Xeomin vs. Botox Cosmetic: Comparing These 2 Popular Facial Injections

Wrinkles are often unavoidable as we get older. These unwelcome lines may appear between your eyebrows, on your forehead, and around your eyes. And, while they’re not a medical problem, they could still leave you searching for a remedy.

They’re not permanent solutions, but products like Botox Cosmetic — which are made from botulinum toxin — have made it possible to treat wrinkles. Botulinum toxin has been used for clinical purposes since the late 1970s, but it has become more popular in recent years due to an increase in demand for cosmetic procedures.

Botox Cosmetic (onabotulinumtoxinA), the original wrinkle-relieving product, first became available in the early 2000s. Xeomin (incobotulinumtoxinA) followed suit several years later. While they’re similar in a lot of ways, there are a few distinctions that may make one more appealing than the other.

Here, we’ll do a head-to-head comparison on how Xeomin versus Botox stack up.

What is Xeomin?

Xeomin is an injectable medication that contains botulinum toxin, which is derived from the bacteria Clostridium botulinum. This is the same bacteria that causes botulism, a life-threatening illness that affects your nerves, breathing, and muscles. However, in small and controlled doses, botulinum toxin can treat various health conditions. 

Xeomin is FDA approved to treat or lessen:

• Frown lines (wrinkles between your eyebrows)

• Forehead lines (forehead wrinkles)

• Crow’s feet (wrinkles at the corner of your eyes)

• Neck spasms 

• Eye twitching 

• Drooling 

• Arm spasms 

What is Botox Cosmetic?

Botox Cosmetic is another injectable medication that’s made from botulinum toxin. It’s approved for cosmetic uses — specifically, to smooth out the same three types of wrinkles that Xeomin treats.

Keep in mind: Botox Cosmetic is different from Botox. The original version of Botox treats health conditions such as overactive bladder, muscle spasms, and excessive armpit sweating, to name a few. In this article, we discuss Botox Cosmetic, specifically.

How do Xeomin and Botox Cosmetic treat wrinkles?

Xeomin and Botox Cosmetic work in a similar way. The medications relax facial muscles by temporarily blocking nerves that cause them to contract. As a result, the injections can help reduce the appearance of wrinkles and prevent the formation of new ones.

What are the similarities and differences between Xeomin and Botox Cosmetic?

Xeomin and Botox Cosmetic are very comparable overall. They share many similarities, including how well they work and how they’re administered. But they also have some differences that make one stand out from the other. 

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For instance, Xeomin is made without some additional proteins that are found in Botox Cosmetic. These additional proteins may eventually cause your body to not respond as well to Botox Cosmetic, preventing its desired effects. You may be less likely to develop resistance with Xeomin, though more research is needed to confirm this.

Uses

Xeomin and Botox Cosmetic have similar cosmetic uses. They’re both approved to temporarily lessen the appearance of frown lines, forehead lines, and crow’s feet. They should only be used by adults ages 18 and older.

Dosages

Xeomin and Botox Cosmetic’s dosages are both based in “units,” which are small amounts of medication. These are typical Xeomin and Botox Cosmetic dosages:

• Frown lines: 20 units per session

• Crow’s feet: 24 units per session

• Forehead lines: 40 units per session (up to 64 units for overlapping upper facial line treatments)

However, keep in mind that these dosages can vary. Your administered dose(s) will depend on your medical background, symptoms, and the clinic or medical spa that’s administering the treatment.

How frequently you receive the injections also depends on how your body is responding. In general, they’re given no more than every 3 months. It’s also important to remember that Xeomin and Botox Cosmetic should only be administered by a trained healthcare professional. 

Effectiveness

Xeomin and Botox Cosmetic appear to be similarly effective options for smoothing out wrinkles. 

In a study that compared the two as treatments for moderate-to-severe frown lines over a 4-month period, Xeomin was found to be just as effective as Botox Cosmetic. They were also comparable in terms of how well people tolerated them and how long their effects lasted.

Xeomin and Botox Cosmetic are also comparable when it comes to the treatment of crow’s feet. However, the two medications haven’t been widely compared as treatments for forehead lines. 

Risks and side effects

Xeomin and Botox Cosmetic have slightly different ingredients, which may impact the likelihood of developing resistance. But they’re generally similar in how safe they are. 

The most common side effects are related to the injections themselves. Pain, bruising, and swelling at the injection site can be expected. Other common Xeomin and Botox Cosmetic side effects reported in clinical studies include:

• Eyelid drooping

• Facial pain

• Headaches

• Muscle weakness (with Botox Cosmetic)

Serious side effects are also possible, but they’re more likely to happen when the medications aren’t injected properly. The medications can spread to areas where they shouldn’t be when injected incorrectly. This can cause potentially serious side effects, such as:

• Blurred vision

• Difficulty breathing 

• Difficulty swallowing 

• Voice changes

• Loss of muscle strength

Using contaminated or counterfeit products can also lead to issues. To avoid these types of administration-related risks, be sure to visit a trained and licensed healthcare professional for your injections. A healthcare professional will also be able to answer any additional questions you have about the procedure. 

Pregnancy and breastfeeding

You may want to avoid using Xeomin and Botox Cosmetic while you’re pregnant. There isn't enough information to know if they’re safe in this situation. 

Most of what we know about pregnancy risks come from animal studies. When Xeomin and Botox were given to animals in higher doses, they had underweight babies with abnormal bones. The mothers also had a greater chance of losing their babies or delivering them too early.

What’s more, it’s generally recommended to refrain from using Botox Cosmetic and Xeomin for cosmetic reasons while breastfeeding. In limited situations, a minimal amount of Botox Cosmetic has entered breast milk after nursing women received it.

Reach out to your OB-GYN about the potential risks of using cosmetic medications while pregnant or breastfeeding.

Which injection costs more, Xeomin or Botox?

The costs of getting the treatments are different for everyone, which makes it hard to compare Xeomin and Botox Cosmetic directly. Depending on how frequently you get your injections and the specific clinic you visit, the prices will vary.

In general, Xeomin may be slightly cheaper at clinics and medical spas than Botox Cosmetic, but not always. When you break it down to price per unit, you may pay between $8 to $35 per unit (in addition to any administration fees) for either medication.

Since there’s so much variability, the best bet is to contact your preferred clinic or med spa and inquire about their prices.

Savings opportunities

When medications are used for cosmetic procedures, insurance programs usually don’t help cover the costs. So it’s likely that you’ll need to pay out of pocket for these treatments. Thankfully, each manufacturer offers a savings program.

Xeomin has the Xperience+ Program, a loyalty program that offers up to $200 off each year for Xeomin injections. And Botox Cosmetic has the Allē Program, a similar membership service that offers participants the ability to earn rewards, save on special offers, and use savings toward qualifying treatments.

If you have any questions about costs, talk to a licensed clinic or medical spa in your area. They can give you more details about what you can expect to spend and also potentially suggest ways to save.

Can you use Xeomin and Botox Cosmetic together?

No, since Xeomin and Botox Cosmetic are both derived from botulinum toxin, they shouldn’t be used together. Combining them is risky and can result in serious side effects.

Your healthcare professional will determine which product is best for you and can answer any questions you may have about it.

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Written by:

Mandeep Sohal, PharmD

Mandeep Sohal, PharmD, is a licensed pharmacist in California with over 7 years of experience. In his career, he’s worked in specialty and community pharmacy, pharmacy benefit management, and pharmaceutical manufacturers.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

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