Ask a doctor

After Several Years of Botox Use Does Your Body Develop a Resistance to the Product? Botox Seems Less Effective with Time.

After Several Years of Botox Use Does Your Body Develop a Resistance to the Product? Botox Seems Less Effective with Time.

Doctor Answers (8)

Botox resistance


While it is possible to be resistant to botox, the condition is extremely rare. Generally, patients on a regular treatment schedule will have botox results that last longer. If you go to a regular injector, ensure that he/she is injecting approximately the same time each month and ensure that you have maintained a regular schedule. Initially, that should be every 3  - 4 months. If you have not kept the same injector, then you may have a quality issue with the injector (either in terms of technique or preparation).

West Palm Beach Plastic Surgeon
4.5 out of 5 stars 14 reviews

Is it possible to develop a resistance to Botox?


This is possible but rare. One may develop a resistance to Botox because antibodies are formed against the protein the Botox is mixed with. Some patients that develop these antibodies may try Dysport or Xeomin.  They are a more purified form of the product and may work better if you have developed antibodies.  The products were produced to decrease the amount of “impurities” in the botox. 
Thanks and I hope this helps!

Web reference:

Charlotte Facial Plastic Surgeon
5.0 out of 5 stars 19 reviews

Effects of Botox over time


In my experience, patients have the opposite effect. That is, they seem to go longer between treatments over time, as they break the habit of making the expressions which cause the wrinkles. Also, the muscles seem to get smaller or atrophy over time. In the beginning, my patients are advised that Botox lasts around 3-4 months but over time, I have had patients come in every 6-9 months or even yearly between treatments. 

There are rare cases in which patients are resistant to the effects of Botox. For these patients, Dysport is generally effective. However, there are a few things to double check before you decide that Botox (or Dysport) is not right for you.

-First off, make sure that you are being treated by a reputable injector. Some places might try to cut costs by telling you that you are receiving more units than they are actually injecting. Make sure you are actually getting Botox Cosmetic (Allergan).

-Secondly, make sure your provider is a high-volume injector, meaning that he or she sees a large number of patients. If Botox is mixed up and left on the shelf for too long, it's efficacy could be diminished.

-Thirdly, and related to the first two, make sure that your injector is experienced and knows the anatomy of the facial muscles. Your suboptimal results could be technique-related. 

If you have been going to the same reputable and experienced provider over the years and notice the effects are not as good as when you began using Botox, try Dysport!

Best regards,

Dr. Mehta


Web reference:

Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 22 reviews

Botox resistance does occur and can be treated by switching to Dysport in most cases.


I am personally totally resistant to Botox, however Dysport work well for me.  I have a large number of patients who have used Botox for years.   I see a Botox resistant patient at least 4 or five times a year.  It is not super common; however it happens often enough to know that it is real.  Switching to Dysport has solved the problem for most of my patients.

Salt Lake City Dermatologic Surgeon
4.5 out of 5 stars 9 reviews

Botox Resistance


While there is no "proof" that this exists, I do believe it does happen. As with any medication, your body becomes more used to it, so it can work through it a bit faster. For patients whose Botox seems to last less, I try to switch them back and forth between Botox and Dysport. Because the products are so similar but just different enough, this seems to help it last longer.

Las Vegas Dermatologist
4.5 out of 5 stars 6 reviews

Botox and resistance


Some patients do eventually develop some resistance to the Botox. You can always try Dysport as an alternative.

Manhattan Plastic Surgeon
4.5 out of 5 stars 14 reviews

It is improbable to develop immunologic resistance to cosmetic botulinum toxin.


However, it is not unusual to have more cosmetic issues over time.  This sometime requires a change in treatment strategies such as increase the dose of BOTOX, using other treatments such as surgery and fillers.

Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 14 reviews

Resistance to botox


Thank you for your question. You could call allergan helpline to get information about resistance to botox. Also consider with time and age, there is more wrinkles and you may need more botox to achieve the same results of earlier years.

San Diego Plastic Surgeon
5.0 out of 5 stars 2 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.

You might also like...

Ask a Doctor

Get personalized answers from board-certified doctors. For free.