Xeomin® – A New Competitor to Botox®?

In Canada – We only had one thing to save us from frowning and looking angry even when we were not – Botox® was the only game in town to treat pesky frown lines and other wrinkles made worse by repeated action of some facial muscles. Well, earlier this year (2012) – Health Canada approved another form of botulinum toxin type A – Xeomin®. Not only was it approved, but it is also available for the treatment of frown lines. That's right folks – for the very first time in Canada consumers and doctors will have a choice in the product they choose to treat frown lines. The question is – is Xeomin® (the brand name of the new product) the same, worse or better than Botox®?


What is Xeomin®?

Xeomin® is a form of botulinum toxin type A that is free from complexing proteins. This is in contrast to Botox®, which is also botulinum toxin type A but it also has other complexing proteins. The significance of this difference for doctors and patients is not fully known and, at this point, it may just be semantics. I think that future research will need to address this subtle difference and answer the question - Does the quantity and type of additional proteins make the product safer, more effective and generally better than the other? Dr. Sapijaszko and his team will discuss your unique needs and concerns during a confidential consultation


How does Xeomin® differ from Botox®?

As I mentioned above, Xeomin® and Botox® have the same active ingredient - botulinum toxin type A. The products are vacuum packed and are stabilized in a glass container. Botox®, in addition to the active molecule, also has complexing proteins whereas Xeomin® does not. The significance of this difference, as mentioned, is not currently known.

In addition to some differences in product composition, Xeomin® can be stored at room temperature as opposed to Botox® which needs to be refrigerated. This subtle difference makes Xeomin® a little easier to handle, as it is more eco-friendly. Both products need to be refrigerated after the molecules have been reconstituted. Both Xeomin® and Botox® come in medical as well as cosmetic forms such as Xeomin Cosmetic™ and Botox Cosmetic™.


What can Xeomin® be used for?

Each new product is specifically approved to treat a particular condition and, in the case of Xeomin®, it is approved in Canada for the temporary improvement in the appearance of moderate to severe glabellar lines, also known as frown lines between the eyebrows. That approval was based on a large number of studies that assessed it effectiveness and safety in more than 800 patients. In these studies, Xeomin® has been compared to a placebo (injections that did not contain any active ingredient). The results were very impressive with the Xeomin® treated patients having an improvement in frown lines compared to those that did not receive active drug.


What are the side effects of Xeomin®?

As is the case with Botox®, Xeomin® is also precisely injected into the muscles that cause facial lines to form. The purpose of the injections is to relax the muscles so that their wrinkle forming ability is reduced. As such, fewer wrinkles are visible and, in some cases, there are no wrinkles left. As can be expected, some of the side effects of Xeomin® injections are bruising, uneven results or, in rare cases, drooping of the eyelid. These potential side effects are not common and reverse over time without lasting consequences. Although it is not possible to eliminate all side effects, having a qualified doctor or nurse perform the injections can limit the risk of these unwanted side effects.


How does Xeomin® work?

Xeomin Cosmetic™ is used in adults for the temporary improvement in the appearance of moderate to severe frown lines. Xeomin Cosmetic™ is a medicine that relaxes the muscles. Just like Botox Cosmetic™, it is injected with very small needles into the muscle that needs to be treated. Once in the muscle region, the active molecule binds with its target and causes the injected muscle to relax. This relaxation is very precise and results in the muscle moving less, smoothing out the skin.


How long does Xeomin® last?

The duration of Xeomin® effects depends on each individual's anatomy, the size of the muscles treated as well as the amount of Xeomin® used. The most recent studies indicate that the effects of Xeomin® are similar to those of Botox® depending on the number of units (dose) used. On average, the patients choose to have their areas retreated every 3-4 months. This frequency is just an average as some patients may need more frequent treatments whereas others can get away with less frequent treatments.


Is Xeomin® better than Botox®?

That is a million dollar question. Studies comparing both preparations have had mixed results and the final verdict is still out. Over time, we may have a winner but it is also possible that both products are almost equivalent or, one may be better for the treatment of one area of concern whereas the other is better for another area. I think that, at the end of the day, it is the patients and treating physicians who will decide. Dr. Sapijaszko and his team will discuss your unique needs and concerns during a confidential consultation

It is important to note that, although both Xeomin® and Botox® are dosed in units, a unit of Xeomin® is not interchangeable with a unit of Botox®. Although the active ingredient in both preparations is the same, the two products are not the same.

In conclusion, it is important for medical practitioners to be familiar with both products so that we have appropriate and balanced information and advice for our patients. We must always strive to do what is in the best interest of our patients and when this principle is applied, we can be confident of a job well done.

Botox® or Xeomin® is not for everyone but it may be very helpful for most people looking to improve their facial appearance. For a confidential consultation, please call us at 780-424-4440 or email us. Dr. Sapijaszko and his team will be glad to see you.

Xeomin® and Xeomin Cosmetic™ are the registered marks of Merz Pharma.

Botox® and Botox Cosmetic™ are the registered marks of Allergan, Inc.


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