Recently the FDA approved a new botulinum toxin to give Botox and Dysport a run for their money. The FDA approved Xeomin (incobotulinumtoxinA) for the improvement in the appearance of glabellar lines in adults on a temporary basis. The glabellar lines are what we refer to as the “11’s” that appear between the eyebrows when we furrow the brow. The data from two clinical trials indicates that this product significantly improved the appearance of glabellar lines within 30 days after injection. Xeomin is not available to US dermatologists at present, but is expected to be available during Spring. The approval of a third botulinum toxin is further proof that this modality of treating cosmetic dermatology issues such as glabellar lines and frown lines is highly effective. Even though there are now two other botulinum toxin products on the market, Botox will likely maintain branding dominance, just as Coke does with sodas, but it will be interesting to see if Botox retains the dominant market share. West Houston Dermatology, as always, will remain on the front lines of evaluating the new product’s efficacy so that we can make sound recommendations to our patients.