Xeomin vs. Botox: which is right for you?

In the world of cosmetic medicines, when most people think about injectable treatments for treating fine lines and wrinkles, they think of Botox. But Botox isn’t the only brand on the market; others, like Xeomin, also exist. So, which is better, Botox or Xeomin? 

Below, we discuss Xeomin vs. Botox, including their risks and side effects, so you can better understand which treatment may be right for you.

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Xeomin and Botox are two brands of injectable medications that contain botulinum toxin type A, which is a neurotoxin made by a bacterial species called Clostridium botulinum.

Both are approved as cosmetic treatments to address facial lines and wrinkles and to treat certain medical conditions (more on those later). As cosmetic injectables, they work by preventing nerve signals from getting to your facial muscles, thus relaxing the muscles and preventing them from working. This causes localized muscle relaxation that smooths the overlying skin, removing wrinkles (Padda, 2022). 

Typically, a licensed healthcare provider like a dermatologist or plastic surgeon administers small volumes of these medications into frown lines (creases that appear between the eyebrows), forehead lines, crow’s feet (lines at the outer corners of the eyes), lines around the mouth, and other parts of the face, using a 1-inch needle (Small, 2014). 

Xeomin is the brand name for incobotulinumtoxinA injections. It’s used to treat facial lines and wrinkles, as well as certain other medical conditions. It works by blocking the nerve signals that cause muscle contractions, causing frown lines and other wrinkles to soften and relax. 

Xeomin injections are clinically proven to temporarily improve the look of moderate to severe glabellar lines (frown lines)—creases that appear between the eyebrows (NIH, 2010).

Botox is the brand name for onabotulinumtoxinA injections. It is referred to as Botox Cosmetic when used for these aesthetic purposes. Botox Cosmetic is used to treat facial lines and wrinkles, as well as certain medical conditions. In addition to treating frown lines, Botox Cosmetic is also approved to treat crow’s feet around the eyes and forehead lines (Satriyasa, 2019).  

Botox injections work just like Xeomin by blocking the nerve signals to the facial muscles, allowing them to relax. 

Botox and Xeomin carry a few similarities. They work the same way on facial muscles, blocking the nerve signals that cause muscle contractions, which causes frown lines and other wrinkles to soften.  

Xeomin and Botox also last around the same amount of time—three to four months—and only take a few minutes to inject. The full effects of botulinum toxin take about two weeks (Rappl, 2013). 

Despite their similarities, Botox and Xeomin treatments are not interchangeable because they vary in their formulation, dosing, and clinical response. Talk to your dermatologist or plastic surgeon about which botulinum medication is best for you.

One significant difference between Xeomin and Botox is that Botox contains added proteins, and Xeomin doesn’t. When there are proteins, you might develop antibodies against the medication, potentially reducing its effectiveness (Frevert, 2012). 

Xeomin also does not need to be refrigerated, while Botox requires refrigeration. Xeomin is also primarily used to treat frown lines, while Botox can treat other areas of the face with fine lines or wrinkles. 

If you’re getting Botox or Xeomin injections for aesthetic purposes, insurance is unlikely to cover them. According to the American Society of Plastic Surgeons (ASPS), an average Botox treatment can include 30 to 40 units and cost anywhere between $300 and $600. How many units are needed depends on the area that’s being treated.

In general, Botox ($370 for 50 units) seems to be more expensive than Xeomin ($270 for 50 units (GoodRx-a, n.d.; GoodRx-b, n.d.). 

If you’re receiving injections for a medical condition, however, your insurance may cover some of the treatment costs if the medication is FDA-approved to treat your specific condition.

Both Xeomin and Botox Cosmetic are FDA-approved to treat fine lines and wrinkles but there are some other medical conditions that each of these medications is also approved to treat.

Xeomin is FDA-approved to treat (FDA, 2010):

• Cervical dystonia, an abnormal head position accompanied by neck pain

• Blepharospasm, an abnormal contraction of the eyelid muscle

Botox is FDA-approved to treat (FDA, 2011):

• Chronic migraines

• Overactive bladder

• Upper limb spasticity

• Cervical dystonia

• Axillary hyperhidrosis, or excessive sweating

• Blepharospasm

• Strabismus, or crossed eyes

Common side effects of both Xeomin and Botox include minor pain, swelling, bleeding, and bruising at the injection site. They may also cause (FDA, 2010; FDA, 2011):

• Eyelid drooping

• Eyelid swelling

• Double vision

• Blurred vision

• Dry eyes

• Headache

• Dry mouth

• Tiredness

• Neck pain

• Muscle weakness

Additional possible side effects of Botox include brow drooping, decreased eyesight, and allergic reactions (FDA, 2011).

You should report serious side effects, such as trouble breathing or swallowing, to your healthcare provider. Further, Xeomin and Botox should not be used with muscle relaxants as this can increase their effects.

Both Xeomin and Botox work similarly, but some might prefer one over the other. 

While Xeomin is slightly less expensive than Botox, Botox is approved to treat more areas of the face for fine lines and wrinkles. One study showed that the effects of Xeomin were seen a few days earlier than Botox. For both products, the treatment effect duration was longer in females than in males (Rappl, 2013). 

In the end, you’ll need to discuss these medications with your dermatologist to determine which suits your needs and budget better. They can help you decide which injectable is best for you.

We’ve given you a lot of information regarding the differences and similarities between these two medications. Here is a summary:

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Current version

June 27, 2022

Written by

Allison Flynn Becker

Fact checked by

Felix Gussone, MD

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About the medical reviewer

Felix Gussone, MD, Ro

Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.