’s important to commit to trying one treatment at a time, as botulinum neurotoxin products are not intended to be combined without ample recovery time between sessions. Dr. Green will be able to work with you to determine which treatment is best for you, and to create a treatment schedule that safely and effectively meets your needs.
Side effects of Xeomin in cosmetic procedures
Due to the nature of neurotoxins, there are some common possible side effects which can occur. Common side effects of Xeomin are temporary and include:
- Redness from injection
- Bruising at the site of injection
- Temporary eyelid ptosis (drooping eyelids) or asymmetry
More uncommon side effects of Xeomin treatment that occur in 2-7% of patients include:
- Dry Eyes
- Dry mouth
- Muscle Weakness
- Respiratory Tract Infection
More serious side effects that can occur include blurred vision, drooping eyelids, double vision, and allergic reactions. When it comes to cosmetic injectable treatments such as Xeomin, it’s crucial to have up-to-date medical history information given to your treatment provider. If you experience any breathing problems, wheezing, hoarseness, change of or loss of voice, loss of muscle strength, loss of bladder control, or a severe rash, you should seek medical advice as soon as possible. Trouble breathing is often the first sign of an allergic reaction and medical help should be sought immediately. For complete prescribing information refer to Xeomin aesthetics.
Furthermore, you should alert your doctor if your medical history includes any of the following:
- Bleeding problems
- Breathing problems, such as asthma, emphysema, or a history of pneumonia
- Dysphagia or difficulty swallowing
- Eye problems (such as glaucoma) or recent eye surgery
- Inability to urinate
- Muscle or nerve disorders, such as Lambert-eaton syndrome, amyotrophic lateral sclerosis (known as Lou Gehrig’s disease or ALS) or myasthenia gravis
- Treatment with any other neuromodulator products within the last 4 months
Side effects in medical indications for Xeomin
Certain side effects are dependent on what treatment is for; generally, cosmetic Xeomin treatment typically has far fewer potential side effects than medical treatment, and side effects are usually related to the injection site:
- For those who are dealing with chronic sialorrhea (excessive drooling), there is a risk of necessary dental extraction, diarrhea, and high blood pressure.
- For those treating upper limp spasticity, there is a risk of nasal congestion, upper respiratory infection, and seizure.
- For those facing cervical dystonia, treatment may have side effects such as difficulty swallowing, injection site pain, muscle weakness, muscle pain, and neck pain
- For those treating blepharospasm, common side effects include drooping of the eyelid, dry eye, and vision problems.
In rare cases, botulinum toxin can have adverse effects if it spreads from the injection area, including but not limited to paralysis, respiratory failure, and even death. Because of these risks, a medical professional should always be relied upon for proper injection and accurate dosage.
Is it Safe to Use Xeomin while Pregnant?
If you are pregnant or nursing, it is best to avoid use of Xeomin or any other botulinum neurotoxin product, as it is unknown whether Xeomin passes on either through the placenta or through breast milk.
Drug Interactions with Xeomin
Xeomin does have some unfortunate interactions with certain medications, including but not limited to:
- Aminoglycosides, which are a variety of antibiotic
- Anticholinergics, which inhibits abnormal nerve impulses
- Anticoagulants, which prevents blood clots
- Alzheimer’s disease drugs
- Muscle relaxants
- Myasthenia gravis drugs
- Quinidine, which is used to prevent irregular heartbeats
If you are currently taking any of the above medication, or are experiencing a skin infection on the planned injection site, it is best to hold off on any Xeomin treatments.
How do I get started with Xeomin?
Dr. Michele Green is an expert in Xeomin® and other cosmetic injectables and dermal filler treatments. With over 25 years of cosmetic experience with Botox, Xeomin, Juvederm, Restylane, Sculptra, skin care, and laser treatments, Dr. Green will rejuvenate your skin and give you the best cosmetic results. To schedule a consultation with Dr. Green in her NYC private boutique office, to help remove fine lines and wrinkles, improve your skin tone and texture, and look younger, call us at 212-535-3088 or contact us online to learn more about whether Xeomin may be right for you.