9,883,711. That’s how many neurotoxin injections Americans got in 2024 alone, a 4% jump from the previous year (ASPS, 2024 Procedural Statistics Report).
But here’s what doesn’t make the headlines: not all of those were Botox.
A growing number of clinics across the country have started offering Xeomin as their primary neurotoxin. Between a landmark FDA approval, genuine clinical trial data, and a Demi Lovato-backed campaign targeting younger patients, Xeomin has quietly carved out serious ground in a space Botox once owned unchallenged.
Nearly 10 Million Neurotoxin Treatments in One Year — Who’s Getting Them?
The wrinkle-smoothing industry isn’t slowing down. In 2023, clinics performed 9,480,949 neuromodulator treatments, a 9% increase over 2022. By 2024, that number crossed the 9.8 million mark (ASPS, 2024 Procedural Statistics Report).
What’s shifting is the audience. Patients aged 40 to 54 still make up over 56% of all neurotoxin treatments. But the 20–29 and 30–39 age groups both grew by more than 8% in a single year (ASPS, 2023 Procedural Statistics Press Release). Younger patients aren’t waiting for deep wrinkles to appear, they’re starting early, and they care about what’s in the syringe.
The global botulinum toxin market reflects this momentum. Valued at $8.92 billion in 2025, it’s projected to hit $15.72 billion by 2030, with North America holding roughly 40% of that market (MarketsandMarkets, Botulinum Toxins Market Size & Growth Forecast to 2030).
What Exactly Is Xeomin?
Xeomin (incobotulinumtoxinA) belongs to the same family as Botox, Dysport, and Jeuveau, botulinum toxin type A. It temporarily relaxes facial muscles to smooth frown lines, forehead creases, and crow’s feet.
The key difference is its formulation. Dermatologists call Xeomin a “naked” neurotoxin because it contains only the active ingredient — pure botulinum toxin — without accessory proteins found in other brands. Merz Pharmaceuticals developed it using their proprietary XTRACT Technology, which double-filters the product down to what’s essential for treatment.
Xeomin first received FDA approval in 2011 for treating glabellar lines, the vertical “11” lines between the eyebrows (FDA, Xeomin Approval History — Drugs.com).
Think of It as the “Clean Label” Injectable
The same mindset that made people swap out parabens and sulfates from their skincare is now influencing injectable choices. Merz Aesthetics highlighted in their July 2024 FDA approval announcement that 90% of surveyed patients said they want only essential ingredients in their neurotoxin treatment (Merz Aesthetics, FDA Approval Press Release, July 2024).
That stat connects directly to how many consumers already shop, reading ingredient lists, asking what’s necessary and what isn’t. Xeomin’s stripped-back formula fits that thinking.
Why Would Someone Switch From Botox to Xeomin?
Botox works. Nobody debates that. But for some long-term users, something changes over time.
A survey cited by Modern Aesthetics in 2024 found that just over 1 in 3 neurotoxin users reported experiencing decreased or lessening effects from their treatments (Modern Aesthetics, “First, Only US Neurotoxin for Simultaneous Treatment of Upper Facial Lines Gets FDA Approval,” 2024). Dermatologists call this secondary non-response, and antibodies are usually behind it.
Here’s the simplified version. Botox contains accessory proteins alongside the active toxin. After repeated injections, some patients’ immune systems recognize those proteins as foreign and start producing antibodies. The result? Treatments that once lasted three to four months begin fading sooner, or stop working as effectively.
Xeomin skips those extra proteins entirely. That reduces the chance of triggering an immune response — which is why many providers now recommend it for patients whose Botox results have plateaued.
New York dermatologist Dr. Doris Day has noted that Xeomin is the only neurotoxin on the US market where resistance is particularly unlikely, specifically because of its pure formulation without binding proteins (NewBeauty, “FDA Approves Xeomin for Upper Facial Lines,” July 2024).
2024 Was Xeomin’s Biggest Year Yet
In July 2024, the FDA approved Xeomin as the first and only neurotoxin cleared for treating all three major upper facial areas simultaneously, forehead lines, frown lines, and crow’s feet (Merz Aesthetics, FDA Approval Press Release, July 2024).
Every other neurotoxin gets used off-label in those areas. Xeomin is now the only one with specific FDA backing for all three at once.
The approval came from two Phase III double-blind, placebo-controlled clinical trials with 730 adult participants. Both trials hit their primary endpoints, Xeomin showed significantly higher response rates than placebo at Day 30 across every facial area. All treatment-related side effects were mild to moderate, and zero serious adverse events linked to the treatment were observed (Merz Aesthetics, FDA Approval Press Release, July 2024).
The recommended dose totals 64 units: 20 for frown lines, 20 for forehead lines, and 24 for crow’s feet.
Demi Lovato Called It “The Smart Choice” — Here’s the Strategy Behind It
In March 2024, Merz Aesthetics brought Demi Lovato on board as the newest face of their “Beauty on Your Terms” campaign, a multi-channel push originally launched in August 2022 to reach Gen Z and millennial women entering the injectables space for the first time (Business Wire, “Merz Aesthetics Announces Demi Lovato as New Xeomin Brand Partner,” March 2024).
Lovato’s social reach spans over 278 million followers across platforms (Fierce Pharma, “Merz Adds Another Star to Its Galaxy of Xeomin Partners,” March 2024). She described Xeomin as her smart choice for maintaining natural-looking results, pointing to its double-filtered formula with no unnecessary ingredients.
It’s a deliberate play. Merz has identified Gen Z and millennial women as the fastest-growing group in aesthetic treatments. Roberto Casas, Merz’s VP of US marketing, confirmed the campaign specifically targets younger, toxin-naïve audiences at the intersection of music, beauty, and fashion (Fierce Pharma, March 2024).
Your Results Depend on More Than Just the Product Name
Here’s something most patients never think about: where does your clinic actually get its Xeomin?
It matters more than you’d expect. Neurotoxins require strict storage, refrigeration between 2 to 8°C, protection from light, and a documented chain of custody from manufacturer to treatment room. One break in that chain can compromise what ends up in your skin.
That’s why clinics that take this seriously establish direct relationships with a licensed xeomin distributor to verify every vial is authentic, properly stored, and traceable. According to verified Xeomin distributors in Texas, demand for authenticated wholesale Xeomin supplies has increased as more providers add it alongside Botox to their treatment menus.
This isn’t a hypothetical concern. In April 2024, the FDA issued public warnings about counterfeit Botox products discovered across multiple US states, some of which had already been administered to patients. Knowing your clinic sources from a licensed, verified distributor isn’t just a nice-to-have, it directly affects your safety.
Should You Ask Your Clinic About Xeomin?
There’s no single “best” neurotoxin for everyone. But Xeomin earns a closer look if any of this applies to you:
Your Botox results have been fading faster or feel less effective than they used to. You prefer products with fewer, cleaner ingredients — even when it comes to injectables. You’re exploring neurotoxin treatments for the first time and want to compare what’s available. You’d like one treatment session that covers forehead lines, frown lines, and crow’s feet with specific FDA approval behind it.
Xeomin isn’t automatically better than Botox in every situation. But the clinical data, the FDA backing, and the growing clinic adoption across the US suggest it belongs in the conversation — particularly if you’re someone who pays attention to what goes into the products you choose.
The numbers don’t lie. Nearly 10 million neurotoxin treatments happened in 2024, and the landscape is no longer one-brand-fits-all. Your best move? Ask your provider what they offer, why they chose it, and where it comes from.