Botox vs. Xeomin: What Are the Differences & What’s Right for You?
In the world of aesthetics, botulinum toxin type A treatments are among the most trusted and effective options for softening fine lines, smoothing facial wrinkles, and restoring a refreshed, youthful look. Two of the most popular brands are Botox and Xeomin, both FDA-approved injectables that work by relaxing facial muscles to reduce expression lines.
While these treatments may appear nearly identical, subtle differences in formulation, onset, and longevity can influence which option is best for you. Below, the experts at Thrive Med Spa break down everything you need to know about Botox vs. Xeomin, including how they work, what sets them apart, and how to decide which treatment aligns with your aesthetic goals.
Key Takeaways
Both Botox and Xeomin smooth wrinkles effectively, but Xeomin’s pure, additive-free formula may lower the risk of resistance over time.
Results appear within days and last 3–4 months for both treatments, with Xeomin sometimes working slightly faster.
Choosing between them depends on your goals and history. Botox offers proven longevity, while Xeomin suits those wanting a cleaner or more cost-effective option.
What Are Botox and Xeomin?
Both Botox and Xeomin belong to the same family of botulinum toxin type A products, which are purified proteins that temporarily block nerve signals to the muscles responsible for frown lines, forehead wrinkles, and crow’s feet. When used correctly, they help smooth facial wrinkles while preserving natural expression.
Overview of Botox
Botox Cosmetic is the original and most recognized botulinum toxin brand, developed by Allergan and approved by the FDA in 2002 for cosmetic use. Over the last two decades, it has become a cornerstone in aesthetic medicine, used by plastic surgeons, dermatologists, and advanced injectors worldwide.
Botox works by targeting the connection between nerves and muscles, temporarily preventing muscle contraction in the treated area. This results in smoother skin and softened dynamic lines, minimizing wrinkles formed by repetitive movement such as squinting or raising the brows.
Overview of Xeomin
Xeomin (incobotulinumtoxinA) is a newer formulation of botulinum toxin type A, approved by the FDA in 2011. Like Botox, it temporarily relaxes facial muscles to reduce wrinkles, but it differs in one key way: Xeomin contains only the active neurotoxin molecule without any added accessory proteins.
Because of its “naked” formulation, Xeomin is sometimes referred to as a pure botulinum toxin injection, which may reduce the likelihood of allergic reactions or resistance over time. It’s an excellent alternative for clients who have used Botox for years or who prefer a cleaner, more minimalist approach to their cosmetic treatment.
How Do Botox and Xeomin Work?
Both Botox and Xeomin use botulinum toxin type A to block nerve signals that trigger muscle contraction. Once injected, the toxin binds to the nerve endings at the injection site, preventing the release of acetylcholine, which is the neurotransmitter responsible for muscle movement.
By temporarily relaxing these facial muscles, the skin above them smooths out, leading to the reduction of forehead lines, crow’s feet, and frown lines. The result is a more refreshed, rested, and balanced appearance without altering natural expression.
Key Differences Between Botox and Xeomin
Formulation
The most significant difference between Botox and Xeomin lies in their formulation.
Botox includes accessory proteins that surround the active botulinum toxin type A molecule.
Xeomin, by contrast, is a “naked” neurotoxin containing only the active ingredient without any complexing proteins.
This difference may make Xeomin less likely to cause antibody development or immune resistance, particularly in patients who receive frequent botulinum toxin injections.
Onset of Action
Both injectables begin working within the first few days, but some studies suggest Xeomin may show results slightly sooner due to its pure composition.
Botox: Results typically appear in 3–5 days, with full effect at 10–14 days.
Xeomin: Results may begin in 2–4 days, reaching full effect within 7–10 days.
Response time can vary depending on metabolism, muscle strength, and the area treated.
Duration of Results
Both Botox Cosmetic and Xeomin last approximately 3–4 months, though some patients experience up to 5 months of effect depending on their muscle activity and treatment consistency. Over time, results often last longer with regular treatments, as the targeted muscles gradually weaken and adapt to reduced movement.
Immunogenicity (Resistance Risk)
One of Xeomin’s biggest advantages is its low risk of immunogenicity — the body’s potential to develop antibodies that reduce treatment effectiveness. Because Xeomin lacks added proteins, it is considered less likely to cause resistance or “tolerance” over long-term use.
For clients who have used Botox for many years or noticed diminishing results, switching to Xeomin can sometimes restore optimal efficacy.
Cost Considerations
The cost of Botox vs. Xeomin is typically comparable, though Xeomin can be slightly more affordable depending on the provider. The total price depends on factors like the number of units needed, the treatment area, and injector expertise.
At Thrive Med Spa, we will customize your plan based on your facial anatomy and goals, ensuring you achieve natural results that fit your aesthetic vision.
Exploring the Pros and Cons of Botox vs. Xeomin
Botox Pros
Extensive clinical history and global recognition
Proven safety and reliability over decades of use
Widely available and supported by strong FDA approval data
Predictable, consistent results for a range of cosmetic and medical conditions
Botox Cons
Contains accessory proteins
May take slightly longer to take effect
Can be marginally more expensive in certain regions or practices
Xeomin Pros
Pure botulinum toxin type A formulation with no accessory proteins
Lower risk of antibody development
Potentially faster onset in some patients
Slightly more affordable depending on provider
Xeomin Cons
Newer on the market with less brand recognition
May require dose adjustments when switching from Botox
Some clients feel results are subtly softer compared to Botox’s firming effect
What Conditions Do They Treat?
