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Xeomin vs. Botox – What’s the Difference?

Medical Aesthetics
Jan Trobisch

Jan Trobisch

Frowning, squinting, smiling and other facial expressions can take a toll on your skin over time and cause wrinkles. Fortunately, if you want to improve your appearance, you have choices in today’s market. With multiple options available, you probably have questions, and we’re here to help.

Since it’s relatively new to the market, you may be wondering, what is Xeomin for? What are the pros and cons of Xeomin and Botox? Is Xeomin better than Botox, or vice versa? At Synergy Wellness, we want to give you all the information you need to make an informed decision about aesthetic facial injections.

Neurotoxin Injections Statistic

Xeomin and Botox are both neurotoxins, which are prescription medications injected into facial muscles to smooth the effects of age. Neurotoxin injections are the most popular cosmetic procedure in the U.S. today.

Xeomin and Botox are both FDA-approved for cosmetically reducing the appearance of moderate to severe frown lines between the eyebrows, crow’s feet and forehead wrinkles. Both neurotoxins are clinically proven to soften wrinkles by blocking muscle movement, not by filling in lines that already exist. They are also used clinically to treat cervical dystonia, a painful disorder causing involuntary contractions in neck muscles, and blepharospasm, an involuntary blinking of the eyes.

What is Botox?

Botox, manufactured by Allergan, received U.S. FDA approval in 2002 to temporarily improve the appearance of moderate to severe frown lines. In 2013, Botox received additional approval to temporarily improve the appearance of moderate to severe crow’s feet.

Even though patients undergo Botox treatment more often than any other cosmetic procedure, it seldom has side effects. It’s been researched and studied for years and is now available for cosmetic use in more than 75 countries.

What is Xeomin?

Merz Pharmaceuticals manufactures Xeomin. Though Xeomin has been available outside the U.S. since 1985, it received FDA approval in the U.S. for the treatment of cervical dystonia and blepharospasm in 2010. In 2011, the FDA approved it for cosmetic use, and it began to compete with Botox. Xeomin is earning a reputation as the new, purer Botox alternative and a promising option for physicians and patients.

The Differences Between Xeomin & Botox

Although Xeomin and Botox are made from the same molecule, they are manufactured differently. The manufacturer of Xeomin purifies the active ingredient so its healing component separates from unnecessary preservative proteins. Although the toxin is the same in both products, the molecular structures of Botox and Xeomin are different. Botox is encased in proteins, while Xeomin is isolated.

Several studies suggest a higher number of proteins in a molecule may contribute to a greater chance of antibody formation. Botox adds proteins to the equation that may trigger the formation of antibodies, while Xeomin does not. These antibodies may block the intended benefits of Botox, and you may develop a resistance, or immunity, to the product.

The logic behind keeping Botox’s proteins intact is that the larger particles may help safeguard the treatment area by preventing the spread of toxins, but clinical studies do not support this hypothesis. The proteins in Botox can also slow the metabolic process as the molecule breaks down.

The fact that Xeomin has no antibodies gives it an advantage over the two products. Since the preservative proteins in Xeomin get stripped away, it is considered a purer substance, and patients are less likely to have an allergic reaction or develop a resistance to injections.

Another benefit of being additive-free is that manufacturers can store Xeomin at room temperature. Since it doesn’t need to be refrigerated, distribution is simpler and less expensive than Botox, which needs to be transported in a freezer.

How Do Xeomin & Botox Work?

Both Xeomin and Botox are made from the same parent molecule: botulinum toxin type A, which is a toxin produced from Clostridium botulinum, the bacteria that lead to botulism. Botulism is a medical emergency that typically results in food poisoning and may cause paralysis, which may sound a little scary, but patients have been reaping the benefits of this toxin for decades.

When you make a facial expression, the muscles underneath your skin contract. As you age, this repetitive behavior causes frown lines and other wrinkles. At the same time, your skin loses elasticity. Xeomin and Botox target those muscles and help them relax, resulting in smoother and more youthful-looking skin.

How Do Cosmetic Injections Work

Injections with these neurotoxins relax facial muscles by attaching to the nerve endings that block the release of a chemical called acetylcholine. Acetylcholine transmits information from nerve cells to muscles. By blocking acetylcholine, facial muscles no longer contract because they become paralyzed. Because the cells in our body constantly turn over, a small dose of Xeomin or Botox only temporarily disrupts muscle activity, and normal functioning returns in just a few months.

The main difference between Xeomin and Botox is that when Botox gets injected, the botulinum molecule needs to release itself from the preservative protein. With Xeomin injections, unnecessary proteins have already been stripped, giving you a cleaner experience.

What Should I Expect During the Procedure?

Specialists perform Xeomin and Botox procedures the same way. Injections take about 10 to 20 minutes, and you can resume your daily routine after your session.

