Rare to hear a patient say…”my Botox seems to be wearing off earlier than usual”…or…”I had Botox but it didn’t seem to work”. Some few patients even suggest that they may be immune to Botox or that they are becoming resistant ot it. Many physicians and even manufacturer reps say that such immunity is impossible. But is it? Is immunity to Botox real?

First and foremost any drug, no matter what its mechanism of action, poses the potential of diminished effectiveness with repeated use. The most classic example is that of antibiotics. (although this really represents resistance of the infecting bacteria not necessarily how the body responds to it) But immunity or developing an immune response to a toxin, an unnatural molecule that the body may eventually recognize as both foreign and harmful, is particularly likely. While I hold most responses on the internet as not a source of absolute scientific information, there is too many patient responses on many different websites that claim a lack of response after injection or a dramatic dropoff in effectiveness after a period of years of successful use. (most common) While some, if not many, of these may be the result of using overdiluted or old Botox or from poor injection technique, all of them can’t be completely drug or injector-related issues. Resistance to serotype A of botulinum toxin (Botox and Dysport) has been reported in some physician series but the incidence is quite low. (usually less than 1%) The point is…it has been reported in professional medical journals in large patient series. Anectodal statements by some physicians such as ‘I have never seen it’ and the like does not count as scientific evidence. Never having seen it does not mean it doesn’t exist. Most of us have never seen a platypus in the wild either, but we know they do exist.

Once you develop Botox immunity, what can you do? There is no absolute answer to this uncommon problem. Perhaps waiting a period of time ( 6 months to a year?) before trying repeat Botox is one option to see if your immune response lessens. The other option is to use a different serotype, type B (Myobloc), and see if you get a response. In theory, different serotypes have slightly different molecules so your immune response may be quite specific to type A only.

Whether someone can be completely immune to Botox, without PRIOR injections, is a different matter. There would be no natural immunity to Botox since most of our immune systems have never seen the molecule before. When a first-time patient of mine calls and tells me they have had no response, actual examination everytime demonstrates that they actually have had a response it is just not as profound as they thought it to be. This is an issue of managing expectations and dosing, rather than some natural resistance to the drug.

By far, the most common patient experience in my practice with Botox is that patients actually develop a somewhat lesser need with Botox over time. After three or four treatments, many patients find that the Botox seems to ‘last longer’ and they may only need injections twice a year as opposed to every three or four months. This is not because the patient has developed greater sensitivity to the drug but because they have most likely ‘retrained’ their expressions. which are learned movements anyway. Once you have not moved or have less movement of any muscle for a long enough period of time, you may have inadvertently retrained your expressions to some degree.

Acquired Botox immunity is a real but uncommon event. It usually presents in the patient who has had Botox for multiple treatments, after a year or two, with a diminished response to a proven dose or sometimes as no response at all. Botox resistance without prior exposure is more likely an issue of expectations and proper dosing rather than a natural immunity.

You may be torn between having a botox injection or not. You are certain that you want to get rid of these ugly frown lines that makes you look older than you really are. However, you are scared because of the possible side effects that it would cause.

In the first place, what is BoTox? A cosmetic treatment involves injection of bacteria called Botulinum Toxin to remove unwanted frown lines or wrinkles. Administration is usually done through a number of injections of small amounts of botox. They say that the procedure only takes 10 minutes, does not require anesthesia and causes only a minimal amount of discomfort.

They would be lying if they tell you that having a BoTox treatment would not cause any side effect. This procedure may sound simple since it is non-surgical in nature. However, what is injected into your skin is a kind of bacteria, which is foremost, a foreign body that the body would expectedly reject at first. This is aside from the fact that this bacterium is commonly found in spoiled food.

So you ask yourself this question: Why in the world do they have to use bacteria found in spoiled food? The answer is simple: you want the effect that this bacterium does, which is paralysis. Scientifically speaking, this is how it works. The botox attach to the nerve endings causing acetylcholine, the neurotransmitter that triggers muscle contractions are to become impeded. When this happens, muscles stop to contract. In fact, people may die of botulinum toxin if it attacks the respiratory system or the muscles in the chest. So going back to the botox treatment context, if this injected area of the face cannot move, it definitely cannot wrinkle. However, note that these effects are also temporary – lasting only about six to eight months.

So now you think it does not sound so bad, after all. Then, what side effects are we talking about? The more normal ones include redness at the injection site, local numbness, swelling, bruising, muscle weakness and facial pain. There can also be temporary headache, nausea and other flu-like symptoms. Some have even reported cases of upper respiratory tract infection. Other complications would include squinting, double vision, ptosis (drooping of the eyes) or even dysphasia (impairment of speech and language comprehension) in extreme cases.

These complications do not happen very often, but are still possible. It is also important to note that botox treatments are strictly not encouraged for pregnant or breastfeeding women, people who are allergic to botox or have infections in the forehead, and those who are under specific medications. You will need to consult your doctor if you have any related concerns.

They say that wrinkles on your face are supposed to be called character lines – that each you find on your tells a different story. They say that these lines mark wisdom, experience and achievement. But if you believe more in youth and appearance than wisdom and experience – then Botox is your choice.

All cosmetic procedures involves some amount of risk. Any procedure that goes contrary to what is natural is risky. However, if you think it is all worth it, go ahead.

Wrinkle erasing botox injections have come home to roost in the living rooms of average Americans from Arkansas to Arizona. Once thought to be accessible only by the wealthy and well-known, Botox, a drug derived from a poison called Botulinum toxin, has been used for years in doctors’ offices to help treat and prevent mild to severe facial wrinkles.

Botox treatments boast diluted samples of nerve blocking toxins, which prevent muscles from contracting during normal facial expressions and help to soften and relax facial wrinkling. For a culture bent on preternaturally youthful looks, this sounds like a miracle cure. Botox is fast, painless, relatively affordable, and it’s becoming a way for estheticians, dermatologists and cosmetic surgeons to grow their patient lists.

At a cost of about $350 per injection and a life span of approximately three months, for those of us with furrowed brows, laugh lines and crow’s feet and a large measure of vanity, Botox injections may seem like the discount fountain of youth- and with Botox parties growing in popularity, you can get it in the Jones’ living room along with hors d’oeuvres and a glass of Chardonnay.

The danger in these parties and with Botox injections in general, is that on occasion, Botox can migrate from the injection area. An injection into a frown line could send the nerve blocking agent to other areas of the face and cause a “sleepy eye” or a frozen appearance. While Botox is not a permanent wrinkle treatment, any amount of time spent with an unmoving expression could cause some distress.

Many doctors strongly disagree with making Botox house calls, saying it invites criticism of their profession, detracts from professionalism and raises the chances for poor results. Although Botox is used mainly to smooth out the wrinkles of an age-obsessed beauty conscious society, the Botox drug itself can also be used to treat excessive sweating in palms and underarms, cerebral palsy in children, and herniated discs. “Botox should not be underestimated as a real drug meant for medical use,” says one doctor.

Doctors and surgeons urge their patients to consider botox and any form of cosmetic improvement with some due deliberation. Reflect on the time, place and the person administering the treatment before going under the syringe, and above all, be aware that there are risks associated with botox treatments.