Botulinum therapy with Xeomin in neurology and cosmetology. Treatments and prices

Botox and other preparations based on botulinum toxin are widely used in medicine and cosmetology as a means to relax the subcutaneous muscles.

However, until recently, their use has raised certain concerns associated with a high risk of complications. Everything changed with the advent of Xeomin, an analogue of Botox, devoid of its disadvantages and retaining all the advantages of botulinum therapy.

Operating principle

The principle of action of Xeomin is based on the ability of its main component (botulinum toxin type A) slow down the production of acetylcholine, an organic compound that makes muscles contract.

Injections of the drug lead to their partial relaxation, which makes it possible to treat diseases associated with excessive activity of the subcutaneous muscles and use Xeomin for cosmetic purposes to combat expression wrinkles.

Composition and form of release

Xeomin was first synthesized in 2001 by the German pharmaceutical company Merz. It has been used in Russia since 2011. The product is available in the form of a white powder, packaged in hermetically sealed bottles of 50 and 100 U (1 U = 0.1 ml).

It contains 3 components:

Act

The main component of Xeomin belongs to the group of neurotoxins of a protein nature and in large quantities is the strongest poison that causes paralysis of all vital systems of the body. In medicine and cosmetology, it is used in micro doses that are not hazardous to health, causing only a partial blockade of the centers responsible for the production of acetylcholine.

Botulinum therapy with Xeomin acts as follows:

• overly tense muscles relax;
• pain caused by spasm disappear;
• wrinkles are smoothed.

The effect of using the drug is limited to several months, after which the tone of the subcutaneous muscles is restored.

A repeated course of injections is possible. In comparison with other medications based on botulinum toxin, Xeomin has a number of advantages associated with its low molecular weight and the complete absence of foreign protein in the composition, previously used for the preservation of drugs.

Namely:

• low likelihood of developing allergies;
• no effect of addiction to the drug;
• high accuracy of administration, excluding the effect of the drug on areas that cannot be corrected. Due to this, the probability of such negative consequences of botulinum therapy as sagging muscles (ptosis) and facial asymmetry is minimized;
• the ability to eliminate the smallest imperfections in appearance;
• preservation of natural facial expressions after the procedure and the absence of the "stone" face effect;
• long shelf life and ease of transportation.

At the same time, one should also remember about the disadvantages of Xeomin:

• a shorter period of action than Botox: it is limited to 3-5 months;
• long time required for the effect to appear (about a week);
• limited applicability due to low diffusion ability: ability to dissipate, penetrate into tissues.

Indications

Due to its ability to relax muscles and relative safety of use, Xeomin injections have become an inexpensive, easy-to-use and painless means of combating pathological conditions caused by hyperactivity of the subcutaneous muscles.

Botulinum therapy with Xeomin is performed for the following diseases:

• blepharospasm (nervous tic) - spontaneous closure of the eyelids or eyelids, difficulty keeping them open, accompanied by dry eyes and high sensitivity to light;
• spastic torticollis - incorrect (with an inclination to the left or right shoulder) head position caused by excessive tension of the neck muscles on one side and their gradual atrophy on the other;
• arm muscle stiffness (post-stroke spasticity).

In addition, Xeomin can be used:

• as a rehabilitation tool after a stroke;
• in the treatment of migraines, strabismus;
• to relieve the symptoms of cerebral palsy;
• for various pains caused by spasm.

In cosmetology, Xeolin is widely used in anti-aging procedures as a means of combating expression wrinkles caused by excessive activity of the facial muscles.

With its help, the following cosmetic flaws can be eliminated:

• nasolabial folds of small and medium depth;
• vertical wrinkles in the eyebrow area;
• longitudinal wrinkles on the forehead;
• periorbital fine wrinkles near the eyes (the so-called "crow's feet");
• straps on the neck;
• wrinkles around the lips.

