Written by Karen Vieira, PhD MSM
Xeomin (incobotulinumtoxinA) is an injectable medication used in non-surgical treatments of certain facial wrinkles associated with aging. It contains botulinum toxin A as its active ingredient, the same type of medication used in the well-known similar medication “Botox.”
Xeomin works by paralyzing and relaxing muscles, so it has uses for medical and cosmetic procedures targeted at releasing unwanted effects of muscle tension.
Its medical applications include treating:
- Chronic muscle spasticity
- Excessive drooling
- Blepharospasm (spasticity around the eyes that forces the eyelids shut).
In this article we will focus on Xeomin’s cosmetic indications:
- Treatment of glabellar lines – the wrinkles that form between the eyebrows
Xeomin is purported to contain a more purified version of botulinum toxin A than do similar products. This means that it is less likely to cause allergic reaction and people are less likely to develop resistance to its effects with repeat treatments.
When used for cosmetic purposes, Xeomin uses a natural muscle paralyzer obtained from the bacteria Clostridium botulinum to relax or paralyze muscles that cause facial wrinkles.
Some types of face wrinkles are caused by tension from the muscles under the skin. Facial expressions and other movements of the muscles under the skin of the face cause the skin to bend and fold, but the skin’s natural elasticity allows it to spring back to its proper form once the muscles relax.
However, as we age, our skin loses its elasticity, and the skin doesn’t spring back to its original supple form as well when the facial muscles relax. The result is the well-known lines and wrinkles that come with age.
By relaxing and paralyzing the muscles under the skin wrinkles, Xeomin smooths the skin and reduces the appearance of these age-related skin defects.
Xeomin may be used cosmetically to treat moderate to severe “frown lines” between the eyebrows (glabellar lines), but is not used to treat any other kinds of facial lines or wrinkles.
Xeomin should only be used in people who are at least 18 years of age.
Xeomin should not be used for women who are or may be pregnant, or who are breastfeeding.
You should not get this treatment if you have an allergy to botulinum, or if you have an active infection or rash in the treatment area.
There are certain medical conditions and medications that can make you a poor candidate for injections; be sure that your doctor is aware of your medical history before treatment.
You should advise your treating healthcare professional if you have used other botulinum toxin fillers, including previous Xeomin, Botox, or Dysport in the previous four months, as you may not be able to receive a Xeomin treatment.
Xeomin treatments typically take place in a doctor’s office and usually take 10-30 minutes. The injection should always be performed by a doctor, nurse, or other healthcare professional specifically trained and certified in doing these kinds of injections.
Generally, there is very little discomfort involved – at worst a small “pinch” sensation – so no anesthesia is required. However, some injectors may use ice to numb the area, or may offer to use a topical or local anesthetic.
Using a thin needle, Xeomin is injected directly into the targeted muscle. Depending on the area being treated, the process may include more than one injection to the same area of the muscle or to two different locations. Usually 3-5 injections into the same area are required.
The most common side effects of Xeomin when used for treating glabellar lines include:
- Headache (the most common side effect)
- Dry mouth
- Pain or discomfort at the injection site
- Neck pain
- Muscle weakness
- Dry eyes
- Drooping or swollen eyelids
- Blurred or double vision (people who experience eye pain or irritation should seek medical help immediately)
While rare, Xeomin – like other botulinum toxin products – may spread from the site of injection to other parts of the body. This may cause serious and even life threatening side effects, such as:
- Muscle weakness in areas other than the treated skin
- Double vision
- Urinary incontinence
- Generalized muscle weakness
- Difficulty swallowing, speaking or breathing
- Allergic reaction (itching, hives, chest tightness, severe swelling).
Xeomin injections are skill-dependent, so the potential for side effects are related to the experience and skill of the healthcare provider.
After a Xeomin treatment, you are free to leave the doctor’s office and will likely require no downtime. For this reason, Xeomin injections are sometimes referred to as a “lunchtime facelift.” Most people are able to carry on with their normal daily routine immediately after a treatment, including returning to work.
During the first three days after treatment you should avoid rubbing or touching your face as this can cause the injected material to spread to nearby muscles. It is also important to keep your head and neck elevated during this time.
On the day of a Xeomin treatment, some precautions are advised:
- Do not lie down for four hours after the treatment
- Do not massage or apply heat to the area treated
- Avoid activities that cause flushing (such as sitting in a hot tub, exercising, or drinking alcohol)
The results of a Xeomin treatment are not immediately apparent. Results begin to appear 8-10 days after the injections, with maximum results taking up to two weeks to appear.
The results usually last for 3-6 months, so repeat treatments will be necessary to maintain the effects.
The cost of Xeomin injections is around $400 to $800 per treatment session. The exact cost depends on several factors:
- The amount of Xeomin product used
- The number of areas injected
- Your geographic area
- The skill level and fee schedule of the injector
Cosmetic injections are seldom covered by health insurance. However, many doctors offer financing options and flexible payment plans to make this treatment more affordable. Many also offer treatment plans so that follow-up treatments are less costly.
- Merz Aesthetics. (2019). Highlights of prescribing information: Xeomin (incobotulinumtoxinA). Retrieved from https://www.xeominaesthetic.com/wp-content/uploads/2019/05/XEOMIN-Full-Prescribing-Information.pdf
- Merz Aesthetics. (2019). Xeomin (incobotulinumtoxinA) [Product website]. Retrieved from https://www.xeominaesthetic.com/