Neurotoxins: treatment guide
Xeomin: what it is, results, side effects and cost
What is Xeomin?
Xeomin is a prescription injection of incobotulinumtoxinA, a form of botulinum toxin type A. The FDA approves it for the temporary improvement of moderate to severe frown lines, forehead lines and crow's feet in adults. It relaxes the targeted facial muscles; according to its FDA label, the effect typically begins within two to seven days and lasts up to 12 to 16 weeks, varying from person to person.[1][4]
Xeomin quick facts
| What it is | Xeomin (incobotulinumtoxinA), a prescription botulinum toxin type A injection[1] |
|---|---|
| What it treats (cosmetic) | Temporary improvement of moderate to severe frown lines between the brows, horizontal forehead lines and crow's feet (lateral canthal lines) in adults[1] |
| Label doses | Frown lines 20 units; forehead lines 20 units, given together with frown lines; crow's feet 12 units per side; up to 64 units when all three areas are treated at once[1] |
| Results timeline | Median onset within two to seven days after injection[1] |
| How long it lasts | Typically up to 12 to 16 weeks, varying from person to person[1] |
| Treatment time | A single office visit[2] |
| Downtime | Most people return to everyday activities right away[3] |
| How often | No more often than every three months[1] |
| Cost | Varies by clinic and area. Depends on how advanced the lines are, the amount of product used, the provider and location.[6] |
| Insurance | Treatment for signs of aging is generally not covered[2] |
How Xeomin works
Xeomin is a brand of botulinum toxin type A. Its active ingredient, incobotulinumtoxinA, blocks the release of acetylcholine, the chemical messenger nerves use to tell muscles to contract.[1] When it is injected into a muscle, it blocks the nerve signals that make that muscle tighten.[4]
Injected in small amounts into specific facial muscles, it relaxes them, so the lines they create when you frown, raise your brows or squint soften. The effect is temporary.[1][3]
The Xeomin label describes how the product is made: the botulinum toxin complex is purified and the active neurotoxin is then separated from the accompanying proteins (hemagglutinins and non-hemagglutinins), leaving the neurotoxin without accessory proteins.[1]
For cosmetic use, the FDA approves Xeomin for three upper face areas in adults: frown lines between the brows, horizontal forehead lines and crow's feet, treated at the same time or individually.[1] Xeomin is also approved for medical conditions, including chronic drooling (sialorrhea), upper limb spasticity, cervical dystonia and blepharospasm.[1][4]
What to expect, step by step
- Before your consultation: preview it in the appIf you like, scan your face in the SkinSync AI app and look at an illustrative neurotoxin simulation, so you can show your provider what you have in mind. The simulation is not specific to Xeomin, it does not predict your result, and your provider decides what is appropriate for you.
- ConsultationTell your provider about your medical conditions, including any muscle or nerve disease, breathing or swallowing problems, drooping eyelids, past eye or facial surgery, side effects from a previous botulinum toxin, and whether you are pregnant or breastfeeding.[1]
- MedicinesShare a full list of the prescription and nonprescription medicines, vitamins and supplements you take.[4]
- PreparationXeomin comes as a powder that is mixed with a liquid and injected by a doctor.[4]
- InjectionsOn the label, frown lines are treated with five injections of 4 units, forehead lines with five injections of 4 units, and crow's feet with three injections of 4 units on each side.[1] The treatment can be done in a single office visit.[2]
- Right afterMost people return to everyday activities immediately, and makeup can be applied as soon as you leave the treatment room.[3]
- ResultsThe label gives a median onset of two to seven days after injection.[1] It may take a couple of days or up to a week to feel the full benefit.[4]
- MaintenanceThe typical effect lasts up to 12 to 16 weeks, and re-treatment should be no more often than every three months.[1]
Side effects and who should avoid Xeomin
Common side effects
Side effects of botulinum toxin therapy tend to be mild and temporary, and most come from the injections rather than the toxin itself.[3] They can include:
- Bruising where you were injected, the most common side effect in the Xeomin upper facial line trials[1]