Cosmetic Uses
Both Botox and Xeomin are commonly used in cosmetic procedures to address dynamic facial wrinkles, including:
Frown lines (between the brows)
Forehead lines
Crow’s feet (around the eyes)
Bunny lines (on the nose)
Lip lines, chin dimpling, and jawline definition
They can also be used for advanced aesthetic techniques such as masseter slimming, brow lifts, and neck rejuvenation, offering natural, balanced results when performed by skilled injectors.
Medical Uses
Beyond aesthetics, both injectables are approved and used to treat several medical conditions, including:
Cervical dystonia (muscle spasms in the neck)
Chronic migraines
TMJ pain and jaw tension
Eyelid spasms (blepharospasm)
These FDA-approved therapeutic uses highlight the versatility and medical safety of both products under professional care.
Side Effects and Safety
Common Side Effects
Both treatments are considered very safe when administered by trained professionals. Common, mild side effects may include:
Slight redness or swelling at the injection site
Temporary bruising or tenderness
Mild injection site pain
Subtle muscle weakness near the treated area
These effects typically resolve within a few hours to days.
Rare Risks
Rarely, more serious reactions can occur, such as temporary eyelid drooping, asymmetry, or unintended muscle relaxation. Extremely rare allergic reactions to the product are possible, though less likely with Xeomin due to its pure formulation.
When administered by qualified injectors who understand facial anatomy, these risks are minimal.
Safety Tips
Choose a licensed medical spa or provider with expertise in botulinum toxin injections
Avoid rubbing or massaging the treatment area for 24 hours
Stay upright for at least 4 hours post-treatment
Delay strenuous exercise, alcohol, or saunas for one day
Always discuss your medical history and medications before treatment
At Thrive Med Spa, every client receives a personalized consultation to ensure both safety and exceptional results.
How to Decide Between Botox and Xeomin
Questions to Consider
When deciding between Botox vs. Xeomin, think about the following:
Have you had previous treatments with botulinum toxin type A?
Do you prefer a brand with a long clinical history (Botox) or a purer, newer option (Xeomin)?
Have you experienced diminished results over time, suggesting possible antibody development?
What is your budget, and how important is onset speed or longevity to you?
Your injector will guide you through these considerations to help determine which product best suits your lifestyle and aesthetic goals.
When Botox Might Be Best
Botox may be the right choice if you:
Are new to cosmetic treatment and want a trusted, well-documented product
Have deeper or more resistant forehead wrinkles or frown lines
Prefer the confidence of a long-established injectable backed by extensive data
When Xeomin Might Be Best
Xeomin may be ideal if you:
Have developed mild tolerance to Botox or notice shorter-lasting results
Prefer a pure, additive-free formulation
Want a cost-effective treatment with similar results
Are interested in minimizing your risk of immune resistance for long-term use
Want to Learn More About Botox Treatment? Schedule a Consultation with the Thrive Med Spa Team
Choosing between Botox and Xeomin doesn’t have to be complicated. At Thrive Med Spa, our experienced injectors will evaluate your facial anatomy, muscle strength, and goals to recommend the best approach for your features. We specialize in natural, balanced results that honor your unique expression.
About Thrive Medical Spa
Located in historic downtown Milford, Ohio, Thrive Med Spa is a destination for refined, evidence-based aesthetic and wellness care. Our services include botulinum toxin injections, dermal fillers, microneedling, Sculptra, and medical-grade skincare, all tailored to help you look and feel your best.
Whether you’re exploring Botox Cosmetic, Xeomin, or a combination of both, our mission is to enhance confidence through thoughtful artistry and clinical expertise. Schedule your complimentary consultation today to begin your journey toward a refreshed, radiant you.
Frequently Asked Questions (FAQs)
What is the difference between Botox and Xeomin?
The main difference lies in formulation. Botox contains accessory proteins surrounding the active neurotoxin, while Xeomin is a pure form of botulinum toxin type A with no additives. This makes Xeomin less likely to trigger antibody resistance.
Is 20 units of Xeomin the same as 20 units of Botox?
Yes, unit for unit, Xeomin and Botox are equivalent in strength and dosing. However, your injector may tailor doses based on your muscle activity and treatment area.
Which lasts longer: Xeomin or Botox?
Both last about 3–4 months. Some patients report slightly longer results with one product over the other, depending on their body’s metabolism and treatment consistency.
Does Xeomin work faster than Botox?
Some people notice Xeomin results a day or two sooner, likely due to its pure formulation. Both achieve full results within two weeks.
Does Xeomin look more natural than Botox?
Both can deliver natural-looking results when injected properly. Xeomin’s formulation may feel subtly lighter for some clients, but the outcome depends far more on injector skill than product type.
Is Xeomin as safe as Botox?
Yes. Both are FDA-approved, well-studied, and safe when administered by licensed professionals.
Are there different side effects between Xeomin and Botox?
Both share similar, minimal side effects, including mild redness or tenderness at the injection site. Xeomin may have a slightly lower risk of allergic reactions due to its lack of accessory proteins.
Is Xeomin better for long-term use?
Xeomin may be better for long-term use in clients who receive frequent treatments, as its pure formulation reduces the chance of antibody development or muscle resistance.
Can you switch from Botox to Xeomin?
Yes, many clients transition between the two seamlessly. Your provider will adjust dosing to match your prior botulinum toxin response.
How much cheaper is Xeomin than Botox?
Pricing varies by provider and region, but Xeomin can be 5–15% less expensive on average. Both treatments remain highly cost-effective options for maintaining smooth, youthful skin.