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We have faced many challenges in 2020 with the COVID -19 pandemic, working from home and schooling remotely. If your focused was improving your home and work space, now is the time to take a look at prioritizing your self care. Wrinkles may have been at the top of your do to list but you are unsure if the treatment of choice is Botox or a dermal filler. Making the right choice is essential for the best results. Let’s focus on using one aesthetic treatment that can be used to treat wrinkles – neurotoxins ( Botox vs Xeomin vs. Jeuveau ).    

Aesthetic services have grown exponentially in the last few years because many are searching for non-surgical alternatives to maintaining a youthful appearance. It is clear a customized treatment plan improves both individual experience and outcome. This is especially true when it comes to the neurotoxins Botox, Xeomin and Jeuveau.    

Becoming an informed person before scheduling a procedure is important. It outlines your goals, informs you on the product and prepares your expectations. This optimizes your results because no two people are alike. Here are a few things you should know before you book your appointment.    

Botox, Xeomin and Jeuveau with Michelle Gillespie, DO




A: Botox, Xeomin and Jeuveau are neurotoxins that can temporarily improve the appearance of moderate to severe wrinkles in adults. Xeomin® is an incobotulinumtoxinA and a product and is a competitor to the more recognized Botox Cosmetic® and the newest neurotoxin to kit the market is Jeuveau. The main difference between Xeomin and Botox, is that Xeomin contains just one ingredient: botulinum toxin A. The manufacturing process is slightly different with all 3, which leads to some potential, subtle differences in clinical practice.

Xeomin is thought of as a “naked injectable,” meaning that it does not contain any additives. A benefit of this pure-form injectable is that the body is less likely to become resistant to it. Overtime, some patients have developed antibodies to Botox. Xeomin is the only one of the three (Xeomin, Botox and Jeuveau) injectables that does not need to be refrigerated before use, due to its lack of additives.

The cost of Xeomin is roughly the same as for Botox and Jeuveau which can vary in price from $9 – $14 per unit.  The cost difference can be related to the expertise of the injector, the amount of total units purchased and sale or membership with the company. On average patients receive 20 – 40 units of Xeomin, Botox or Jeuveau per visit.

Xeomin might have the slowest “onset” of action of the 3 (Botox and Jeuveau onset in 72 hours, and Xeomin onset in 4 days.)

Xeomin may be “mildly more convenient” than Botox or Jeuveau, as the “product’s lack of complex proteins will help prevent antibody formation, or resistance to neuromuscular treatment with botulinum type A toxin, in patients being treated for neuromuscular conditions.”

Neurotoxins diffuse differently, in part because Botox has protective proteins clustered around the active part of the molecule, while Xeomin has no protective proteins. In areas like the forehead, diffusion is good so you can cause greater effect over a larger area. Around the eyes and mouth you want less of a diffusion and the effects of the medication to stay in one area.

Jeuveau™ on the other hand, is also a neurotoxin like Botox Cosmetic and it can be injected in between the eyebrows or at the corners of the eyes to stop the natural muscle contractions that form the wrinkles. It can also prevent new lines from forming and smooth out the old ones which could potentially deepen with time. Jeuveau™ is almost the same as Botox® treatment since both are extracted from the same type of bacteria. In other words, the same molecule as the one used in Botox® is in Jeuveau™. There have been no reports of bad side effects or adverse complications from the use of Jeuveau™.

Jeuveau™ is meant to be a play on the French word “nouveau” which means “recent” or “modern” and patients will evolve with the product as they move forward in their journey towards youth. Similar in weight to Botox, Jeuveau™ is an FDA approved purified botulinum toxin formula type A. Until now there were not many options in treatments and the three most common toxins used to smooth out the lines were Dysport®, Botox®, and Xeomin®. These three are the only ones that passed the FDA criteria and Botox® has dominated the market since 1989.

Although all the drugs used for aesthetic treatments contain the same formula, the safety and effectiveness profile for Jeuveau™ is similar to the one of Botox®. Therefore, the injectable can be substituted for one another.


A: No. All three products have been FDA approved to help reduce fine lines and wrinkles. Typically there are little to no side effects. Side effects may include slight pain at the injection site, headaches, and numbness. Bruising is another rare but potential side effect that may occur in certain areas of the face such as under the eyes and the chin area. Stopping certain medications and supplements a few days prior to your procedure may also help reduce the risk of any side effects. If you have any sensitivities or concerns about any reactions, it is best to discuss this with your provider during your appointment. At PRAMAH we customize your treatment following a complimentary appointment between myself and you.


A: Whether you choose Botox, Xeomin or Jeuveau your appointment for the procedure is very convenient. All procedures are completed in the doctor’s office and no hospitalization is required. Should you have a specific event coming up that you want to look best for, you can even schedule both procedures up until the day before. We will discuss how long it will take to see the full effects of your treatment. Typically there is no downtime but we do recommend no vigorous activity or alcohol for 4 hours. Tinny marks at the site of needle injections will resolve in a few hours.


A: The main goal is smoother skin appearing skin with reduction of fine lines and wrinkles! All three injectables relax the muscles so you can see a a reduction in the appearance of wrinkles. Results typically last for three to four months and longer in some cases. It is important to remember treatment with neurotoxins is not permanent and regular updates may be needed to continue optimal results. At PRAMAH our focus is reshaping perspective on beauty, body and age. Your results are of our utmost importance. We are always available even for the most minor of touch ups.


A: Anyone adult can receive Botox, Xeomin or Jeuveau. At PRAMAH we offer treatment for both men and women. Our provider will discuss with you all of your options and answer any of your questions before any treatment is administered.

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