Botox vs Xeomin

February 16, 2017 0 Comments

Botox vs Xeomin

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. I have had good results with it.

Since 2002, when the US Food and Drug Administration (FDA) approved botulinum toxin type A for the treatment of moderate to severe glabellar furrows, it has been used to restore an illusion of youth, and many dermatologists routinely use botulinum toxin "off label" for total facial rejuvenation.
Botulinum toxin has 7 distinct serologic types lettered A to G; the most common type used in the United States is type A. The botulinum toxin A currently approved by the FDA and available in the United States is Botox® (Allergan, Irvine, California). Botulinum toxin type B, which is available under the trade name Myobloc® (Solstice Neurosciences, Malvern, , is approved for treating cervical dystonia. 


To understand the differences among these type A neurotoxins, one must understand some of the pharmacology behind botulinum toxin. Botulinum toxin type A in its innate form is a 150-kDa protein composed of both a heavy and a light chain.[2] This "naked" protein is surrounded by a hemagglutinin protein complex. The only purpose of this complex is to protect the naked protein from degradation by stomach acid (and may be irrelevant for injectable botulinum toxin). At some point during or after injection at a physiologic pH, the hemagglutinin proteins dissociate, leaving the same 150-kDa protein regardless of the product. The heavy chain then allows for attachment of the toxin to the axon terminals, and the light chain degrades synaptosome-associated protein 25 kDa, a protein that is required for signal transduction. Xeomin®  is a "naked" toxins without surrounding hemagglutinin proteins. The current thinking is that when patients develop antibodies to neurotoxins, it is to the surrounding proteins and not to the toxin itself. Pharmacologic-grade injectable neurotoxins also contain human serum albumin in the vial, and, depending on the brand, sucrose or lactulose as stabilizers.
Several botulinum toxins are approved  in  the US market. Below is a brief overview of the neurotoxins.

Currently approved in over 65 countries and the US is Dysport®. It is a type A botulinum toxin that is FDA approved for the  the glabellar complex. Whereas Botox® is purified by repeated precipitation and redissolution, Dysport® is manufactured by using a column separation method. The different purification processes produce differences in the multihemagglutinin protein complex that surrounds the neurotoxin.

The difference in this complex is  differences in the onset of action and duration of Dysport® compared with Botox®. Dysport® is a smaller molecule so it diffuses further and has a faster onset of action than Botox®


Xeomin®, is an uncomplexed botulinum toxin A product. and is approved for treating glabellar frown lines in  the USA. In terms of results Xeomin® is considered to be identicall almost to Botox®  with  results showing  the average duration of Xeomin® was 3.7 months, compared with 3.5 months for Botox®. In terms of potency, Xeomin® appears to exhibit a 1:1 dose ratio compared with Botox®. When compared with Botox® for therapeutic indications, safety and efficacy  they did not significantly differ between treatments.

There was also no apparent difference in field of effect compared with Botox®. The manufacturer points out that the lack of complexing proteins in Xeomin® does not limit its efficacy and theoretically may reduce sensitization and antibody formation. Although this is more likely to affect therapeutic use because higher doses are used in therapeutic indications, it may be of interest to cosmetic dermatologists with patients who are treated with neurotoxin over several years.

Xeomin will likely cost $400 to $600 for a standard treatment in that you only paid $300.00 I doubt you got the full dose