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Aesthetics Practice Today

Healthy Competition

Published November 8, 2011 8:20 AM by Cindy Cobb
First there was Botox, then there was Dysport, and now there is Xeomin (incobotulinumtoxinA). Xeomin is the latest addition to a growing list of botulinum toxin type A injectables. The Food and Drug Administration recently approved this new botulinum product to treat severe frown lines between the eyebrows, and I'm anxiously waiting for its introduction.

Botox, Dysport and Xeomin seem to have a lot in common according to the literature I've read. In particular, Xeomin, like the other two, works by paralyzing muscles. It blocks the signals from the nerves to the muscles. As a result, the targeted muscle cannot contract. All botulinum toxins must carry a boxed warning, and Xeomin is no exception.

But the three products also seem to have some important differences. Unlike its competitors, Xeomin does not need to be refrigerated. This would seem to be an advantage when it comes to distribution, making it less costly to ship. But the cost of Xeomin is predicted to be similar to that of Botox. Another difference of note is that Xeomin has no additives. Xeomin only contains botulinum toxin type A, nothing else. This nakedness should reduce a patient's likelihood of developing antibodies to Xeomin, thus increasing the probability of its desired effects.

Xeomin is said to be more like Botox, taking about 1 week for the full effects to be realized. Once this occurs, the results last from 3 to 6 months. Dysport, Xeomin and Botox should not be used interchangeably.

Having additional choices in botulinum toxin type A products will hopefully increase the likelihood of having a product that should be effective on any patient.  The topical applications are expected to debut soon. I can't wait.


Yes...I always love having choices to offer my patients.  With the introduction of Dysport it provided all those Botox failures or minor side effects an alternative.  I also loved the fact that the price of Botox did not continue to rise at the rate it had done so since it's FDA approval.  Saw a price increase every January since 2002.  And I'm looking forward to the topical botulinum toxin knowing full well it'll have its limitations but it does provide us another option....As I've already said, I love choices, not only does it provide additional choices for the patients and practitioner but also that healthy competition doesn't hurt with keeping the costs down.

Cindy Cobb, Aesthetics - Nurse Practitioner, Allure Enhancement Center November 20, 2011 7:40 PM
Lafayette LA

Very positive outlook for Xeomin in that it will not invoke an antibody response.  Some non responders to other brands may have hope. As for the topical neurotoxins, their efficacy will be in the thin dermal areas such as the axilla and lateral orbits. The proof will be in the pudding.%0d%0a%0d%0aJ. Elizabeth Gallagher%0d%0aInternational Aesthetics Educator%0d%0a

Joan Gallagher, Medical Aesthetics - Board Certified NP, Fresh Faces RX November 10, 2011 5:46 PM
Portland OR

Yes, the topical applications should debut soon. Please don't think they will be the end-all and be-all in terms of neurotoxins. They will not be nearly as exacting as the injectibles. And they are predicted to be only 50 - 60% as effective as the injectables. I would also think they would not last as long. So it's another option.

Gigi Schlueter, Medical Aesthetics - Family Nurse Practitioner November 9, 2011 5:00 PM
La Canada CA

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About this Blog

    Occupation: Physician Assistant/Nurse Practitioner
    Setting: Miami & Upland, Calif.
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