However, it should be remembered that Xeomin, for all its merits, is not omnipotent: in particular, the drug:

• will not cope with deep nasolabial folds, the reason for the appearance of which is not only muscle hypertonicity, but also the downward displacement of the array of soft tissues of the cheeks;
• is powerless against age-related skin changes associated with a decrease in collagen production, since it does not affect this process in any way;
• ineffective in the fight against hyperhidrosis and deep wrinkles due to low diffusion (ability to penetrate into tissues).

Instructions and dosage of the drug in neuralgia and cosmetology

Before use, Xeomin powder is diluted with saline. The concentration of the drug depends on the purpose of the procedure and on the stage of therapy.

In medicine and cosmetology, the following ratios are accepted:

The technique of performing the procedure, the number of injections, doses, the area of ​​exposure are determined by the purpose of botulinum therapy using Xeomin and the patient's condition.

Blepharospasm therapy

Injections are performed in the lotral and medial ligaments (for the upper eyelid), only in the lateral (for the lower). The primary dose does not exceed 2.5 U (0.25 ml), the result becomes noticeable on the fifth day. For short-term effects (less than 60 days), the dose is doubled.

The maximum total dose of the drug for one eye (if the botulinum therapy schedule is designed for a period of less than 12 weeks) is 25 IU, the maximum volume of a single injection is 5 IU. If the duration of the procedure exceeds 12 weeks, the total dose can be increased to 100 units. For the treatment of the eyelid zone, needles marked 27-30 G (that is, with an outer diameter of 0.3 to 0.4 mm) are used.

Arm muscle stiffness

The choice of needles depends on the depth of the problem muscles: for superficial injections, 26 G needles are required (length - 37 mm, outer diameter - 0.45 mm)When processing muscles located deeper, thicker and longer needles are used (length - 75 mm, diameter - 0.7 mm).

The number of injections and the time required for a full course depend on the size of the affected area and the severity of the disease. The total dose should not exceed 170-400 units. A clearly noticeable positive effect is achieved after 4 weeks of therapy and lasts 12 weeks.

Spastic torticollis

The dose and area of ​​treatment depends on several factors:

• head position;
• the intensity of pain;
• the level of development of the muscles of the neck;
• patient weight.

The amount of Xeomin that can be administered in one injection is limited to 50 units, in total, no more than 200-300 units can be administered per procedure.

To relax the superficial muscles, needles 25-30 G are used, for deeper layers - needles 22 G. The patient notices a persistent improvement in a week after the start of the course, the effect lasts up to 4 months, after which you can repeat the course.

Eyebrow area (glabellar wrinkles)

To smooth out glabellar wrinkles (that is, located vertically between the eyebrows), 5 injections are performed in the following zones:

• the medial and central regions of the muscle wrinkling the eyebrow - 2 injections in each. The injection site should be at least 1 cm above the edge of the orbit bone;
• muscle of the proud - 1 injection.

For each injection, 4 units of the drug are needed, the total dose for one procedure is 20 units. Already after 2-3 days, the depth of wrinkles decreases, a lasting result is achieved after 4 weeks, the effect lasts 4 months.

Lateral periorbital wrinkles (crow's feet)

By the decision of the doctor, various schemes can be used to select the injection sites in order to correct the area of ​​the outer corner of the eye.

3-point scheme

The first point is located 1 cm further than the outer edge of the bony orbit, the 2nd and 3rd points are 1 cm above and below the site of the first puncture. One injection requires 4 units of the drug, in total for the procedure - 24 units.

4-point scheme

First, a point is marked 1 cm from the outer edge of the orbit, then 0.5 cm upward (1st puncture) and downward (2nd puncture) are retreated from it. Places of the 3rd and 4th punctures are located, respectively, 1 cm above the 1st and below the 2nd puncture.

For one injection, 3 units of the drug are taken, in total for the procedure - 24 units. The effect will be noticeable in a week, by the end of the second week, the skin is completely leveled, the result lasts for 4 months.

