Xeomin vs Botox

Should Botox Be Worried?

Are you considering getting injections to reduce your facial wrinkles?

If so, you now have another choice.

There’s a new neuromodulator called Xeomin on the market that’s set to give Botox a real run for its money, but does it perform as well as the proven wrinkle-relaxing giant? Keep reading to find out!


Before a drug can be used to treat specific aesthetic or physical conditions in the United States, it must be approved to treat that condition by the FDA. If doctors use a drug to treat conditions that it’s not approved for, chances are good that results aren’t guaranteed to be either safe or effective.

Botulinim toxin – based neuromodulators have been proven useful for both therapeutic and cosmetic purposes in the treatment of several conditions but they aren’t all FDA-approved for the same things. Let’s see what the differences are.


Allergan invests a ton of money into medical research for Botox and though the cosmetic use of the product is what it’s best known for, its sales are equally divided between cosmetic and therapeutic uses. Botox is FDA-approved for the following uses:

  • Moderate to Severe Glabellar Lines. These are the ones between your eyes.
  • Urinary Incontinence
  • Blepharospasm, aka uncontrollable blinking or spasming of the muscle around your eye.
  • Cervical Dystonia
  • Chronic Migraine
  • Severe Primary Axillary Hyperhidrosis, aka severe underarm sweating
  • Strabismus, aka crossed or wall eyes
  • Upper Limb Spasticity
  • Currently seeking FDA approval to treat overactive bladder

Botox controls about 78% of the global neuromodulator market, which translates to about $1.7 billion. Botox also represents about 30% of Allergan’s total revenue, so the company stands to lose significantly if they don’t stay ahead of other similar products.


Though Xeomin isn’t approved for nearly as many therapeutic uses as Botox is, it is approved for the same cosmetic uses. Here’s what your doctor can use Xeomin for:

  • Cervical Dystonia
  • Blepharospasm
  • Glabellar Lines

It’s that last one that’s going to give Botox a run for its money because Xeomin claims to have a couple of distinct advantages over Botox. Let’s move on and discuss those differences.

What’s In Them?

This is where the rubber meets the road when you’re comparing the two neuromodulators. One of the primary concerns with Botox is that a person can build antibodies to the toxin so that it quits working after a while.

The notable point here is that while Botox contains the botulinum type A toxin, it also contains other complex proteins. Xeomin is naked; it contains only the toxin. This may or may not increase the odds that it will spread or become unstable.

Some professionals say that this may lessen your chances of becoming resistant to treatment and others say that the odds of that happening are so slim anyway that it doesn’t really make that much of a difference from either a marketing or functional standpoint if you’re using it cosmetically. It may make a difference when using much higher doses therapeutically.

How Much Does It Take?

The products are pretty much equal in both dosage and viscosity with one major distinction. Merz claims that 1 unit of Xeomin is equal to 1 unit of Botox. If you’re using the products at higher doses for spastic disorders, the lack of proteins in Xeomin may significantly decrease your odds of developing antibodies to the toxin but it hasn’t been proven yet.


Most places are selling the products at about the same price though in some places, Xeomin is a little bit cheaper; about $400 per unit versus $500 – $600 per unit for Botox.


Both Xeomin and Botox take effect within a couple of weeks and last the same amount of time. There are a few people who believe that Xeomin begins working just a bit faster than Botox but Merz doesn’t claim that, nor do the majority of doctors or users say it.


This is probably the most significant different between the products as far as function goes. Unlike Botox, Xeomin doesn’t require refrigeration prior to being reconstituted. It does after it’s been reconstituted but that’s not generally an issue because it’s usually used immediately at that point.

Final Word

Xeomin is a viable, and possibly cheaper, alternative to Botox. It functions in the same way and has received FDA approval to be used to treat glabellar lines just like Botox has.

I wouldn’t be surprised to see Xeomin seek approval for many of the same therapeutic uses that Botox currently corners the market in, but we’ll just have to wait and see. Make sure that if you decide to use a neuromodulator, you go to a licensed administrator such as a cosmetic surgeon.

If you’ve used either Botox or Xeomin, please tell us about your experience in the comments section below!

Next: Xeomin Versus Dysport

Previous: Xeomin: A New Face in Neuromodulators

One Response to “Xeomin vs Botox”
  1. Cynthia Palazzo says:

    I started with Botox in McLean Va in 2000 with the wonderful Dr Scott Gerrish . Perfect injections, without any problems and have continued using Botox to present day until I was introduced to Xeomin. I was impressed at first, however, I didn’t get as many injections as I needed or I was just so stuck in Botox world. Do I need to switch to Xeomin since I’ve been doing Botox for 16 years. Or should I just go under the knife. I need to locate a new physician where I have relocated to in West Virginia. If Scott Gerrish still practices in McLean, I will drive four hours for injections. Please respond

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