Xeomin vs. Botox - Which is Better?

UPDATE: The research discussed below is now completed. Feel free to check out the link I posted. This will discuss the final results. I've asked myself the same question. I am still not ready to recommend Xeomin use to my patients for a few reasons. I should also point out that I am in the process of completing a very large study comparing Botox, Dysport and Xeomin using only the highest quality research (a meta-analysis). Here is a link to the study I am doing.  You can search online for A comparative assessment of three formulations of botulinum toxin A for facial rhytides: a systematic review and meta-analyses to read the project we are working on. 

Like all businesses, there is a lot of marketing. Xeomin's claims to fame are #1 you dont need to refrigerate it and #2 there is less risk of allergies. After reviewing over 20,000 patients in a number of randomized studies, there are no reports of allergies with botox. Yes, there are reports of this happening in other series but it is extremely rare thus I dont believe that Xeomin offers any advantage in this regard. At this point, there is absolutely no evidence one is better than the other. Its just marketing based on "theory."



Also, Botox is such a popular brand now, people ask for it by name. I think many people are nervous about trying a product that has been on the market for a few years versus one that has been around over 15 years. I tend to use Botox cause I know it works, its safe and people are happy with the results.



Also, there is evidence that Xeomin may not last as long as Botox. Now, this is controversial but hopefully the study I am doing will answer this question. At this  time, there is no reason to believe one lasts longer than the other, however....time will tell.



Finally, one of the "benefits" of Xeomin is that it is considered a more purified version of the active component of the toxin. Basically, botulinum toxin contains an active component (the part that results in the key effect) and some other proteins. Xeomin removed these proteins and thus the notion that there is less of a risk of allergy as some believe the allergy risk is associated with these proteins. However, there is another side to the story. Some people suggest that these proteins are important for making the medication work better, thus some believe this is the reason why Botox may last longer, it keeps some of these "extra" proteins that may have a role in improving its effect.



Wheww...Long winded I know, but its a complicated topic and one I find interesting.



I think I'll end by saying, I dont know what the right answer is, it may turn out there is no difference between products. But as a physician, my goal is to treat people with a medication that I believe is the safest and most effective available. At this point, Botox is that product. Perhaps my opinion will change once more evidence is out there, but for now, I continue to recommend Botox.I've inserted a link to my linkedin account so you can see the publication and read the protocol. The final results will be published this year. 

Xeomin is just a newer alternative to Botox. They both contain the main active ingredient called Botulinum toxin A, effectively sharing the same result. The main difference between the two is that Xeomin uses the purest form, lacking some proteins that Botox contains. This, however, makes little to no difference in the overall result. Patients who want quicker results tend to use Xeomin more frequently because once it is injected the protein becomes active immediately. On the other hand, Botox may take a while longer due to the time it takes for the protein to activate.

I would echo what has been said by previous doctors. My preference is for injecting Dysport due to my experience with Dysport having increased potency and onset of action. However, when looking at longevity between Xeomin, Dysport, and Botox, all three neurotoxins last about the same time based on clinical return of brow movement. If you're a purist, then Xeomin has no associated protein attached to it, so it may be best for you. I've also never seen a Botox allergy. 

The toxins are all very similar. Some start quicker and wear off quicker (in my experience this is the case with xeomin compared to botox).It really is much more the method than the product though.Find an injector you trust and give it a shot! "pun intended".Hope this helps,Best of luck,DrC

Great question.  These are both similar neuromodulating agents that give excellent results when it comes to softening the appearance of facial lines.
The main difference between these two medications is that Botox is a molecule that has a carrier protein attached to it and Xeomin is a "naked" toxin.  When Botox is injected the protein disconnects within a minute of injection and then the Botox becomes active.  Xeomin is active immediately as soon as it is injected.  
Because Xeomin is a "naked" molecule it is possible that it may be useful in patients who have become tolerant to Botox.  It may also be useful in patients who are allergic to the Botox carrier protein.
I have had thousands of patients with wonderful results from both products, as well as with Dysport.
As always, an in-person consultation with a board certified dermatologist with cosmetic training is the best way to assess your needs and provide medical advice. 

Hello.  Great question.  Since 2009, two new neurotoxins have been introduced, Dysport and Xeomin.  Both are close in composition to Botox and all three are Botulinum Toxin Type A.  in our practice, we do not use Xeomin, but we have done our own trial with it.  The concern that we had was that 20 units of Xeomin we did not feel was lasting as long as 20 units of Botox or 60 units of Dysport.  In our minds, more Xeomin was necessary to achieve the same result as with our Botox and Dysport, so we did not decide to start using the product.  Some patients and practitioners actually prefer the products, but we feel there are small differences.  

Botox and Xeomin are essentially the same.  They each contain botulinum toxin A. However, Botox also has a protein, whereas Xeomin does not. Results with Xeomin & Botox take 1-2 weeks. Best, Dr. Emer 

Xeomin is nearly identical to Botox in its chemical structure. It also works very similarly in its speed of onset, and works in the same way, by temporarily paralyzing the muscles in the affected area. The net effect is that it reduces muscle action which in turn reduces wrinkling of the skin in the treated areas.All the best,

Thank you for sharing your question.  Both botox and xeomin belong to a class of injectables termed neuromodulators.  They work in similar fashion to prevent the nerve function that causes facial muscles to contract and wrinkles to form.  Many papers have demonstrated that the time to onset, efficacy and duration of results is identical between both medications.  If a patient develops resistance to one the other medication can be tried for improved results.  Hope this helps.

Xeomin has the same active ingredient as Botox.  The only differences are the preservatives.  Xeomin is the purest form of the Botulinum toxin type A.  This makes it theoretically much less likely to have antibody formation against the drug.  In clinical practice, the results are very similar if not the same.  

The fact that you see a multitude of different opinions about these two products means that there isn't a clear answer or a clear winner amongst the two. You will see arguments about the purity and decreased number of proteins we can possibly react to with Xeomin, and right next to it you will see arguments for a longer duration and more proven track record with Botox. This is the battle of big industry. In time we may find that there is no difference, and if there is one it will likely be subtle.