I have been using Botox, and have had Xeon recommended instead. What is the difference?

Can you please give me some info on this product Xeon? I've had Botox first time 7 wks ago and i was advice by my nurse that my next injection age thinks I would really like Xeon. But as it's a different product I want to get some info on it first please

Doctor Answers 12


Thank you for your question in regards to Xeomin. Botox and Xeomin are just two different brands of botulinum toxin molecule. They are prepared and stored differently, but have the same results. To be sure, see two or more board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have treatment. I hope this helps.

Nashville Plastic Surgeon
5.0 out of 5 stars 182 reviews

Xeomin Vs. Botox

Botox has been around for longer and is therefore well known. The results are similar yet doses will vary between the two products. Botox can be harder on patients who are sensitive to the pain. The full results of either treatment will start to show 5-7 days after treatment. If you are unhappy with the results of botox you may want to discuss the option of using Xeomin as it is an alternative. 

Navin K. Singh, MD
Washington DC Plastic Surgeon
4.8 out of 5 stars 36 reviews

Xeomin and Botox both have advantages

Thank you for your question. It seems that you are referring to Xeomin. Xeomin and Botox are safe and effective and are approved for use in Canada and the U.S. Both products contain the same active ingredient, which is derived from botulinum toxin type A (basically, a type of protein). Both of these neuromodulators are used to relax the muscle that they are injected into by blocking the signals that the nerves send to that muscle. Xeomin and Botox have the same size of molecules, which makes their unit size comparable.

As for differences between them, Botox requires refrigeration, but Xeomin does not. Because of this, it is assumed that Xeomin’s integrity is not compromised when injected. Xeomin can boast that it has no additives; therefore, it has less risk of antibody formations. However, Xeomin also has less protein around each active molecule, which has sometimes caused it to be less stable and spread beyond the injection site, resulting in unwanted muscle relaxation. Xeomin requires about 1 week to see its full effect, whereas the onset of Botox is 3 to 4 days.

Xeomin and Botox should not be used interchangeably, and they should be only be injected by a certified plastic surgeon or dermatologist.

Cory Torgerson, MD, PhD, FRCSC
Toronto Facial Plastic Surgeon
4.8 out of 5 stars 148 reviews

Botox and Xeomin

Thanks for your question and the easiest answer is that Botox and Xeomin are very similar in their effects and what they do, how long they last, and what they are all about. There are differences – we call Xeomin a pure toxin, as it does not have the same proteins around the molecule that we see in Botox. What the need for these proteins is not known and many of the newer toxins are pure and do not have them. Most of the medical literature shows that the two are interchangeable – they are mixed the same, they work the same, and they last the same. Some in the Botox family think that it takes more Xeomin to make it work, and that it lasts longer than Xeomin – but most of the studies suggest equivalence.

What is important that skilled injectors in the offices of board give them all certified dermatologists or plastic surgeons as they understand toxins the best and know that anatomy and the best places for the injections to take place for the most optimal results.

Michael Gold, MD
Nashville Dermatologic Surgeon
4.0 out of 5 stars 18 reviews

Botox and Xeomin are almost the same.

The only recognizable difference between Botox and Xeomin to the patient is the time to onset and the pain.

Xeomin will take effect a day or two faster than Botox. If you are in a hurry to see results then choose Xeomin.

Xeomin hurts less going in. When I inject a patient with an agent, they get pain when the needle enters the skin and another burning sensation when the agent enters the tissues. Botox burns more than Xeomin. So when I use a very powerful numbing agent for the skin and choose Xeomin, there is almost no discomfort to the procedure.

The most significant difference is Hype. Botox was first to market and is well known.

I hope this helps you to make an informed choice.

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Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 33 reviews

I have been using Botox, and have had Xeon recommended instead. What is the difference?

Botox and Xeomin are brand names for the same product made by two different companies. There are some slight molecular differences between the two that relate to resistance in Botox, but as far as everything else is concerned, they are essentially the same. You really should not see any difference clinically between the two. Dysport is slightly different and is dosed differently.

Eric Desman, MD
Alexandria Plastic Surgeon
4.9 out of 5 stars 9 reviews

Xeomin, Dysport, and Botox - similar results

 Xeomin, Dysport and Botox are all preparations of botulinum toxin A derived protein that works at the nerve-muscle interface to relax targeted muscles. Each preparation is slightly different, for example the protein size differs. Dysport and Xeomin have been around in Europe for a long time and more recently introduced in the USA. Note the dosage is not the same between the drugs though each works well in my experience.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews

I have been using Botox, and have had #Xeomin recommended instead. What is the difference?

They are essentially identical and interchangeable products.  Both are forms of botulinum toxin, which are used to "relax" various muscles, primarily of the face and neck, that when contracted form lines.  Many doctors use whichever of these is available most readily, and also include among the forms of the product another one, called Dysport.

Some patients prefer one over the other but in general those numbers are about equal for each product and, as such, they are used basically interchangeably.

I hope that this helps and good luck,
Dr. E

Alan M. Engler, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 125 reviews

Treatment with Xeomin

Botulinumtoxin type injections work by blocking nerve impulses to the injected muscles. This reduces muscle activity that causes moderate to severe lines to form. Currently there are 3 types of toxins on the market, Botox, Dysport and Xeomin.

Botox is made by Allergan the makers of Juvederm and Latisse and was the first of this type of injectable.

Dysport is made by Medicis the makers of Restylane and Perlane. Dysport’s molecule is slightly smaller than Botox and Xeomin and therefore has more “spread.”

Xeomin is made by Merz the makers of Radiesse and Belotero. This is the newest toxin and does not contain a complex protein that Botox and Dysport contain that you can eventually become resistant to. If Botox/Dysport is not lasting as long as a patient would like then I inject them with Xeomin to see if it is better suited for them.

Ultimately, I base my decision as to which one to use by the patient’s history and lifestyle as I offer all at my practice. It’s unclear why they would recommend that you switch if you are happy with your Botox treatment, please consult with a Board Certified Dermatologist to see which option is best for you concerns.

Nissan Pilest, MD
Irvine Dermatologic Surgeon
4.7 out of 5 stars 19 reviews

Appears to work the same. Different company and different manufacturing process.

Hi Clairearcher,

If you did not know whether you had Xeomin injections or Botox injections, most likely you would not be able to tell the difference.  

The Botox molecule is larger (900 kD kilodalton) and has some proteins that accompany the actual active portion (150 kD) which causes the muscle to be paralyzed.  The Xeomin molecule has only the 150 kD active Botox molecule without the accessory proteins that Botox cosmetic has.

Since the active portion of the molecule is the same, it should work same.  Both Botox and Xeomin come in 100 unit vials and the dosing for Xeomin is the same as Botox, so I don't need to make a special calculation as I need to do with Dysport (2.5 ratio.)

Currently the Xeomin vials are less expensive during their introductory roll out, but this may change in the future as with Dysport which started off cheaper, and is now about the same price as Botox cosmetic per vial.


Dr. Yang

P.S. There is a new feature on Realself, which is the "Follow" button. It is similar to the "Like" button on Facebook. If you like my response or any of the doctor responses while you research on Realself, you should "Follow" them. You will get email updates, when the doctors you follow post any new answers to questions, post new photos, or have any new reviews.

George Yang, MD
New York Facial Plastic Surgeon
4.8 out of 5 stars 34 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.