Is Xeomin the New Botox?

here’s a new dermal filler in town—at least, there will be soon. Just last month, the FDA approved a botulinum toxin made by Merz Aesthetics called Xeomin; Merz says it will be available nationwide as early as the spring of next year. Already approved for use in many European countries (under a different name, “Bocouture”)—including France, Italy, Spain, Germany, and the UK—Xeomin has been found to significantly reduce glabellar (wrinkle) lines. Once introduced in the U.S., it will join the ranks of Botox competitors—but unlike those competitors (such as Dysport, which requires a different dosage system), it is purported to have unit-to-unit equivalence with Botox. This similarity to Botox may give Xeomin a competitive edge over Dysport and other fillers, both in terms of pricing and of doctor preference.

What makes Xeomin different from all of its competitors, including Botox, is that its makeup does not include complexing proteins—it’s a “naked toxin.” This lower protein load doesn’t appear to change how the external effects of Xeomin develop (it seems to take about the same time as Botox to work); but it could mean that patients who have experienced adverse reactions to Botox will respond more positively to Xeomin treatments.

Until Xeomin is released in the U.S. and we plastic surgeons have a chance to witness its effects for ourselves, it’s hard to say whether we’ll be recommending Xeomin over Botox and Dysport or not. Regardless of how Xeomin stacks up, though, there’s a good chance that introducing a new product to the market will drive down botulinum prices across the board—which is nothing but good news for our patients!