Botox vs Xeomin: Key Differences and How to Choose

What Is Botox?

Botox Cosmetic (onabotulinumtoxinA) is a prescription injectable made by Allergan, an AbbVie company. It temporarily relaxes the specific facial muscles that crease your skin every time you frown, squint, or raise your eyebrows. When you express your emotions, your facial nerves release a neurotransmitter called acetylcholine. This chemical tells your muscles to contract. Over time, those repeated movements carve lines into your skin.

Botox blocks that signal, so your muscles relax and the overlying skin looks smoother. During manufacturing, Allergan wraps the active molecule in protective accessory proteins. We’ll come back to these proteins when we compare formulas.

The FDA approved Botox for four main cosmetic treatments. It smooths moderate glabellar lines (vertical lines like an ‘11’ between the brows), lateral canthal lines (crow’s feet on the outer corners of the eyes), and horizontal forehead lines. In October 2024, the FDA also approved Botox for vertical neck bands, also known as platysma bands.



Apart from cosmetic use, doctors use medical Botox to treat a variety of conditions. The FDA separately approves Botox to manage chronic migraine symptoms in individuals over 18 who experience headaches for more than 2 weeks in a month, as well as Botox for excessive underarm sweating (hyperhidrosis) and an overactive bladder. Qualified injectors often use it off-label to treat the jaw joint on each side of your face (TMJ) and prevent teeth grinding.

What Is Xeomin?

Xeomin (incobotulinumtoxinA) is a prescription injectable produced by Merz Aesthetics. It relaxes facial muscles like Botox, but its purification process differs. During manufacturing, the active toxin is separated from its complexing proteins, which is why Xeomin is often nicknamed the “naked neurotoxin.”

The FDA first approved Xeomin in 2011 to treat glabellar lines. In July 2024, the FDA approved the product to treat horizontal forehead lines and crow’s feet. This made Xeomin the first neurotoxin approved to treat all three upper facial lines simultaneously using up to 64 units.



Xeomin can also provide medical treatments. It is prescribed for chronic drooling (sialorrhea), upper limb spasticity, cervical dystonia (painful neck muscle spasms), and blepharospasm (eyelid twitching).

What Is the Difference Between Botox & Xeomin?

The main difference between Botox and Xeomin treatments in San Marcos is the formulation. Xeomin contains no accessory proteins, and unopened vials do not need to be kept in a refrigerator. Both products are FDA-approved to treat frown lines, forehead lines, and crow’s feet at the same labeled doses. The two products are more alike than different, and the practical differences come down to approved areas, storage, and cost, which we discuss in more detail below.

Formulation and Accessory Proteins

Botox and Xeomin both start with the same active ingredient: botulinum toxin type A. The key difference is how each product is packaged. Botox contains the toxin plus accessory proteins, sometimes called complexing proteins. Xeomin contains only the purified toxin, with no accessory proteins. Both products also include human albumin as a stabilizer to keep the formula consistent from vial to vial.

Why does this matter? Some experts believe that, over many repeat treatments, the extra proteins in Botox may prompt a small number of people to form neutralizing antibodies. Those antibodies can weaken the body’s response and, in rare cases, lead to reduced response or even treatment resistance. 



This is one reason injectors may suggest Xeomin when Botox seems to wear off sooner than it used to. That said, both product labels warn that any botulinum toxin can trigger antibodies. They also state that antibody rates cannot be compared between products because testing methods differ, so Xeomin is not “resistance-proof,” and no one can guarantee you will never become a non-responder.

FDA Approved Treatment Areas

Both products are FDA-approved to treat the three major upper-face concerns. These include moderate to severe glabellar lines (the 11 lines between your brows), horizontal forehead lines, and lateral canthal lines (crow’s feet). 

Only two main approval differences exist between the brands.

• Botox Cosmetic has FDA approval only to treat vertical platysma bands (neck bands).
• Xeomin holds explicit FDA approval to treat all three upper facial lines simultaneously in a single session.



Injectors also treat other areas off-label, like bunny lines (the wrinkles next to your nose) or gummy smiles. To learn more about standard treatment areas, check out our guides on treating frown lines and forehead wrinkles.