- Swelling, redness or soreness at the injection site[3]
- A mild headache (uncommon)[3]
- Weakness in a neighboring muscle, causing a temporarily droopy brow or eyelid (rare)[3]
To lower the chance of a drooping brow, the label advises treating forehead lines together with frown lines, and it lists injection techniques to reduce the risk of a drooping eyelid.[1] Bruising, if it happens, lasts about a week.[3]
Serious but rare: spread of toxin effect
The FDA label carries a boxed warning: the effects of Xeomin and all botulinum toxin products may spread from the injection area and cause symptoms such as muscle weakness, double or blurred vision, drooping eyelids, and trouble swallowing, speaking or breathing. These symptoms have been reported hours to weeks after injection, and swallowing and breathing problems can be life threatening. Get medical help right away if they occur.[1]
Allergic reactions are also possible. Get medical help right away for wheezing, trouble breathing, dizziness or feeling faint, and call your provider about eye pain or irritation after treatment.[1]
Who should avoid Xeomin or talk to a provider first
- Allergy to Xeomin or its ingredients, or an allergic reaction to any other botulinum toxin product[1]
- Infection at the planned injection site[1]
- Muscle or nerve disease such as ALS, myasthenia gravis or Lambert-Eaton syndrome[1]
- Breathing or swallowing problems, such as asthma, emphysema or a history of inhaling food or fluid into the lungs[1]
- Drooping eyelids or past eye or facial surgery[1]
- Pregnancy or breastfeeding. There are no adequate data on the risk of Xeomin in pregnancy, and it is not known if Xeomin can harm an unborn baby.[1]
- Under 18. It is not known if Xeomin is safe and effective for upper facial lines in children.[1]
Only get Xeomin from a licensed provider
Do not buy botulinum toxin online, and avoid injections at a non-medical spa, a party, a salon or someone's home, where serious complications have occurred.[3]
Xeomin aftercare
- Do not rub or massage the treated areas, so the product does not spread where it is not wanted.[3]
- Makeup is fine if you apply it gently without pressing or rubbing.[3]
- Wait two hours before strenuous activity, such as heavy lifting or a workout. Follow your own provider's instructions.[3]
- Do not drive or do other risky activities if you notice loss of strength, muscle weakness, blurred vision or drooping eyelids.[1]
- Watch for warning signs such as trouble breathing, swallowing or speaking, and get medical care right away.[1]
Xeomin vs Botox vs Dysport
Xeomin, Botox and Dysport are all botulinum toxin type A products approved by the FDA for frown lines. They differ in their approved cosmetic uses and in how their doses are measured.[1][7][8] Jeuveau (first approved in 2019) and Daxxify (first approved in 2022) are also FDA approved for frown lines.[9][10]
Swipe sideways to see all three products.
| Xeomin | Botox Cosmetic | Dysport | |
|---|---|---|---|
| Active ingredient | incobotulinumtoxinA | onabotulinumtoxinA | abobotulinumtoxinA |
| Company on the FDA label | Merz North America, Inc. | Allergan, Inc. | Galderma Laboratories, L.P. and Ipsen Biopharm Ltd |
| First U.S. approval (any use) | 2010 | 1989 | 2009 |
| FDA-approved cosmetic uses | Frown lines, forehead lines, crow's feet (adults) | Frown lines, crow's feet, forehead lines, neck bands (adults) | Frown lines (adults under 65) |
| Label dose for frown lines | 20 units | 20 units | 50 units |
| Can units be compared? | No. Each label states that its units are specific to that product and cannot be compared with or converted to units of another botulinum toxin. | ||
| Source | FDA label[1] | FDA label[7] | FDA label[8] |
Two label details set Xeomin apart. Its label describes the active neurotoxin as separated from accessory proteins during manufacturing, and it states that unopened vials can be stored at or below 77°F (25°C) without refrigeration.[1] Even where the frown line dose is the same number of units as Botox, the units are not interchangeable: one brand or type of botulinum toxin cannot be substituted for another.[1][4]
Not all botulinum toxin brands are approved to treat the same problems, and your provider can discuss the best option for your situation.[5]
Which product suits you is a decision to make with a licensed provider.
Frequently asked questions about Xeomin
How long does Xeomin last?