Longitudinal forehead wrinkles

In order to determine as accurately as possible the sites of future punctures, the patient is asked to wrinkle his forehead by raising his eyebrows. The number of injections depends on the depth of the wrinkles, on average, the consumption of the drug per session is 10-20 units. Injections are made at a distance of at least 2 cm from the eyebrow line. The result becomes noticeable as early as 2-3 days, the effect lasts about 3 months, after which the course must be repeated.

Training

The success of the procedure depends on how correctly the preparation was performed.

The preparatory period includes several stages:

1. Consultation with a specialist in order to discuss existing problems and choose the best ways to solve them, taking into account the wishes of the client and the possibilities of medicine.
2. Careful collection of anamnesis, which will give a complete picture of the state of health and can identify the presence of contraindications.
3. Repeated conversation with the patient, during which he is given recommendations that must be followed.

It may take 7-10 days before the procedure to stop taking medications that can cause an undesirable effect when interacting with Xeomin: antibiotics, pain relievers, blood thinners.

Prohibited:

• aspirin;
• ibuprofen;
• escedrin;
• vitamin "E";
• medicines used for Alzheimer's disease.

The day before the procedure, it is necessary to exclude the use of alcohol: by expanding blood vessels and increasing blood circulation, it can lead to an increase in the affected area, cause facial asymmetry, ptosis, swelling and bruising.

On the day of the procedure, you should try not to perform any heavy physical work, accompanied by frequent bending, lifting weights, high stress on the respiratory system.

Procedure progress

Botulinum therapy with Xeomin injections is performed on an outpatient basis, pain relief is usually not required.

The procedure time does not exceed half an hour, during which:

1. The protective cap is removed from the vial containing the drug, and the stopper is disinfected with an alcohol solution.
2. Saline is added to the powder contained in the vial in order to obtain a solution for injection of the desired concentration.
3. The skin is cleansed of cosmetics, sebum, impurities.
4. The points of future punctures are marked.
5. In some cases (for cosmetic manipulations), a cream is applied to the face, which has a weak anesthetic effect.
6. Injections are performed at selected points.

Rehabilitation

Strict adherence to some restrictions in the first time after botulinum therapy will make it possible to reduce the risk of negative consequences.

In particular, you cannot:

• lie down and bend over for the first 4 hours;
• immediately after the procedure, touch the face or rub the puncture sites;
• do makeup during the first day;
• drink plenty of fluids (when correcting the area around the eyes, it can cause swelling);
• in the first week, refuse to visit the pool, sauna, steam room;
• for the next 3-4 days, reduce to a minimum the time of exposure to the sun and refuse solarium services;
• within the next 20 days, do not take medicines from the "prohibited" list and alcohol;
• limit sports and physical activity for the first week;
• for the entire time, until the action of Xeomin ends, manual massage, myostimulation, microcurrent therapy are prohibited.

At the first time after the procedure, it is recommended, in order to more evenly distribute Xeomin, to perform simple exercises that make the muscles located in the injection area work: smile, move eyebrows, frown. After the end of the rehabilitation period, gentle peeling and light masks are allowed.

Undesirable consequences

Side effects when using Xeomin can be caused by:

• inexperience of the doctor;
• low quality of the drug;
• non-compliance by the patient with the rules of behavior before and after the botulinum therapy session, set out above.

The type and intensity of side effects depends on the area and purpose of the treatment.

With blepharospasm

It is extremely rare that severe swelling of the eyelids and the development of angle-closure glaucoma are possible.

More often observed:

• weakness of the eye muscles;
• inability to open one or both eyes (drooping of the upper eyelid);
• lacrimation;
• dry mucous membranes;
• headaches.

With spastic torticollis

Patients complain of difficulty swallowing, a feeling of a lump in the throat, pain in the neck.