Onset and Duration of Results

So, which lasts longer? In a head-to-head study, Botox and Xeomin gave similar frown line results over four months, so neither has a proven longevity advantage. Onset is similar for both: most people see the first changes within a few days, feel the product kick in over the first week, and reach full results at around two weeks. How long Xeomin lasts and how long Botox lasts varies by person. But many patients schedule a touch-up or retreatment interval at three to four months. Metabolism, muscle strength, and total dose all influence how long the results last.



Regardless of the brand you choose, safety labels recommend a treatment interval of about three months. Read our breakdown on how to schedule a touch-up to learn more about Botox maintenance.

Units and Dosing

Standard labeled doses are the same for both products. 20 units for frown lines (distributed across five injection sites), 24 units for crow’s feet, and 40 units for treating forehead and frown lines. Xeomin allows up to 64 units when treating all three upper face areas at once.

We tailor your dose based on your unique physical attributes.

Cost

When comparing Botox vs Xeomin cost, patients often ask: Is Xeomin cheaper than Botox? Xeomin price per unit is slightly lower than the average Botox price per unit across providers.

Take advantage of our cost savings through our Diamond Membership program.

Prices as of September 2026. View our full pricing page for current rates and membership discounts.

Side Effects and Safety

Common Botox and Xeomin side effects are similar and usually mild and temporary. Individuals may experience minor bruising, swelling, or tenderness at the injection site, along with temporary headaches.

As per clinical trials, specific reaction rates include:

• Botox cosmetic label. Eyelid drooping or ptosis (3%), brow ptosis (2%), and headache (9%).
• Xeomin label. Headache (5% vs. 2% on placebo) and injection site bruising (2% vs. 1% on placebo).

Both products carry a boxed warning. Seek immediate emergency care for any difficulty swallowing, speaking, or breathing. No trial proves Xeomin causes fewer side effects, so using a licensed injector matters more than the actual product label. To avoid unsatisfactory results, review common Botox mistakes.

Storage and Handling

Unopened Botox vials require strict refrigeration between 36°F and 46°F, whereas unopened Xeomin vials are safe at room temperature (up to 77°F). This temperature range makes shipping easier and extends shelf life. Once either product is opened, both require refrigeration and must be used within 24 hours. 

Can You Switch Between Botox and Xeomin?

Yes, you can switch from Botox to Xeomin, and back again at a later appointment when your injector changes your plan. Because no studies have shown the safety of using different botulinum toxin products in the same session, we never combine products during one visit. Before we can switch treatments, we need to know your treatment history. It helps to mention whether you noticed your previous treatment wearing off too soon or a reduced response.

Botox or Xeomin: Which Is Right for You?

Here’s what we tell our clients. While both products deliver effective results, the right choice depends on your goals, history, and budget.

We recommend Botox for:

• Brand-loyal individuals. You have received Botox for years with consistent results and have no reason to change your routine.
• Neck band treatment. You want to target vertical platysma bands along your neck, an area uniquely approved for Botox.
• Predictable timing. You prefer a product with ample clinical data tracking onset and duration.

We recommend Xeomin for:

• Budget-conscious clients. You want to reduce your spending while still getting smoothing results.
• Developing tolerance. You’ve noticed your Botox treatments wearing off faster than before and want a longer-lasting solution.
• Comprehensive sessions. You prefer a single treatment session that treats all three upper facial areas at once.

Botox and Xeomin at The Studio Med Spa

These products share similarities. Each is FDA-approved for upper facial lines at matching doses. The differences are in the formulation, unique neck band treatment ability, storage needs, and pricing.

Your individual muscle structure dictates your approach, so scheduling a consultation helps you plan your treatment. Our experienced team, including aesthetic nurse Kendra and lead consultant Trevor, carefully evaluates your aesthetic goals and treatment history under medical supervision. 

Visit us at our San Marcos location (310 S. Twin Oaks Valley Rd., Suite 109) or our Rancho Penasquitos clinic (9995 Carmel Mountain Road, Suite B3). You can easily book online today to explore our full line of neuromodulator treatments.

Frequently Asked Questions