Nascent Health Clinics

Everything You Need to Know about Botox and Xeomin

JANUARY 2023 | Dr. Ashley Southern

What is Botox?

Botox injections are most commonly known for treating, softening, and preventing facial wrinkles and fine lines. However, lesser-known uses of Botox extend beyond facial cosmetics!

Botox, also known as onabotulinumtoxinA, is an injection consisting of botulinum toxin A, a neurotoxin produced by the same bacteria that cause botulism, a nerve poisoning usually found in food. This toxin works by temporarily blocking the signals between nerves and muscles. This lack of communication causes the injected muscle to relax and prevents the contractions and movements associated with wrinkle formation. Botulinum toxin A is an effective ingredient because research has shown it can decrease and/or prevent muscle activity, improve neuro responses, and increase the longevity of the filling agent (Alastair Carruthers MD, 2005). Trace amounts of botulinum toxin A are injected directly into the muscle under the skin. The number of injections required is dependent on the condition, severity, and area of the body being treated.

‍Results are typically seen within 1 – 3 days of treatment. It’s important to remember that the effects of Botox are temporary and typically last up to 3 months. While research has shown that regular Botox injections can help to slow down the rate of which symptoms return, Botox does require routine injections in order to maintain desired results.

Uses and Benefits of Botox

FDA approved, Botox can provide effective support for both cosmetic symptoms and conditions that impact vital bodily functions, including:‍

  • Chronic migraines
  • Facial wrinkles and fine lines
  • Focal dystonia including muscle spasms
  • Cervical dystonia: a condition caused by severe neck spasms and muscle contortions that can cause the neck to twist or tilt uncomfortably
  • Muscle spasticity (particularly in the arms, hands, legs and feet): a muscle control disorder caused by an abnormal increase in muscle tone and stiffness, causing muscle pain and resulting in difficulties with movement and/or speech
  • Eye muscle conditions including blepharospasm (eye spasms), twitching, uncontrolled or excessive blinking, lazy eye, and strabismus (a condition where eyes don’t point in the same direction when focusing on an object)
  • Hyperhidrosis (excessive sweating)
  • Bladder dysfunction, including incontinence caused by overactive bladder

Side Effects and Risks with Botox

Botox is not without its list of side effects, and being aware of the risks is crucial when deciding whether it’s right for you. Studies show that the plus side of Botox’s transient nature means that most side effects are typically temporary. Common side effects include:

  • Pain, bruising and swelling at injection site
  • Cold symptoms including stuffy nose, sneezing, sore throat, cough, chest congestion
  • Droopy eyelids
  • Crooked eyebrows
  • Crooked smile
  • Drooling
  • Eye dryness
  • Eye leakage

‍Less common but more serious side effects include:

  • Muscle weakness
  • Vision dysfunction including blurred or double vision
  • Difficulties speaking or swallowing
  • Difficulties breathing
  • Loss of bladder control

‍It’s important to know that Botox can be dangerous when administered incorrectly or too frequently. It is recommended that routine Botox injections be administered by a professional no sooner than 12 weeks apart. Also, it’s possible for your body to develop antibodies to botulinum toxin A, resulting in decreased effectiveness or symptoms returning more quickly. In some cases, there is a risk of botulinum toxin A spreading to other parts of the body, which can have more serious implications to your health.

What is Xeomin?

While Botox was the first drug to utilize the botulinum toxin, many other forms of treatment have since been developed, including Xeomin.

Xeomin injections, also known as incobotulinumtoxinA, work much in the same way as Botox in that Xeomin utilizes the same botulinum toxin A neurotoxin. As with Botox, it temporarily reduces muscle activity by blocking the receptive signals between nerves and muscles, temporarily decreasing or preventing muscle contraction and movement. Xeomin differs from Botox, however, in that it is manufactured in such a way that removes some of the complex proteins found in the active ingredients in Botox. Many people find Xeomin’s more concise ingredient list more appealing. Though more comprehensive research is needed, many doctors believe that Xeomin’s more purer toxin formulation may decrease the chance of developing drug resistance; Xeomin has been known to work in patients who have become unresponsive to other types of toxin treatments like Botox (Edgar, 2020).

‍As with Botox, results of Xeomin injections are typically seen within 1-3 days of treatment. As with all toxin treatments, the effects of Xeomin are temporary and typically last up to 3 months, though regular repeat injections may decelerate how quickly symptoms return.

Uses and Benefits of Xeomin

FDA approved, Xeomin has proven to be an effective treatment in both adults and children above the age of 2. The benefits of Xeomin are very similar to Botox in that they can help support a number of symptoms, including:

  • Chronic sialorrhea (excessive drooling) in both adults and children
  • Focal dystonia and muscle spasms that can cause headaches and body aches
  • Muscle spasticity particularly in arms, elbows, wrists, fingers, ankles, and toes
  • Cervical dystonia
  • Facial wrinkles and fine lines
  • Eye muscle conditions including blepharospasm
  • Bladder dysfunction including incontinence

The pros of Xeomin treatments include:

  • Requires no downtime: very fast recovery post injection
  • No anesthesia
  • Effective preventative wrinkle treatment: smooths existing wrinkles while helping to prevent new wrinkles from forming
  • Safe for all skin types
  • Has both cosmetic as well as functional benefits: known to shrink masseter muscles and other larger facial muscles, resulting in improved cosmetic results while reducing symptoms associated with jaw clenching and teeth grinding (TMJ)
  • Common side effects are minimal and transient

Side Effects and Risks with Xeomin

Potential effects of Xeomin include:

  • Pain, swelling and bruising at injection site
  • Dry mouth
  • Muscle weakness
  • Vision changes including blurred vision, eye pain, irritation, double vision
  • Trouble swallowing
  • Droopy eyelids
  • Dry eyes
  • Headache
  • Neck pain
  • Body aches
  • Swelling of eyelids
  • Crusting or leaking eyes
  • Diarrhea
  • Loss of bladder control
  • Cold symptoms including stuffy nose, sneezing, sore throat, cough, chest congestion

It is worth noting that while Xeomin is effective for smoothing and minimizing facial wrinkles and fine lines, treatments may not be able to fully erase deeper, more “etched in” wrinkles apparent when the face is at rest.

‍Further, it is important to wait at least 12 weeks between treatments. Getting Xeomin administered more frequently than prescribed does not increase its effectiveness, and may result in overdose symptoms including:‍

  • Severe muscle weakness
  • Weak or shallow breathing
  • Difficulties swallowing
  • Loss of movement and bodily autonomy

Some medications may increase the risk of side effects. It is important to disclose any and all medication, vitamins and supplements you are taking with your healthcare provider when discussing whether Xeomin is right for you. Such medications include:

  • Antibiotics
  • Muscle relaxers
  • Cold and allergy medication
  • Depression, anxiety, and mood disorder medication
  • Medication for treating Parkinson’s disease
  • Medication for stomach issues including motion sickness or irritable bowel syndrome (IBS)
  • Medication for overactive bladder
  • Bronchodilator asthma medication‍

As is common when beginning any new therapeutics, there are pros and cons and potential side effects that can occur – it is important to choose a provider with appropriate training and thorough knowledge of the anatomy of the area you are injecting. Schedule a consult with Dr. Southern today to discover how Xeomin can enhance your skin and prevent aging!


Alastair Carruthers MD, J. C. (2005). Use of Botulinum Toxin Type A in Facial Rejuvenation. In Surgery of the Skin. Retrieved from ScienceDirect.

Edgar, J. (2020). Xeomin: What You Need to Know. Retrieved from RealSelf: