First, there was Botox and then Dysport. Both of these products were manufactured about twenty five years ago and great care was taken to secure the maximum results, with the most minimal risk to the patient. This involved wrapping the botulinum toxin with a protein as a layer of protection in the event the protein migrated from its intended target.
In the past twenty five years, we have learned that there is no evidence to support that the added layer of intended protection provides any benefit. In fact, there are cases where a tolerance is developed by the patient making the toxin less effective, so it has been determined that the protein is what the body is actually making antibodies against, not the toxin itself. As a result, if one develops a tolerance, it is not to the toxin but rather to the protein intended to protect the patient.
This brings us to the long awaited introduction of Xeomin! Xeomin is what we refer to as a second generation botulinum toxin. We are excited about this new product for several reasons which benefits the patient financially and therapeutically. First… It is the only “naked botox” currently on the market, which means the nuerotoxin does not have the complex protein load linked to it. While resistance to Botox is relatively uncommon, it does exist and the chances of future cases developing is only increasing, particularly since patients have used Botulinum toxins for several years now. Since the resistance is linked to the protein rather than the toxin itself, the concern about developing resistance is less of a concern.
Second. Finally!! there is competition in the market and no one company now holds the lock on the product which keeps the price artificially high and out of the reach of many who would benefit. The average price of Xeomin® should be a couple of dollars cheaper per unit. The client will still have to face the same concerns about hyper dilution of the product. However, this is true with Botox and Dysport, so the same degree of caution about choosing a competent and ethical provide must be employed.
With every new botulinum toxin that is approved and the safety profiles for the product remain consistently good, there is more possibility that the FDA will allow more choices for the consumer in the future.