Before your appointment, it’s important to discuss your medical history and medical conditions with your physician. Make sure to discuss:

  • Any diseases that affect your nerves or muscles
  • Allergies or side effects from botulinum toxin products
  • Current prescription and non-prescription medications
  • Vitamins and herbal supplements
  • History of botulinum product use

You should also take steps before your procedure to prevent bruising. Some medications and supplements can thin your blood and make bruising more likely to occur after the procedure. Talk to your physician about your medications and supplements and see what makes sense for you.

The following supplements and medications are known to cause bruising:

  • Clopidogrel
  • Dabigatran
  • Dipyridamole
  • Enoxaparin
  • Ibuprofen
  • Ticlopidine
  • Warfarin
  • Some serotonin reuptake inhibitors
  • Vitamin E
  • Garlic
  • Ginkgo biloba

During the procedure, the physician will use a micro-needle to deliver Botox or Xeomin to the targeted muscle. Some patients report injections feel like a pinch, and most don’t report any significant pain. No anesthesia is necessary, but your specialist may use ice packs or topical creams to keep you comfortable.

Doctors cannot always clearly see the muscles that are affecting your facial lines with the naked eye. If this is the case, the doctor may hook the micro-needle up to an electromyography machine to pinpoint the muscle’s location. The doctor will instruct you to contract a certain muscle, and, when the machine detects a high level of muscle activity, it will provide audio feedback.

Physicians usually inject the muscle in more than one place, and doses vary by muscle groups. The size of the dose depends on the size of the target muscle and the sensitivity of the surrounding areas. For example, a clinician would use a lower dose near the lips and around the eyes, as those areas are particularly sensitive.

After treatment, your health care provider will give you aftercare instructions. Make sure to follow your instructions to achieve optimal results from your treatment.

Aftercare instructions for Xeomin and Botox injections include:

  • Exercise the treated muscles for one hour after treatment by frowning, smiling, squinting, etc. This activity will allow the injections to work into your muscles.
  • Don’t touch the treated areas of your face for four hours.
  • Don’t rub the treated areas for 24 hours. Rubbing may cause the treatments to affect other areas of your face.
  • Don’t perform strenuous exercise or lie flat on your back for at least three hours to avoid increased bruising.
  • Don’t use a tanning bed, Jacuzzi or sauna for at least four hours. These activities can cause your blood pressure to rise and increase the chance of bruising.
  • Some people develop a slight headache post-treatment, though most do not. If you get a headache, take Tylenol.

The Benefits of Xeomin and Botox

Deep facial lines can make you look concerned, or even angry, and can age you prematurely. Xeomin and Botox injections can reduce the appearance of dynamic lines and help you restore a more pleasant and youthful image. You probably want to look and feel your best, and both Xeomin and Botox can help you do just that.

Maybe you compare your appearance to that of others, possibly generating negative feelings about yourself. If so, you may benefit from either Xeomin or Botox injections.

Benefits of Cosmetic Injections

People often use facial expressions to communicate. Do your deep facial lines or aging skin makes you feel awkward at work or in social situations? Wrinkles can, in fact, negatively impact your self-esteem and self-image. By restoring a youthful appearance, you can improve your psychological well-being as well as your social interactions.

Each day, we express our emotions in different ways. We smile, laugh, frown and contemplate. The facial areas commonly treated with Botox and Xeomin are typically those that receive higher levels of muscular activity because they are the most expressive.

Commonly treated areas include:

  • Frown lines between the eyebrows, also known as glabellar lines
  • Crow’s feet and other wrinkles around the eyes
  • Lines on the forehead
  • Corners of the mouth
  • Dimples on the chin

Xeomin and Botox reduce wrinkles from aging, giving you the appearance of younger, smoother skin. Unlike microdermabrasion and chemical peels, neurotoxins get to the root of the issue by relaxing the muscles that cause wrinkles. The procedures are quick and efficient with essentially no recovery time.

Although both Botox and Xeomin are well-known for treating wrinkles and facial lines, cervical dystonia and blepharospasm, they can also treat other conditions, including the following.

  • A drooping brow
  • Migraine headaches
  • Eye coordination or lazy eye
  • Muscle spasms in the eyes, such as squinting or twitching
  • Severe sweating of the armpits, feet or hands
  • Overactive bladder
  • Urinary incontinence
  • Nerve damage
  • Bell’s palsy
  • Muscle aches

How Long Do Xeomin and Botox Treatments Last?

How Long Do Cosmetic Injections Last

You can see some effects of Xeomin as soon as three to four days after injections take place, while the full effect takes longer. Patients usually start to see visible smoothing between five and 14 days post-treatment, but, in some cases, may not see the full results for a month. Results typically last three to six months, but can vary from patient to patient.

