Neurotoxins –
Botox & Xeomin

Botox is a well-known brand name of neurotoxin, but there are also another one we prefer called Xeomin. These treatments only take minutes and result in improvement of dynamic wrinkles – like crows feet, the furrow between your brow, and forehead lines. We are known for our natural, great results with these products. You will look and maybe even feel more relaxed and youthful after a treatment with either Botox or Xeomin!

Botox in Boulder, CO available at Evolution Dermatololgy

What are Neurotoxins?

When Botox and other neurotoxins are used for cosmetic purposes they decrease dynamic wrinkles, or those wrinkles that form as a result of facial movements like squinting, smiling, and furrowing your brow. By decreasing the exaggerated expressions caused by hyperdynamic muscles, there is improvement and smoothing of the facial wrinkles in the areas treated.

Botulinum toxin has been in use since 1970, but it wasn’t officially approved by the FDA for cosmetic use until April 2002 . Since then botulinum toxin has truly transformed aesthetic medicine!

Now neurotoxin treatments (like Botox) are the most popular single cosmetic procedure in the U.S. In fact, The American Society of Plastic Surgeons estimated that in 2018 more than seven million people received these injections. To put that number in perspective, more people received neurotoxin injections than live in Colorado!

Botox for men in Boulder CO from Evolution Dermatology and wellness

Are Neurotoxins Safe?

Injections for cosmetic improvement with Botox and the other approved neurotoxins are one of the safest cosmetic treatments around today, even though it initially may sound the scariest. Botox has been used for over 20 years and has an outstanding safety profile. The botulinum toxin stays in the muscle it is injected to and does not travel anywhere else in the body. If you stick to an expert injector, such as a cosmetic medical derm provider, the risks are extremely low. Adverse side effects are possible, including: pain, swelling, or bruising at the injection site. Headache or flu-like symptoms have also been reported.

The main risks are, for instance, a temporarily droopy eyebrow or eyelid if the placement of the neurotoxin isn’t perfect or too much is injected. Sometimes people complain of a slightly heavy feeling in the forehead if neurotoxin is used in that area, but that, too, is temporary. There is a small, theoretical risk of developing antibodies to neurotoxins and becoming immune to it, but I personally have only seen this once in thousands of injections over 22+ years.

Where can Neurotoxins be used for cosmetic improvement?

It is used to correct furrow lines between your brows, horizontal forehead lines, lines on the nose, smile lines (crow’s feet) around your eyes. It can also lift the eyebrows a little and help to fix a smile that shows too much gum on the upper teeth. It can be used in the lower face to lift the corners of the mouth, smooth chin dimpling and reduce lines in your upper lip. It can even soften the tight bands in your neck, known as platysmal bands, that get more obvious with age.

Additional Applications: Underarm Sweating
This area can be treated with Botox and will decrease underarm sweating for up to 9 months!

How long do these Neurotoxins last?

Patients can begin to see results within five to seven days, with full correction at the fourteen-day mark. These effects are temporary and typically wear off somewhere between 3 and 5 months.

Where can Botox be used - find out from Evolution Dermatology in Boulder CO
What type of Neurotoxins are available in Boulder CO Evolution Dermatology Specialists

What are the different neurotoxins offered at Evolution Dermatology + Wellness?

Botox® (OnabotulinumtoxinA):

This was the first commercially available type of Botulinum toxin in the United States. Its approval for cosmetic use was approved by the FDA in 2002. Its safety is well established. Botox is not only FDA approved for cosmetic use, but also approved for medical use to treat a number of conditions including chronic migraines, spastic disorders, bladder incontinence, excessive underarm perspiration, and certain types of neck pain and eye issues.

Xeomin® (IncobotulinumtoxinA):

Xeomin was given the FDA approval in July 2011 for cosmetic treatment as well as the treatment of medical conditions such as cervical dystonia and blepharospasm
How does it differ from Botox?
Xeomin is an innovative Botulinum type A formulation, in which the complexing proteins have been removed from the botulinum toxin complex. In contrast to the other preparations, Xeomin contains the pure 150 kD neurotoxin (the active ingredient). Xeomin, without the extra proteins, has the lowest content of bacterial protein of all of the available botulinum toxins. This means that even in high doses, it has a lower incidence of forming antibodies (therefore resistance). One unit of Xeomin is equal to one unit of Botox.

Which Neurotoxin is best for you?

They have been used safely and effectively for years. Which of these products is best for you will depend on your unique anatomy, your goals, and your medical provider’s recommendations. A good way to think of it is like toothpaste…some prefer Colgate toothpaste, others Crest, but no matter what the brand they all get the job done!

Just make sure you have an experienced medical provider performing the treatment. It makes a difference with someone who knows your anatomy, the nuances of these neurotoxins, and how to best avoid unwanted side effects.

For instance:

  • We have found that pain and bruising at the injection site can be minimized with the use of a small-gauge needle, and icing the area post injection.
  • We know that it is important to make sure a balance is achieved between decreasing the activity in hyperactive muscles and maintaining natural facial animation.
Botox for forehead lines in Boulder CO

Before Your Neurotoxin Appointment


To minimize bruising consider stopping (if not medically necessary) any blood thinners such as aspirin, ibuprofen, naproxen, and even fish oil supplements for 2 weeks prior to your appointment.


