Skip to content Skynn MD offers Xeomin in Holly Springs, NC, a physician-led wrinkle-relaxing injection that softens frown lines, forehead lines, and crow’s feet without flattening your expressions.
Xeomin (incobotulinumtoxinA) is the only neurotoxin filtered all the way down to the pure active molecule, with no extra bacterial proteins along for the ride, which is why it is often called the “naked” toxin.
With Xeomin, people usually start to see lines ease within about a week, with the full effect by two weeks and results that last roughly three to four months. The appointment itself takes about ten to fifteen minutes, and most clients head straight back to work, the gym, or the school pickup line afterward.
Xeomin is a prescription botulinum toxin type A, the same family as Botox and Dysport. When a few tiny doses are placed into specific muscles, the toxin briefly blocks the nerve signal that tells those muscles to contract. The muscle relaxes, the skin over it stops creasing with every expression, and the lines that come from years of frowning, raising your brows, and squinting gradually smooth out. It treats dynamic lines, the ones caused by movement, rather than filling them the way a dermal filler does.
What sets Xeomin apart is what is left out. Its maker, Merz Aesthetics, uses a double-filtration step called XTRACT Technology to strip away the accessory proteins that surround the active toxin in other products. The result contains just three ingredients: botulinum toxin type A, human albumin, and a little sugar (sucrose).
Botox and Dysport carry those extra complexing proteins; Xeomin does not. That is the whole reason it earned the “naked toxin” nickname, and it is the primary reason people seek it out.
Xeomin first earned FDA approval in 2010 for therapeutic use and in 2011 for frown lines between the brows. In 2024, the FDA expanded that approval, and Xeomin became the first and only neurotoxin cleared to treat all three upper-face areas at once: frown lines, horizontal forehead lines, and crow’s feet. That makes it a genuinely modern choice for a full upper-face refresh, not just the “11s” between your brows.
The three areas Xeomin is FDA-approved to treat are the glabellar frown lines (the vertical “11s” between your eyebrows), the horizontal lines that run across your forehead, and the crow’s feet that fan out from the corners of your eyes. These are the expressions you make thousands of times a year: concentrating on a screen, lifting your brows in conversation, and squinting through a bright Carolina afternoon. Over time those repeated movements etch in, and Xeomin is designed to soften them while still letting your face move naturally.
Skilled injectors also use neurotoxins like Xeomin in several areas the FDA has not specifically labeled, based on a clinician’s judgment of your anatomy and goals.
Common examples of these off-label uses include:
Those off-label uses are a normal part of aesthetic practice, but they call for an experienced hand and a clear conversation about what is realistic. If neck bands or a sagging jawline are part of your concern, it is worth reading about your neck-skin treatment options so you can decide what fits.
All three products do the same basic job, and in the right hands, all three look natural. The differences are in the formula, the dosing, and who tends to choose them.
Botox is the original and the most familiar name. Dysport spreads a little more from each injection point, which some injectors like for broad areas such as the forehead. Xeomin is the purified one, with no complexing proteins.
Dosing is where people get confused, so here is the honest version.
In day-to-day practice, injectors often use Xeomin at a dose close to Botox’s, roughly one to one. Dysport is measured on a different scale, often around two and a half of its units to one of Botox’s. Even so, the FDA is explicit that units of one toxin cannot be converted into units of another; they are specific to each product and its own assay.
What matters far more than the brand on the vial is the person holding the syringe. To compare your options directly, see our Botox in Holly Springs, NC page and our Dysport page, or start with the Wrinkle Relaxers overview.
This is the question that brings a lot of people to Xeomin specifically. A small share of long-term toxin users find that their treatments gradually do less than they used to. One suspected reason is that the body can, in rare cases, form neutralizing antibodies against the extra proteins packaged with some toxins, which can blunt the effect.
Because Xeomin is filtered down to only the active molecule, it carries the lowest foreign-protein load of the group. According to Merz’s clinical data, no patients in its pivotal Xeomin studies developed treatment resistance from neutralizing antibodies.
None of this guarantees a longer or stronger result for any one person, and the research has limits. But for someone whose Botox or Dysport seems to be wearing off faster than it once did, switching to the purified toxin is a reasonable, physician-guided next step, and it is one Dr. Gotur is happy to talk through honestly.
After your appointment, you will not see anything change right away, and that is normal. Movement in the treated muscles usually begins to soften within a few days; the FDA label puts the median first onset at about seven days, with the full effect settling in around two weeks.
If you have an event on the calendar, plan your visit two to three weeks ahead so you are looking your best on the day.
Results generally last about three to four months, though this varies with your metabolism, the area treated, and the dose. Many people settle into a rhythm of three or four visits a year. Coming back on schedule, before the muscle fully regains its strength, tends to keep results smoother over time and can let some people stretch the interval as the habit of expression softens.
Xeomin is priced per unit, the same way most neurotoxins are. The number of units you need depends on the areas you want treated, how strong those muscles are, and the result you are after, so the most honest answer to “what will it cost” comes after a quick in-person assessment.
At your consultation, Dr. Gotur maps your anatomy, recommends a plan, and gives you a full estimate before anything is decided. There are no surprises at checkout.
To set expectations, the table below shows the unit ranges from Xeomin’s FDA-approved upper-face dosing. Treat it as a planning framework, not a quote.
| Area | Typical Xeomin units (planning guide) |
|---|---|
| Frown lines (glabella / the “11s”) | about 20 units |
| Horizontal forehead lines | about 20 units |
| Crow’s feet (both sides) | about 24 units |
| Full upper face, combined | about 64 units |
Your actual dose is personalized, and a lighter or fuller plan is completely normal. One more note for anyone comparing brands: Xeomin units are specific to Xeomin and do not translate one-for-one into Botox or Dysport units, so a “units” number only means something alongside the product it describes.
