I have had botox for several years and love it but I am debating on having dysport as I think botox doesnt work as well now - can you build up a resistance to Botox?
Can You Build a Resistance to Botox?
Doctor Answers 24
You can build a resistance to BOTOX,
You can build a resistance to BOTOX, but it’s rare. With the newer BOTOX formulations, very few people (less than 1%) really develop a true resistance to BOTOX. Some people who have had a resistance to BOTOX have had good results when they switch to a different neuromodulator like Dysprot or Xeomin.
Dysport, Xeomin and Botox are all preparations of botulinum toxin A which is a derived protein. It works at the nerve-muscle interface to relax targeted muscles.
Resistance to Botox
Yes, you can develop antibodies to Botox that will render it ineffective. Try Dysport. It has a different molecular composition and is more likely to work well. I've had two patients with this problem and Dysport worked great.
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is unlikely. If it used in higher doses a resistance can develop. There is no difference between the manufacturers.
It is very possible to develop resistance to onabotulinum toxin A (Botox Cosmetic), although rare. It would be a great idea to try Dysport with an injector who is experienced in using both of these drugs to see if you can get the same results with Dysport as you used to with Botox.
Does Resistance to Botox REALLY Exist?
Theoretically, our bodies can form a tolerance to many drugs if they are given to us for prolonged periods of time. The medical term is TACHYPHYLAXIS. However, in practice, this rarely happens. It is FAR more common for Botox not to work properly because :
- it was injected by an unskilled injector
- it was expired Botox
- it was old or overly diluted (less active units)
- it was a cheaper fake or overseas Botox (poorly shipped - not properly refrigerated)
I have a large Botox practice and have heard many new patients coming in telling me that "somehow Botox does not work on me". In every single such case, Botox DID work making the earlier Botox failures due to one of the above or a combination of the above factors.
Dr. Peter Aldea
Resistance to Botox is rare; Dysport may be a solution
Although rare, it is thought that antibodies can develop to the Botox molecule, resulting in shorter durations of effect. For my patients where this has been a concern, usually switching to Dysport will provide the expected results.
If Botox doesn't work for you, try Dysort!
I have patients who have reported a change in the effectiveness they perceive from Botox injections in my practice - as you have related in your inquiry. While the cause of this occurrence is not known for certain, it certainly would be a great option to try Dysport or in cases of significant lack of effect, Myobloc. Good Luck.
Botox and tolerance
Most physicians who inject much Botox for cosmetic use are not convinced of the development a resistance to Botox as a real effect but there may be a couple of my patients who don't maintain benefit longer than two months despite considerable units being injected. Switching to Dysport might be worthwhile despite both Dysport and Botox being composed of serotype A of Botunlinum toxin and therefore a difference in resistance shouldn't be an issue. It might be worthwhile to try Dysport as there is at least one report in the medical literature that Dysport may last a few weeks longer.
Botox resistance is uncommon but possible
The usual explanation for lessening effect with Botox after repeat injections is the formation of antibodies, but this is actually rare. More likely, what happens is that when muscles are repeatedly targeted with Botox, adjacent muscles can be "recruited" to take over, and so an adjustment in technique to include these muscles may be the solution. Dysport also works well and I have had at least one patient who had resistance to Botox but had a good response with Dysport. The answer may be that Dysport spreads a little bit more after injection so it may have affected nearby muscles more.