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I Have Always Used but Botox but Tried Xeomin Recently and Haven't Had Great Results. Am I Resistant?

I have always love botox but my doctor stopped offering it and said xeomin would work better. I've waited three weeks with still no results, just some twitching near my right brow. Could I be resistant? I had the same amount/units as normal, if I switch back to botox will it still work. I have heard that it isn't recommended to go back and forth. I also take olive leaf extract and read that sometimes it is a natural antitoxin( use it for acne) Thanks!

Doctor Answers 21

Xeomin vs Botox

  It is quite unlikely that you developed resistance to Xeomin.  Although it is quite rare, patients are much more likely to develop resistance to Botox.  It is possible that your Xeomin dose needs to be tweaked, for best results.

Saint Petersburg Oculoplastic Surgeon
5.0 out of 5 stars 68 reviews

Botox vs Xeomin for eye twitching

Xeomin is an FDA approved botulinum toxin similar to Botox. Its dilutions are the same as Botox and it lasts as long as Botox, but is much less expensive.

We have replaced Botox for Xeomin for cosmetic injections. The results have been the same.

However, we have not gotten the same results for hyperhidrosis (sweating) as we do with Botox. I do not know the reason.

It sounds like you are receiving the drug for eye twitching. Maybe it is not as effective as Botox for muscle twitching.

Go back to Botox. It should work as well now as it did in the past.

Good luck.

I Have Always Used but Botox but Tried Xeomin Recently and Haven't Had Great Results. Am I Resistant?

You may need more units applied to the area to see full correction, seek a reputable physician who can provide you with the result you wish to achieve 

I Have Always Used but Botox but Tried Xeomin Recently and Haven't Had Great Results. Am I Resistant?

I have had excellent results with Xeomin and I now routinely offer it as a neuromodulator (along with Botox and Dysport).  It is perfectly reasonable to go back and try the Botox to see if that gives you a better result but it is equally important to make sure that you are receiving the same number of units (1 of Xeomin = 1 of Botox) and that the solution is fresh (there is some question as to exactly how long each lasts once it is made up but I try to make it fresh for each patient, or at least within just a few hours).  Within those parameters you should be as happy with your Xeomin treatments as you have been with Botox.

I hope that this helps and good luck,

Dr. E

Differences in Xeomin activity more likely relate to dose

It is more likely that differences in activity between the available type A botulinum neurotoxins - Xeomin, Botox, and Dysport - are due to the amount given and amount needed in the individual person to achieve a desired result.  There are individual variations in the activity of ALL of the toxins, and while many injectors use convenient "conversion factors," like 2 or 3:1 for Dysport to Botox units or 1:1 for Xeomin to Botox units, the truth is that these conversions are only guidelines and won't work 100 % of the time for all people.  Rather than totally discard Xeomin or any of the toxins, if you wish to convert, my advice is to keep working with your physician to determine YOUR optimal dose of your chosen neurotoxin based on your desired result.

Botox vs. Xeomin

The active drug in each of these products is the same, therefore treatment outcomes should be similar.  There is no question that some patients prefer one product over the other.  They are not interchangeable from a dosing standpoint so it may be that the dose of Xeomin you received may need to be adjusted. 

Brian Biesman, MD
Nashville Oculoplastic Surgeon
5.0 out of 5 stars 33 reviews

Xeomin for wrinkles in patients who have resistance to Botox

My patients have done very well with Xeomin injections, particularly those who have used Botox for years and have developed a resistance to Botox. Surgery90210

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 61 reviews

Xeomin Treatment

Hello and thank you for the question.

Our practice has been using Xeomin since it became commercially available last year.  From my experience, the efficacy of Xeomin is comparable with that of  Botox and Dysport.  While you may have a "resistance" to Xeomin, the likelihood is low.  

Best of luck,

Glenn Vallecillos, M.D., F.A.C.S. 

Glenn Vallecillos, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 21 reviews

Botox dysport and xeomin should be similar

There shouldn't be a reason that any one of the three botulinum toxins, Dysport, Botox or Xeomin, is signficantly better than the others.  One patient may like one, whereas another patient may prefer the effects of another. Some may say there product works a day or more sooner and others may say there is less free protein to cause immune reactions but I the three products may be quite similar.  The number of units for each to be equivalent, may differ and more studies may need to be done.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
5.0 out of 5 stars 33 reviews

Xeomin vs Botox

Xeomin is the newest neuromodulator available in the U.S. and thus far, only experienced injectors are being given access to it for patient use.  Therefore, each physician who answers here has excellent credibility.  I have been using it in patients who have previously had Botox, as well as some who have never been treated, and I am diluting it exactly the same as Botox.  My results thus far have been equivalent between the two products for cosmetic purposes.  I am able to offer Xeomin at a slightly lower cost to the patient, which is attractive to many.

I have one long term patient who gets injections for essential blepharospasm (uncontrolled eyelid twitching), and when she switched to Xeomin she did not get nearly as good a result as with Botox.  Her spasms went away only for three weeks instead of the three months she gets with Botox.  In her case, we have gone back to Botox.

Provided that everything else is the same (injector, dilution, location of injections), I think that you are similar to my one patient in that, for unexplained reasons, Botox works better for you than Xeomin.  There should be no problem with going back to Botox and you should get the same good result you did before.

James Bartels, MD
Manchester Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.