If we're talking Botox, we're talking Hollywood's worst-kept secret. Botox is so commonplace these days that you hardly ever hear about other brand names for botulinum toxin type A. It's like Kleenex; the brand name has come to encompass all facial tissue, whether or not they're actually Kleenex. If you've done some Botox reconnaissance on your own, you've probably heard of Dysport, another kind of commonly used botulinum toxin that's more diluted than the big name brand. There is, however, a third option that sometimes flies under the injection radar. We talked to plastic surgeon Dr. Norman Rowe and cosmetic dermatologist Dr. David Goldberg to answer all our questions about it. Keep reading to learn all about Xeomin.
Meet the Expert
- David J. Goldberg, MD, JD, is the Director of Cosmetic Dermatology and Clinical Research at Schweiger Dermatology in New York City. He has been practicing since 1985 and has been named one of the "Top Ten Laser Surgeons in the U.S." by Self magazine.
- Norman Rowe, MD, MHA, LLC., is a plastic surgeon and founder of Rowe Plastic Surgery in New York City. He is certified by the American Board of Plastic Surgery and a member of the American Society of Plastic Surgeons.
What Is Xeomin?
Like Botox and Dysport, Xeomin is a botulinum toxin type A, which is approved to treat wrinkles like the "11" lines between the brows and frown lines. Botox and Xeomin work by the exact same mechanism, which is blocking the signals from nerves to muscles, causing the muscles to relax and wrinkles to smooth out. The "primary difference between the products is that Botox has an accompanying, inactive protein, while Xeomin does not have additives," Rowe says. Xeomin is a purified form of the neurotoxin; it's manufactured in such a way that it removes accessory proteins from the active ingredient. "Foreign accessory proteins are not necessary to the function of the drug," he adds. So, you get the same results without injecting yourself with unnecessary proteins. (Toxins? Yes. Additives? No).
How much will turning back time cost you? It will vary by geographical location, the area of the body being treated, and how many units of a product are being used. According to Rowe, expect to pay at least $300 per treatment.
Benefits of Xeomin
- Smoothes the appearance of wrinkles in between the eyebrows, around the eyes, in the forehead, or around the mouth
- Blocks the signal from the nerve to muscles, causing the muscle to relax and preventing further wrinkling
- Short treatment time, fast recovery time, and noticeable results right away
- Less likely to cause allergic reactions due to the absence of added fillers
Xeomin is often called "naked Botox" due to the purity of the product itself—but what's the benefit of a one-line ingredient list? "The concern is… years of Botox injected with the associated proteins ultimately leads to desensitization because of the other proteins, akin to getting allergy shots leading to desensitization, so that the Botox after many years may not work as well," says Goldberg. "Since 'naked' Xeomin does not have these proteins, it has been suggested such desensitization does not occur with this product."
Xeomin vs. Botox vs. Dysport
Is there a difference between these injectables, or is it six of one, half-dozen of the other? The answer is yes, and no. "All currently available 'neuromodutlators' are botulinum toxin A. They all attach to the same receptor in the same muscle to soften wrinkles," says Goldberg. "Having said that, although they share the same mechanism of action, they are different and not interchangeable."
How to Prepare For a Xeomin Treatment
The most important thing to do when you've decided to take the injectable plunge is to do thorough research on the provider you want to see for the procedure. Goldberg recommends asking questions about what products they use and why, how many years they have been injecting, and if they have ever taught injecting techniques; teaching others leads to better injection techniques, he says.
If you're comfortable with your provider's qualifications, the chances of a botched job should be very slim. "Xeomin is a technique-sensitive treatment," Rowe says. "You should not lose the ability to show expression when you are treated by someone who is licensed, trained and a medical expert in facial anatomy. It's important to talk to your provider about the results you want from treatment."
Schedule your treatment appointment out at least two weeks from any event or special occasion you've got on your calendar (it's not worth recreating that veiled-hat-moment Samantha had in Sex & The City), and discontinue use of any retinol products for two days before and two days after your treatment.
What to Expect During a Xeomin Treatment
The treatment is fairly turnkey; the actual injection process can take less than 10 minutes. Your provider will numb the area beforehand, although you may feel a slight pinch from the needle itself. Again, the number of injections will vary depending upon the size of the area; for treatment of the dreaded "11" forehead lines, expect four to five different pokes. "Less is always better than more," says Goldberg. "Go to a provider who will give you a few more injections after the first injection—better not to inject too much the first time." You should be able to go on about your day as you normally would normal after your treatment.
Aftercare & Possible Side Effects
Hands off your face for three hours after the injections. Additionally, avoid lying down and any vigorous activity for four to six hours afterward to keep the product where it is supposed to go and not have it track elsewhere.
The most common possible side effects of a Xeomin injection are eyelid ptosis (drooping), dry eyes, visual impairment, possible onset of a cold, injection site pain, dry mouth, muscle weakness, and neck pain.
Before & After
It can take up to a week for the full results of your treatment to show. "Good and bad results will be seen three to seven days after treatment and will generally last for about two to three months," says Goldberg. "Problems associated with the injection are always due to the injector—not the product."
Rowe quotes a similar time for the duration of effects, saying results usually last three to four months, but that also varies by age and skin quality.
The Final Takeaway
If the idea of extra "stuff" in your injectables rings an alarm for you, then Xeomin might be the answer. It is an accessible wrinkle-reversing and prevention treatment with a relatively low price tag, compared to other, more invasive treatments. The key to success is a thorough practitioner research process and clear communication about your desired results.
Walker TJ, Dayan SH. Comparison and overview of currently available neurotoxins. J Clin Aesthet Dermatol. 2014;7(2):31-39.