The Science Behind Neurotoxins: How Botox and Xeomin Actually Work

Once a niche procedure, Botox and its counterparts like Xeomin have surged in popularity, becoming household names synonymous with a refreshed, more youthful appearance. Yet, despite their widespread use, there's often a lack of understanding about the fundamental science behind how facial muscles respond to neurotoxins and what makes these facial injections so effective. Read on to learn more about the mechanisms of these injectables, aka more knowledge to make informed decisions along your anti-aging cosmetic journey.

What Are Neurotoxins?

In a cosmetic context, neurotoxins refer to purified forms of botulinum toxin type A, a naturally occurring protein produced by the bacterium Clostridium botulinum. In the hands of a qualified medical professional and when administered in minute, controlled doses, these substances are incredibly safe and effective for both therapeutic and aesthetic purposes. The Food and Drug Administration (FDA) has approved several brands of botulinum toxin type A for various uses. The most well-known is Botox, which pioneered the market. Other prominent brands include Xeomin, Dysport, and Jeuveau. Each brand has subtle differences in its formulation and molecular structure which we'll explore below, but they all share the same mechanism of action.

The Science: How Botox and Xeomin Work

Botox and Xeomin temporarily interrupt nerve signals that cause muscle contractions. The process works like this: When you want to make a facial expression, your brain sends an electrical signal down a nerve. At the end of that nerve, a chemical messenger is released that then binds to receptors on the muscle, causing the muscle to contract. Repeated contractions of certain facial muscles over time lead to the formation of dynamic wrinkles, aka lines that appear with movement like frown lines, crow's feet, and horizontal forehead lines. When a tiny amount of Botox or Xeomin is precisely injected into a targeted muscle, the botulinum toxin molecules are absorbed by the nerve endings. Once inside the nerve, the toxin blocks the release of the aforementioned chemical messenger, so the nerve signal cannot reach the muscle effectively. The muscle's ability to contract is temporarily reduced or halted. This temporary muscle relaxation reduces dynamic wrinkles. By relaxing the muscles responsible for these expressions, the skin overlying them becomes smoother, and the wrinkles soften or disappear. The effect is not immediate; typically, patients begin to see the onset timeline of results within 3-7 days, with the full effect around 10-14 days after injection. The duration of effects generally lasts 3 to 4 months, after which the body naturally metabolizes the neurotoxin, and muscle activity gradually returns.

Botox vs. Xeomin: What’s the Difference?

Molecular Structure

Botox (onabotulinumtoxinA) is formulated with accessory proteins surrounding the core neurotoxin molecule that help stabilize the toxin. Xeomin (incobotulinumtoxinA), on the other hand, is often referred to as the "naked" neurotoxin because it undergoes an additional purification process that removes these accessory proteins.

Purity and Formulation Differences

This difference in protein content means that Xeomin is a "purer" form of the neurotoxin. Some practitioners suggest that the absence of accessory proteins in Xeomin might reduce the theoretical risk of antibody formation. However, this is a very uncommon occurrence with any of the neurotoxins.

Storage and Shelf-Life

The formulation also affects storage: Xeomin does not require refrigeration before reconstitution, making its storage and transport slightly more convenient than Botox.

Clinical Outcomes

In terms of clinical outcomes, both Botox and Xeomin are equally effective at relaxing muscles and reducing wrinkles when administered correctly and have comparable safety and efficacy profiles. The choice most often comes down to the injector's preference, patient history, and sometimes, cost. For patients, the experience and results are largely similar, so the best neurotoxin for wrinkles is highly subjective and dependent on individual response and injector skill.

What Conditions Can They Treat?

Cosmetic Uses

• Forehead lines
• Crow’s feet
• Frown lines (Glabellar lines)
• Facial symmetry
• Lip flip
• Bunny lines
• Jaw slimming (Masseter reduction)
• Neck bands

Medical Uses

• Chronic Migraines
• Hyperhidrosis (Excessive Sweating)
• TMJ Disorders
• Muscle Spasms

Safety and Side Effects

When administered by a qualified professional, Botox and Xeomin are considered very safe. However, like any medical procedure, there are potential side effects. Common side effects are usually mild and temporary, resolving within a few days. These include bruising at the injection site, mild swelling, redness, slight pain, tenderness, and headache (rare). Rare complications are typically associated with improper injection technique or excessive dosage and include ptosis (drooping eyelid or eyebrow), asymmetry, and allergic reactions (extremely rare). Only a board-certified dermatologist, plastic surgeon, or other medical professional with experience in facial injections will possess the anatomical knowledge and technical skill to minimize risks and achieve beautiful results.

How Long Do Results Last?

The effects of Botox in Parrish and Xeomin are temporary, with an average duration of 3 to 4 months. Afterward, the nerve endings gradually regenerate, and the muscle's ability to contract returns. Several factors can affect longevity, including individual metabolism, dosage, lifestyle (sun exposure, smoking, etc.), and muscle strength. To maintain the desired aesthetic, most patients schedule follow-up maintenance injections every 3 to 4 months to prevent the return of dynamic wrinkles. Consistent treatment can sometimes lead to longer-lasting results over time, as muscles get reprogrammed to be less active.

Who Is a Good Candidate?

People in their late 20s to 60s who want to prevent or reduce the appearance of dynamic wrinkles are considered good candidates for botulinum toxin. There are no specific age and skin type considerations that universally exclude someone, but neurotoxin injections are most effective on wrinkles caused by muscle movement, rather than static lines caused by sun damage or collagen loss. Contraindications include pregnancy, breastfeeding, certain neuromuscular disorders, allergies to the formulation, and infection at the injection site.

The Role of Skilled Injectors in Optimal Results

Why technique matters more than brand

A skilled injector understands facial anatomy intimately: the precise location and function of each muscle, the depth of injection, and the correct dosage for each area. They know how to achieve a natural, refreshed look and avoid the dreaded "frozen" appearance. The difference between a beautiful, subtle treatment and an undesirable, unnatural-looking result often lies entirely in the injector's skill, not the specific brand of neurotoxin used.

Experience and anatomical knowledge of providers

These highly trained professionals can assess your unique facial expressions, identify specific muscles contributing to your wrinkles, and tailor treatment to your individual needs. They also set realistic expectations and develop personalized treatment plans that align with your goals and budget. If you’re getting Botox in Parrish or Xeomin treatment for the first time,  be sure to prioritize the qualifications and experience of the injector.

The Beauty of Neurotoxin Science

Botox and Xeomin are products of sophisticated science that offer a safe and effective solution for reducing dynamic wrinkles and getting that anti-aging glow. To close, remember that the success of these remarkable facial injections completely hinges on the expertise of a qualified, experienced injector who can artfully achieve natural, beautiful results. If you're considering these treatments, schedule a consultation today at Elite Med Spa Parrish to explore your options and begin your journey to smoother, age-defying skin.