The Xeomin label says the typical effect of each treatment lasts up to 12 to 16 weeks, although it varies from person to person.[1] The results of botulinum toxin therapy last about 3 to 4 months, and sometimes longer.[2]
How long does it take for Xeomin to work?
The label gives a median onset of two to seven days after injection.[1] It may take a couple of days or up to a week to feel the full benefit.[4]
Is Xeomin the same as Botox?
No. Both are botulinum toxin type A injections that relax the muscles behind expression lines, but they have different active ingredients (incobotulinumtoxinA and onabotulinumtoxinA), different approved uses, and units that cannot be compared.[1][7]
Does Xeomin contain complexing proteins?
The Xeomin label describes the active neurotoxin as separated from the accompanying proteins (hemagglutinins and non-hemagglutinins) during manufacturing, so it is supplied without accessory proteins. Ask your provider what this means for you.[1]
What areas is Xeomin approved for?
For cosmetic use, Xeomin is FDA approved for moderate to severe frown lines between the brows, horizontal forehead lines and crow's feet in adults, treated together or individually.[1]
Can I switch from Botox or Dysport to Xeomin?
Your provider can discuss the options, but doses do not carry over: the label states that units of Xeomin are not interchangeable with units of other botulinum toxin products.[1][4]
How much does Xeomin cost?
Varies by clinic and area. The price of botulinum toxin injections depends on how advanced the lines are, how much product is used, the provider's expertise and the office location.[6]
Who should not get Xeomin?
You should not get Xeomin if you are allergic to it or its ingredients, have had an allergic reaction to another botulinum toxin product, or have an infection at the planned injection site. Tell your provider about any muscle or nerve disease, breathing or swallowing problems, or a pregnancy.[1]
What is the biggest risk of Xeomin?
The FDA label carries a boxed warning that the effect of Xeomin and all botulinum toxin products can spread beyond the injection area and cause problems with swallowing, breathing or speaking, which can be life threatening. Get medical help right away if this happens. Most side effects are mild and temporary.[1][3]
How often can I get Xeomin?
The label says re-treatment should be given no more often than every three months.[1]
Does insurance cover Xeomin?
Treatment for signs of aging is generally not covered by insurance. Check with your plan about medical uses.[2]
SkinSync AI: Aesthetic Care
See a simulation before you book.
Read up here, then use the app to picture a neurotoxin treatment on your own face and take the next step with a clinic. Arrive at your consultation informed and ready to ask whether Xeomin or another product suits you.
- Scan your face and see an illustrative neurotoxin simulation from the front and both sides: forehead, frown lines, crow's feet, lip flip, masseter reduction and more. The simulation is not specific to Xeomin or any other brand
- Find participating clinics and providers, with availability and pricing
- Book a consultation, in person or virtual, or a treatment in the app
- Save your scans and get reminders and aftercare guidance
Simulations are illustrative and do not predict results. The app does not give medical advice; a licensed provider determines appropriate treatment.
Sources
Every medical fact on this page is linked to one of these sources. Reviewed October 30, 2026.
- U.S. Food and Drug Administration approved prescribing information and Medication Guide: XEOMIN (incobotulinumtoxinA), via DailyMed, National Library of Medicine
- American Academy of Dermatology: Botulinum toxin therapy, overview
- American Academy of Dermatology: Botulinum toxin therapy, FAQs
- MedlinePlus, National Library of Medicine: IncobotulinumtoxinA injection
- MedlinePlus (U.S. National Library of Medicine): OnabotulinumtoxinA Injection
- American Society of Plastic Surgeons: How much do botulinum toxin injections cost?
- FDA approved prescribing information: BOTOX Cosmetic (onabotulinumtoxinA), via DailyMed
- FDA approved prescribing information: DYSPORT (abobotulinumtoxinA), via DailyMed
- FDA approved prescribing information: JEUVEAU (prabotulinumtoxinA-xvfs), via DailyMed
- FDA approved prescribing information: DAXXIFY, via DailyMed
Related guides
Botox, Dysport, Xeomin, Jeuveau and Daxxify are trademarks of their respective owners. SkinSync AI is not affiliated with or endorsed by these companies.