Xeomin Injections – Are You a Candidate?

Reviewed by Yael Halaas, MD

First there was Botox, then there was Dysport, and now there is Xeomin (incobotulinumtoxinA). The Food and Drug Administration (FDA) recently approved this new botulinum toxin type A product to treat severe frown lines or "11's" between the eyebrows. Xeomin was already FDA approved for use in adults with cervical dystonia and blepharospasm. Cervical dystonia is characterized by abnormal neck pain and movements, and blepharospasm is marked by abnormal, involuntary blinking or spasm of the eyelids. Xeomin is manufactured by Merz Pharmaceuticals, and has been used by more than 84,000 people worldwide. It is now approved for use in 20 countries.

Like other drugs in this category, Xeomin works by paralyzing wrinkles. It blocks the signals from the nerves to the muscles. As a result, the targeted muscle cannot contract.

Xeomin versus Botox and Dysport

Botox, Dysport and Xeomin have a lot in common, but they also have some important differences. Unlike its predecessors, Xeomin does not need to be refrigerated. This may be an advantage when it comes to distribution. What's more, Xeomin is "naked." There are no additives — just botulinum toxin type A. This may lessen a patient's likelihood of developing antibodies to Xeomin. When your body senses a foreign invader, it responds by creating antibodies and launching an attack. If this were to occur with a neurotoxin such as botulinum toxin type A, it may not have its desired effects.

Xeomin is said to be more like Botox than Dysport. It takes about one week for the full effects of Xeomin injections to be realized, and once this occurs the results last from three to six months. Dysport, Xeomin and Botox should not be used interchangeably. They should also only be administered by skilled injectors such as board-certified facial plastic surgeons in sterile environments such as medi-spas or doctors' offices. Xeomin should not be injected in beauty salons, malls or at Xeomin parties in the home.

If you are interested in Xeomin injections, consult with a facial plastic surgeon to explore your candidacy. Be sure to choose a qualified surgeon with extensive experience providing various types of injectables. It can often be difficult to sort through all the hype to find a surgeon you can trust. To help in your search, All About Facial Rejuvenation has developed a directory of highly trained, reputable surgeons with years of experience performing a range of facial plastic surgery procedures. To find a surgeon near you, click here or on the right side of this page.

Xeomin Complications

Like other botulinum products, Xeomin must carry a black box warning regarding a rare risk for spreading outside of the injection site. If this occurs, life-threatening swallowing and breathing problems may result. This has not been seen in people receiving neurotoxins for cosmetic reasons or to treat blepharospams. It has mainly occurred among children treated off-label for cerebral palsy-related muscle spasms. Other general Xeomin risks may include:

• Bleeding and bruising at the injection site
• Allergic reactions such as itching, swelling or shortness of breath.

Your doctor should discuss all the potential Xeomin risks with you during your consultation. Possible Xeomin side effects when this neurotoxin is used to treat cervical dystonia may include:

• Neck pain
• Muscle weakness
• Injection site pain
• Musculoskeletal pain.

Xeomin side effects when used to treat blepharospasm may include:

• Eyelid sagging (ptosis)
• Dry eye
• Dry mouth
• Diarrhea
• Headache
• Visual impairment
• Shortness of breath (dyspnea)
• Upper respiratory infections.

Xeomin Cost

Xeomin will likely cost $400 to $600 for a standard treatment. The costs are expected to be similar to Botox cost. That said, exact price points are not yet available given the recent approval of Xeomin. Ask your doctor for the Xeomin cost before your treatment.

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