Botox vs. Xeomin: What's the Difference?
Both smooth wrinkles by relaxing facial muscles. Both use botulinum toxin type A. So why choose one over the other? Here's an honest comparison from providers who offer both.
The Key Difference
Purity vs. Track Record
Botox contains the active botulinum toxin plus accessory proteins that help stabilize the product. It's been FDA-approved since 2002 with extensive long-term data.
Xeomin is a "naked" neurotoxin—pure botulinum toxin without those accessory proteins. The theory: fewer proteins = less chance of developing antibodies that reduce effectiveness over time. FDA-approved in 2011.
In practice? Results are virtually indistinguishable. Most patients can't tell the difference. The choice often comes down to personal preference, past experience, and pricing.
Botox
OnabotulinumtoxinA (Allergan)
The original cosmetic neurotoxin. FDA-approved for frown lines in 2002, with over 20 years of clinical data. Contains the active toxin plus complexing proteins that help stabilize the product.
Botox is often considered the "gold standard" simply because it's been around longest and has the most extensive safety record.
Xeomin
IncobotulinumtoxinA (Merz)
The "naked" neurotoxin. FDA-approved in 2011. Xeomin undergoes an extra purification step to remove accessory proteins, leaving only the active therapeutic component.
This may reduce the risk of developing antibodies—though antibody resistance is rare with any neurotoxin (affecting less than 1% of patients).
Side-by-Side Comparison
How Botox and Xeomin compare across key treatment factors.
| Factor | Botox | Xeomin |
|---|---|---|
| Active Ingredient | Botulinum toxin type A | Botulinum toxin type A |
| Formulation | Toxin + complexing proteins | "Naked" toxin (purified) |
| FDA Approval | 2002 (longer track record) | 2011 |
| Onset Time | 3-5 days | 3-5 days |
| Full Effect | 10-14 days | 10-14 days |
| Duration | 3-4 months | 3-4 months |
| Storage | Requires refrigeration | Room temperature OK |
| Antibody Risk | Very low (<1%) | Theoretically lower |
| Spread Pattern | Slightly more diffusion | Slightly more precise |
| Treatment Areas | Forehead, glabella, crow's feet, etc. | Forehead, glabella, crow's feet, etc. |
Who Should Consider Each?
For most patients, either product works great. But certain factors might tip the scale.
Consider Botox If:
- You've used Botox before and are happy with results
- You want the product with the longest safety track record
- Your provider has more experience with Botox
- You're treating larger areas where diffusion is beneficial
- You prefer the "original" with most clinical data
Consider Xeomin If:
- You've developed resistance to Botox (very rare)
- You prefer a "cleaner" formulation without additives
- You've had reactions to Botox in the past
- You want more precise placement with less spread
- You're looking for potentially better value pricing
Frequently Asked Questions
No—studies show equivalent efficacy between Botox and Xeomin. Both smooth wrinkles effectively with similar onset times and duration. Most patients can't tell the difference in results. The choice is more about formulation preference than effectiveness.
Some patients report Xeomin working slightly faster, but clinical studies show similar onset times (3-5 days for both). Full results take 10-14 days with either product. Individual variation matters more than product differences.
Yes, absolutely. Many patients try both and stick with their preference. There's no waiting period required between products. Some people alternate based on pricing or availability.
Pricing varies by provider. At Highland Longevity, we price both competitively. Xeomin is sometimes slightly less expensive, but the difference is usually minimal. Both are typically priced per unit.
Dysport and Jeuveau are also botulinum toxin type A neuromodulators with similar effects. Dysport may have a faster onset and wider spread; Jeuveau (the "Newtox") is essentially equivalent to Botox. We can discuss all options during your consultation.
Not Sure Which Is Right for You?
Book a consultation and we'll recommend the best option based on your goals, treatment areas, and personal preferences.