Xeomin: cosmetic uses, side effects and what its FDA label says

Xeomin is a prescription botulinum toxin injection. For cosmetic use, its FDA-approved label covers adults and three kinds of upper facial lines: the frown lines between the brows, horizontal forehead lines and lateral canthal lines at the outer corners of the eyes.¹

Here is what the label says about the side effects seen in trials, who shouldn't have it and what the boxed warning means. It gives no dose. Whether Xeomin is right for you is a question for a clinician.

What it is

Xeomin (incobotulinumtoxinA) is a botulinum toxin product. The FDA says these products are injectable drugs that work by keeping muscles from tightening, so the wrinkles don't show as much. They are not dermal fillers.²

The label also lists medical uses, including drooling, muscle stiffness and neck spasms, which we don't cover here.¹

What the label says it is for

For the look of lines, the label says the improvement is temporary, and that it applies to moderate to severe lines in adults.¹

The label says its safety and effectiveness haven't been established in children for these uses.¹

Side effects seen in trials

The label reports two placebo-controlled trials in 730 adults with upper facial lines. Side effects were reported by 11% of the people given Xeomin and 8% of those given placebo. Injection site bruising was 2% with Xeomin and 1% with placebo. Brow ptosis (a drooping brow) and injection site discomfort were also reported more often with Xeomin, in under 1% of people.¹

In longer trials with up to three treatments, the most common side effect was a collection of blood under the skin at the injection site (a hematoma), in 8% of people. Headache and bruising were each 3%, and brow ptosis 1%. The label says these effects tended to decrease with later treatments.¹ In the frown-line trials, headache was 5% with Xeomin and 2% with placebo.¹

These are the label's trial figures. The label says rates from one drug's trials can't be directly compared with those of another drug, so we don't compare brands here.¹ They may also differ from what happens in practice.

The boxed warning

Like every botulinum toxin, Xeomin has a boxed warning about distant spread of toxin effect. Its effects may spread from the injection site and cause symptoms such as generalized weakness, double vision, drooping eyelids, trouble swallowing or speaking, urinary incontinence and breathing difficulties. They have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life threatening, and deaths have been reported.¹

Who shouldn't have it

The label says Xeomin must not be used by people with a known allergy to any botulinum toxin product or any of its components, or with an infection at the proposed injection site.¹ On pregnancy, it says that based on animal data it may cause fetal harm, and that it should be used in pregnancy only if the potential benefit justifies the potential risk.¹ Tell your provider if you are pregnant, planning a pregnancy or breastfeeding.

Units and other brands

The label says Xeomin's dosing units can't be compared with, or converted into, the units of other botulinum toxin products.¹ A price per unit for Xeomin is not comparable with a price per unit for another brand. Our comparison of the five brands covers the shared warning and the labels side by side.

At the clinics we list

616 of the 7,475 med spas we list name Xeomin among their brands. Naming a brand doesn't tell you what a clinic stocks or uses, so ask.³

Which licensed professionals may inject depends on your state. See our guide to choosing a Botox provider, which applies to any botulinum toxin.

Here is what to bring to a consultation.

Cost

We don't give prices on this page. Our Botox cost guide explains how clinics quote, per unit.

Common questions