Everything You Need to Know About Xeomin, the Botox Alternative

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We've all heard the rumor circulating that, when injected enough times with Botox, your body has the ability to become immune to the toxin, rendering its muscle-freezing abilities useless. When your go-to treatment has started to lose its magic touch, rest assured that you have another option in Xeomin. Though we've only just heard about Xeomin, the treatment has been around in the dermatology and medi-spa worlds for years, and patients who have tried it claim it's so similar to Botox, they can't tell the difference in the end result. "We've been using Xeomin in our practice for around 3 years now, but when it was initially coming to market, it was a bit slower to launch with Botox and Dysport as its competitors," explains San Antonio-based dermatologist Dr. Vivian Bucay. "I offer all three because it's our job as dermatologists to be familiar with the alternatives out there, so we can determine which is the best option for specific patients." We asked Dr. Bucay to give us all the details on how the treatment works, who is the best candidate, and what differs between this formula and its injectable counterparts. Read on for your crash course in the treatment, either if you're considering it, or for the sake of pure curiosity.

What Is Xeomin, and What Does It Do?

Xeomin is a form of botulism toxin that is used to block muscle movement in areas that contribute to wrinkles. It is used in the forehead, typically between the brows to soften frown lines. Unlike filler, Xeomin only impacts muscle movement, and has no effect on filling deep wrinkles that have already formed. The same ingredients in Botox and Dysport are used, though Xeomin is somewhat of a purer form of the toxin.

Wait, So It's the Same Thing as Botox?

Minus a few proteins. "With Botox or Dysport, the active part of the toxin is encapsulated in complexing and accessory proteins, and this was by design," says Dr. Bucay. "What's different about Xeomin is that it undergoes an extra step of purification so that there is no complexing protein." When explaining the differences to her patients, Dr. Bucay likens Botox, Dysport, and Xeomin to three separate M&M candies—while the first two may have red or green outer shells, the third, representing Xeomin, is just the chocolate core. "The middle, active portion is the same in all of them, so it behaves the same way as Botox and Dysport," she adds. The only key differences are on the side of the physician administering the treatment, as Xeomin does not require refrigeration, and the vial must be flipped instead of swirled to ensure the ingredients are dissolved.

Who Is a Better Candidate for Xeomin Over Botox?

Because Xeomin leaves the complexing and accessory proteins out of the mix, it's a good alternative for those who feel their Botox and Dysport treatments just aren't working the way they used to. "If someone were to react and become immune to Botox, then it's very possible that they are becoming immune to the proteins coating the active part," she tells us. "Because Xeomin does not have the extra proteins on the outside, it is much less likely that they will develop antibodies for it." Dr. Bucay notes that in a double-blind study comparing Xeomin and Botox, both the doctors and patients couldn't tell the difference of the end result between the two formulas, although many patients noted that there was less of a tight Botox-esque feeling in the areas where Xeomin was injected once it started kicking in. "If you don't want to feel the tightness as much, then you're a good candidate for Xeomin," she says. "It is a little less expensive across the board, so knowing both work equally well, you can consider Xeomin if cost is an issue, but I wouldn't choose a treatment based solely on that."

How Long Does It Last?

Just like Botox and Dysport, Xeomin typically lasts anywhere from 3 to 4 months, but many users claim it starts to take effect much quicker than the alternatives, which take anywhere from a day to 10 days to kick in.

What Should I Avoid Post-Treatment?

"I tell people not to rub or scratch the area, or use treatments that involve applying heat directly to the skin, as heat can slow down the binding of Xeomin in the same way it does with Botox and Dysport," Dr. Bucay explains. "The old wives tales of not laying down or having to be really still don't apply, so you're good as long as you don't manipulate the treated area."

How Can I Find a Practitioner?

Let the official xeomin.com website be your guide. "If a physician has a Xeomin account, then they'll be listed on the website," Dr. Bucay says. "You'll want to make sure you visit someone who is a board-certified dermatologist, plastic surgeon, or a doctor trained in facial plastics."

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