For Botox injections, you can usually see results in one or two days, but the full result usually takes a couple of weeks. Results typically last three to four months, though it’s possible to make the effects last longer by maintaining a regular Botox schedule. An ideal schedule would be to receive injections three or four times in your first year and two to three times the following year. Make sure to wait at least 12 weeks between treatments to avoid developing a resistance to the injections. If you receive injections too often, you may develop an immunity to the product.

Side Effects of Xeomin and Botox

Like most medications, neurotoxins have side effects, and you need to weigh the pros and cons. The side effects of Xeomin and Botox vary in severity. Some side effects are common and less severe, and some are life-threatening. You will see commonalities between both medications. Here is the breakdown.

The more common side effects of Xeomin include:

  • Discomfort, pain, bleeding or bruising at the site of injection
  • Muscle weakness
  • Dryness of the mouth
  • Fatigue
  • Neck pain
  • Diarrhea
  • Reduced blinking
  • Bruising or swelling of the eyelids
  • Serious side effects can occur immediately, as well as up to several weeks after the injection. If you have any of the side effects listed below, contact your physician or seek immediate medical attention.

Serious side effects can occur immediately, as well as up to several weeks after the injection. If you have any of the side effects listed below, contact your physician or seek immediate medical attention.

Serious side effects of Xeomin include:

  • Allergic reactions, including hives, swelling or itching of your face, lips, tongue or throat
  • Redness or rash
  • Tightness in your chest
  • Asthma symptoms
  • Trouble breathing
  • Dizziness
  • Feeling faint
  • Hoarse voice
  • Eye pain or irritation
  • Blurred vision
  • Double vision
  • Drooping of the eyelids
  • Unusual muscle weakness
  • Loss of strength
  • Loss of bladder control

Common side effects of Botox include:

  • Swelling, muscle weakness, redness, pain, bruising or bleeding at the site of injection
  • Headache
  • Muscle stiffness
  • Back or neck pain
  • Nausea
  • Flu-like symptoms, including fever, sore throat, runny nose and cough
  • Fatigue
  • Dizziness
  • Anxiety
  • Dryness of eyes or mouth
  • Ringing in ears
  • Excessive sweating
  • Swelling or bruising of eyelids

The serious side effects of Botox are listed below. Side effects can occur right away and up to a few weeks after injections. If you experience any of these side effects, contact your physician or seek emergency medical assistance immediately.

Serious Botox side effects include:

  • Symptoms of an allergic reaction, such as hives, trouble breathing, feeling faint, swelling or itching of lips, tongue or throat
  • Skin rash or redness
  • Difficulty swallowing or talking
  • Difficulty breathing
  • Hoarse voice
  • Drooping eyelids
  • Double vision
  • Change of voice or hoarseness
  • Difficulty speaking
  • Overall body weakness, or severe or unusual muscle weakness
  • Loss of bladder control
  • Irregular heartbeats
  • Chest pain, or a heavy feeling
  • Pain spreading from the chest to arm or shoulder
  • Urinary issues such as urinary tract infections, loss of bladder control, painful or difficult urination

Botox and Xeomin may spread beyond the injection site to other parts of the body and cause difficulty breathing and swallowing, both of which can be life-threatening. This reaction has occurred primarily in children with cerebral palsy who received off-label treatment. It has not been seen for people using Xeomin or Botox cosmetically or for blepharospasm. If these symptoms occur, get medical assistance immediately.

How Do I Know Which Is Right for Me, Xeomin or Botox?

The best way to decide whether Xeomin or Botox is the right solution for you is to set up a pre-treatment consultation with a cosmetic surgeon or physician specializing in aesthetic medicine. With extensive experience administering neurotoxin injections and an established background in cosmetic medicine, a provider will be able to discuss your goals and options and address any questions or concerns.

Talking To Doctor About Cosmetic Injections

Your physician will also review your goals, medical history and evaluate your areas of concern. Make your physician aware of any medications, vitamins or supplements you are taking. Although some of the information may seem insignificant, it’s important to be forthcoming and share your entire history, as various medications, neurological disorders and allergies may exclude you from treatment. After considering all the facts, your provider will advise you on the best course of action.

If you are a candidate for neurotoxin injections, but have experienced resistance to Botox in the past, Xeomin is probably your best option. Because Xeomin gets stripped of unnecessary proteins, your system won’t build up the antibodies that cause resistance and negate the restorative benefits of the injections.

Once you find a provider with the right expertise and experience, you can start your journey to rejuvenation safely and efficiently. Perhaps you’re more comfortable with the years of experience behind Botox, versus the newer Xeomin? Or, maybe you’re more interested in Xeomin, the cleaner, purer, more holistic alternative with proven clinical results? These are questions you and your physician will answer together.

Whether you want to improve the appearance of deep lines or facial wrinkles or just want to create a more youthful look than you have today, our highly trained team of professionals at Synergy Wellness Center is ready to help you achieve your goals. Give us a call today at 661-878-9100, or stop by our new office in Bakersfield, and we’ll get you on your way to looking and feeling great.

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