Xeomin is an FDA-approved alternative to Botox for glabellar wrinkles

Xeomin and Botox work the same way to paralyze muscles and smooth wrinkles. They share the identical active ingredient - botulinum toxin A. The difference is that Botox has an accompanying protein, but Xeomin is naked. In the skin, all of the protein detaches from Botox within 1 minute of injection so there is no reason why the effect of Xeomin should differ from Botox. Xeomin has proven effective in clinical trials. It is approved in Europe and the US to diminish glabellar (between the eyebrow) wrinkles. 

Xeomin versus Botox

  • The main difference between Xeomin and Botox or Dysport is that Xeomin contains just one ingredient: botulinum toxin A.
  • The manufacturing process is slightly different with all 3, which leads to some potential, subtle differences in clinical practice.
  • Xeomin is a “naked injectable,” meaning that it does not contain any additives. A benefit of a pure-form injectable is that the human body is less likely to become resistant to it. Some patients have developed antibodies to Botox and Dysport.
  • Xeomin is the only one of the three (Xeomin, Botox, and Dysport) injectables that do not need to be refrigerated before use, due to its lack of additives.
  • The cost of Xeomin is roughly the same as for Botox at $5.00-5.40 per unit.  Dysport is about $3.99 per unit.
  • Patients average 20 units of Xeomin per visit, vs. 20 units of Botox and 40 units of Dysport.
  • The average retail cost to a patient in the US, for a Xeomin treatment, is between $300.00 – $400.00 every 3 months based on the recommended dose of 20 Units per treatment session.
  • Xeomin might have the slowest “onset” of action of the 3 (Dysport onset in 24 hours, Botox onset in 72 hours, and Xeomin onset in 4 days.)
  • Xeomin may be “mildly more convenient” than Botox or Dysport, as the “product’s lack of complex proteins will help prevent antibody formation, or resistance to neuromuscular treatment with botulinum type A toxin, in patients being treated for neuromuscular conditions.”
  • Neurotoxins diffuse differently, in part because Botox and Dysport have protective proteins clustered around the active part of the molecule, while Xeomin has no protective proteins.
  • Botox has a full complement of protective proteins and weighs about 900 kD. Dysport is a mixture of 500 kD and 300 kD complexes of protective proteins and botulinum toxin A. Being heavier, these complexes migrate more slowly than Xeomin/NT-201, which is BTX-A without protective proteins. Conversely, you will have less precision.
  • Dysport has been shown to “drift” or diffuse more than Botox, increasing the chances of an accidental droopy eyelid or unintentional relaxation of a neighboring muscle due to diffusion of the product.
  • Botox and Dysport are not interchangeable because the products are dosed and injected differently.