Also possible:

• migraine;
• feeling of dry mouth;
• omission of one or both eyelids;
• difficulty pronouncing words;
• the appearance of symptoms characteristic of colds

With immobility of the muscles of the hands

After botulinum therapy, rash and itching may appear, sometimes patients notice impaired coordination of movements, lack of sensitivity in the fingers. Also on the list of negative effects are various disorders of the nervous system: headaches, unexplained anxiety, insomnia.

When smoothing mimic wrinkles

Side effects appear during the first days after the procedure, then gradually subside.

It can be:

• bruising at the injection sites;
• loss of sensitivity in the area of ​​injection;
• swelling of the face;
• asymmetry;
• sagging tissues.

Rarely after the procedure is observed:

• development of blepharitis;
• feeling of dry mouth;
• photophobia;
• the appearance of "cold" symptoms;
• bouts of nausea.

The manifestation of any side effects is limited by the time the botulinum toxin is present in the tissues. As soon as it is removed from the body, the phenomena caused by it will also disappear.In order to speed up this process, drugs, massages, microcurrent therapy are used.

Contraindications

In most cases, provided that all the rules of the procedure are followed, botulinum therapy using Xeomin is well tolerated.

But, since the main active ingredient of the drug is a neurotoxin, there are a number of absolute and relative contraindications:

• allergy to the components of the drug;
• any diseases that cause muscle weakness;
• poor blood clotting;
• oncological diseases;
• the need to take antibiotics;
• the presence of skin diseases at the injection sites;
• some eye pathologies.

In addition, the procedure is not performed if you feel unwell for any reason, during pregnancy and lactation, or if the patient is under 18 years of age.

Interaction with other drugs

Botulinum therapy with Xeomin is incompatible with many drugs, so one of the main requirements of botulinum therapy is to refuse to take them.

It is important to consider that:

• antibiotics can reduce (tetracycline drugs) or enhance (aminoglycosides) the effect of Xeomin. For this reason, the dose may be too small and ineffective or too large, and the composition administered during injection migrates to adjacent skin areas, causing any of the side effects described above;
• drugs of the group of analgesics, in particular, aspirin, thin the blood, reducing its clotting. This leads to the appearance of bruises and bruising at the puncture sites;
• myolesants (drugs that affect the transmission of nerve impulses to muscle fibers) in combination with Xeomin can cause any unpredictable effects and negative changes in facial features.

Overdose

If the dose of Xeomin is exceeded, muscle paralysis may develop in areas that have not been exposed.

Paralysis can cause:

• feeling weak;
• profuse sweating;
• difficulty speaking and swallowing;
• breathing problems.

To restore normal body functions, the patient is hospitalized for maintenance treatment. In case of paralysis of the muscles responsible for breathing, intubation and artificial ventilation of the lungs are used until the symptoms disappear.

Terms of sale and storage

When buying a drug, you should make sure the package is tight and check the date of manufacture An unopened pack can be stored until the expiration date (for Xeomin it is 3 years) at a temperature not exceeding 25 ° C.

It is advisable to use the drug diluted under sterile conditions as directed., but it can be stored in its original packaging during the day at a temperature of 2-8 ° C.

Analogs

Xeomin's analogues are Botox, Dysport, Relatox. With a similar mechanism of action, each of the botulinum toxin-based drugs has its own characteristics, advantages and disadvantages.

Their comparative assessment according to several of the most important criteria is as follows:

The cost of the drug in pharmacies

A bottle for 100 units costs 10259 rubles, for 50 units - 6179 rubles. Xeomin is considered the safest of the group of drugs based on bolulotoxin. Among the advantages are high accuracy of introduction, convenience of storage, reasonable price.

At the same time, the drug is inferior to its counterparts in terms of the appearance of the effect, duration of action, ability to penetrate into tissues. We must not forget that this is a new and insufficiently studied botulinum therapy tool.

Video about botulinum therapy with Xeomin and its effectiveness

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