Xeomin is a quick, in-office treatment with very little fuss. Most people describe the injections as a brief pinch or sting, over in a few seconds per spot, and numbing cream or ice is available if you want it. The whole visit runs about 10 to 15 minutes, which is why it earns the “lunch-break” reputation. There is essentially no downtime.
A little preparation helps. Where you can, skip alcohol the day before and avoid blood-thinning supplements such as fish oil, vitamin E, and high-dose ibuprofen for a few days, since these raise the odds of a small bruise.
Afterward, stay upright for about four hours, keep your hands off the treated area so the product settles where it was placed, and hold off on hard workouts, saunas, and facials for the rest of the day. Mild redness, a pinpoint bruise, or a faint headache can happen and usually fade within a day or two.
Xeomin is not right for everyone, and screening for that is part of the visit. It is avoided in pregnancy and breastfeeding, in people with certain nerve-and-muscle conditions such as myasthenia gravis, Lambert-Eaton syndrome, or ALS, and in anyone with a known allergy to a botulinum toxin or to Xeomin’s ingredients, or an active infection at the injection site.
Some medications, including certain antibiotics and muscle relaxants, can interact, which is exactly why a physician reviews your health history before a single unit is drawn up.
There is a quiet bit of local trivia worth knowing: The company that makes Xeomin, Merz Aesthetics, runs its global headquarters and North American research center up Six Forks Road in Raleigh, about 25 minutes from our door. The toxin so many of our neighbors are curious about is, in a real sense, a Triangle product. It is a fitting match for Holly Springs, a town full of people who commute into RTP and Raleigh for work and want to look rested and like themselves rather than frozen or overdone. Xeomin’s whole pitch — natural movement, clean formula, a refreshed upper face — lands well here.
The Carolina climate plays a small part too. Our long, bright warm season means a lot of squinting, on the greenways, at the ballpark, and out on the water, and squinting is one of the surest ways to deepen crow’s feet and frown lines. Treating those areas before they set is easier than chasing them later.
We see clients from across the area, including Apex, Cary, Fuquay-Varina, Morrisville, Garner, and Willow Spring. So many make the short drive from Raleigh and the wider Wake County and Research Triangle community to get their Xeomin right here at our Holly Springs practice.
Skynn MD is a physician-owned practice, and your Xeomin is supervised by Dr. Raghav Gotur himself. Dr. Gotur is board-certified in Internal Medicine through the ABIM, with training at Mount Sinai School of Medicine, and board-certified in Aesthetic Medicine through the AAAM, with more than twenty years in medicine.
With injectables, that medical depth is the point: choosing the right product and dose for your face, reading your anatomy so results stay balanced, and screening the medications and conditions that should give any injector pause. It is the difference between someone following a template and a physician making a judgment call about you.
At Skynn MD, you get a dedicated Xeomin conversation with the doctor and an honest plan. If you are weighing Xeomin against fillers for volume loss, ask about combining treatments with dermal fillers; and if you are curious about the therapeutic side of botulinum toxin, our note on Botox for migraines is a good read.
If you have been looking for Xeomin in Holly Springs, NC, the consult is the easiest first step: Come in, get a real assessment, and decide from there.
Neither is universally “better”; they are close cousins that suit different people. Xeomin’s edge is its purified, protein-free formula, which appeals to anyone who wants the simplest possible product or whose other toxins seem to be losing effect. Botox has the longer track record and the most name recognition. In skilled hands, both deliver natural results, so the better question is which one fits your history and goals.
The biggest difference is the formula: Xeomin is the purified “naked” toxin with no complexing proteins, while Dysport contains them and tends to spread a bit more from each injection point. They are also dosed on different unit scales, so the numbers are not comparable between brands. Many injectors reach for Dysport on broad areas and Xeomin for patients focused on a clean formula or a possible resistance issue.
For most people, results last about three to four months. Your metabolism, the area treated, and the dose all affect the timeline, so some see a little more and some a little less. Returning before the effect fully wears off helps keep results consistent over the year.
Movement usually begins to soften within a few days, and the full effect settles in around two weeks; the FDA label lists a median first onset of about seven days. If you have an event coming up, book your appointment two to three weeks in advance.
Most people feel only a quick pinch at each spot, and numbing cream or ice is available if you would like it. There is essentially no downtime: You can return to your day right away, just stay upright for about four hours and skip hard exercise, saunas, and facials until the next day.
Yes, and that is one of the more common reasons people try it. Because Xeomin carries the lowest foreign-protein load of the group, it is a sensible option if your previous toxin seems to be fading faster than it used to. Dr. Gotur will review your history and set realistic expectations before recommending a switch.
Xeomin is avoided during pregnancy and breastfeeding, in people with certain nerve-and-muscle disorders such as myasthenia gravis, Lambert-Eaton syndrome, or ALS, and in anyone allergic to a botulinum toxin or to Xeomin’s ingredients. Certain antibiotics and muscle relaxants can interact as well, which is why a physician reviews your health history first.
Skynn MD is in Holly Springs, NC, and welcomes clients from Apex, Cary, Fuquay-Varina, Morrisville, Garner, Willow Spring, Raleigh, and the wider Wake County and Research Triangle area. The practice is physician-owned, and Dr. Gotur performs Xeomin treatments personally.
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