The neurotoxin injectable Botox has gained a strong foothold in aesthetics in the US, and last year {!Dysport's | dysport} FDA approval finally gave Botox some competition. Now there is a third botulinum toxin based option for patients just approved last month called Xeomin.
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Currently, Xeomin's FDA approval isn't for cosmetic use, but physicians will be able to use it off label, just as Botox was used originally. The concept of all these injectables is the same - a diluted and purified form of the botulism toxin is injected into key muscles. The toxin blocks neural signals causing the muscles to become paralyzed. When these muscles can't move, no wrinkles can be formed. Botox, Dysport and Xeomin are all approved to treat patients with cervical dystonia, a painful condition in which the muscles in the head and neck spasm.
Dr. Heidi Waldorf, Director of Laser and Cosmetic Dermatology at Mount Sinai Medical Center in New York, New York says that it's always good to have a number of options for her patients. "The nice thing is we'll have yet another injectable and we can figure out as time goes by, and as we use it with more patients, who is the best patient for which option. As a cosmetic dermatologist, one of the best things for me is to have more in my tool box, so that when a patient comes in I can tailor treatment to the patient's needs."
Dr. Waldorf says that though Dysport, Xeomin, and Botox are all similar, each of the medicines work differently. "We're now getting a sense of which patients Dysport is beneficial for over Botox and vice versa. There's always a lot of hype and rumor before release about the benefits and disadvantages of each product. I think that we really need to get them into our hands and use them on a variety of patients to really know."
In a press release, Merz Pharmaceuticals says that Xeomin is the only botulinum toxin that doesn't require refrigeration, which they hope will ensure product integrity at the time of injection. All three medicines carry the FDA black box warning for the distant spread of toxin, meaning that there is a possibility that the toxin will spread to other parts of the body, causing swallowing or breathing difficulties that could lead to death. According to WebMD, as of April 2009, there were no deaths or distance spread events associated with cosmetic use of Botox.