To minimize both bruising and pain, ask your medical provider for ice packs to cool the area treated before and after your treatment.

A Few Post-Treatment Things to Consider:

One great thing about these injections is that no recovery time is required! You won’t have to take off work or school. You can resume your normal activities right after (with a few small exceptions mentioned below).


Neurotoxins need some time to settle into the muscle. For the first 24 hours, avoid other skin treatments like: facials, facial massages, exfoliating scrubs (where pressure is applied)


Sit up for the first 4 hours after getting your treatment. Bending or lying down might spread the toxin and promote bruising. This means no taking a nap, massage or anything where pressure might be applied to the area treated.


If exercise is part of your daily routine, wait at least 4 hours (and up to 12 hours if you can!) to work out. Physical activity increases blood flow. This could potentially spread the toxin to unintended areas and reduce its effectiveness at the injection site. It also increases the risk of bruising.

Additional FAQ from our providers

Please click on the links below

I have been seeing Kim Guthke as a PA for 15 years for all my medical and cosmetic dermatological needs. Kim Guthke is exceptionally knowledgeable, skilled, compassionate, and forthright. She is determined to get you and your skin the best possible result.

E.K. - Boulder, CO 
E.K. - Boulder, CO

Kim has been our family dermatology PA for 10 yrs.  Skin and doctors, in general, are a sensitive topic for me due to some traumatic past experiences.  Once a year, I happily have a skin check with Kim to care for my 1950’s sunbaked skin.  After my first appointment with Kim, I knew I had found a skilled, trustworthy PA.  I feel at ease no matter what she is helping me with and trust her gentle guidance.  She is kind, calm, sensitive, enthusiastic, compassionate, honest and treats us as family.  Usually I work hard to relax at any doctor’s appointment but am calmed just by her presence.  Kim is loved and appreciated by all her patients.  I have referred many grateful friends who understand how precious it is to find a health practitioner who is skilled, listens and understands people.  Gratefully yours.

C.P. - Boulder, CO Life Coach
C.P. - Boulder, CO

“Kim Guthke is an amazing practitioner.  She is thorough, professional, and attentive.  I have been a patient for over a decade and regularly refer people  to her care  for dermatology.”

A.P. - Boulder, CO Vice President of Strategic Accounts
A.P. - Boulder, CO

“I have been a patient of Kim’s for several years now, and I absolutely LOVE working with her as my dermatology PA.She is thorough, insightful, and so fun and pleasant to see. I trust her implicitly, and know she has a very keen eye. Her professionalism is truly top notch.”

C.E. - Boulder, CO Doctor of Chinese Medicine
C.E. - Boulder, CO

“I have been seeing Kim Guthke as a PA for 15 years for all my medical and cosmetic dermatological needs. Kim Guthke is exceptionally knowledgeable, skilled, compassionate, and forthright. She is determined to get you and your skin the best possible result.”

E.K. - Boulder, CO Speech-Language Therapist
E.K. - Boulder, CO

“Kim allows patients to feel immediately at ease and welcome. Her bedside manner is at the top and she has even helped with our children. I have seen Kim for over 10 years and appreciate her knowledge, experience and professionalism in the dermatology setting. I would highly recommend Kim to any friend, or family member without hesitation. She is the best!!”

L.C. - Boulder, CO Home Staging & Design Business Co-owner
L.C. - Boulder, CO

“Pauli Morrow is a gem of a human being and dermatologist. As an ex-sun worshiper, I really appreciate her thoroughness on skin checks and assistance around sun damage. Pauli is also a true artist with the needle. I walk out of her office knowing I’m going to be super fresh faced in a naturally enhanced way. I owe Pauli so much when it comes to keeping my skin healthy and looking amazing. I am very lucky to be in such amazing knowledgeable hands for the last 10 plus years. I feel beyond cared for – Pauli is simply the best!

J.H. - Boulder, CO 
J.H. - Boulder, CO

“I have seen Pauli for Botox and Facial Filler several times.  She is extremely professional, listens carefully, provides honest objective recommendations and her results are impeccable.  I would highly recommend Pauli to my friends, family and colleagues (in fact I already have!).”

M.M. - Scottsdale, AZ 
M.M. - Scottsdale, AZ

“I have been a patient of Pauli Morrow’s for over 20 years. Words that come to mind when thinking of Pauli are talent, passion, skill, experience and trustworthy. Pauli loves her work and that shows in the way she treats her patients—with an exceptional curiosity, focus, and real interest in caring for others—and in the incredible results I see in my skin after every office visit. It may be slightly over-the-top, but even though I now live several states away, sometimes I still fly across the country for treatments with Pauli because I trust her so much and know her skills are worth the effort and will make a difference every time.”

E.D. - Atlanta, GA Public Health Specialist
E.D. - Atlanta, GA

“Pauli Morrow keeps me looking 10 years younger … oh yeah, and she saved my life. Literally. I’ve been a patient of Pauli Morrow for over 20 years. Cosmetic treatment was my primary goal and she is an ARTIST. She saw me for my general derm checks. She brilliantly zeroed in on a spot on my arm which turned out to be melanoma. Without her seeing this, I would never have had it looked at! I owe her my life. Plus I look fabulous while living it, all thanks to her!!!”

L.D. - Del Ray, FL  Commercial Real Estate Executive
L.D. - Del Ray, FL