Immune to Botox?

Hi DW, Of the thousands of Botox patients that I have injected, I have never encountered a patient with immunity to the effects. There have been patients that require higher dosages, sometimes twice the usual amount. The most popular Botulinium Toxin type A in use, and the one that you probably received from your 5 injectors is Botox manufactured by Allergan. You may consider using Dysport which will soon be marketed by Medicis as Reloxin. Mentor will be putting out another alternative... more

Patients who receive dilute Botox at clinics, then come in frequently for touch-ups when the weak Botox fails can, I believe, essentially develop immunity to Botox. It is actually a growing problem. Fortunately, if all the Botox is allowed to go away for a period of 6 months, and the patient goes to a reputable doctor who uses concentrated Botox, applied to the right muscles, most patients can return to a normal Botox injection cycle every 3 or 4 months.

There are rare situations where a person's body may not react to Botox as expected, and you appear to be one. As an alternative, you might want to try a filler for the number 11 lines such as Restylane or Juvaderm. Without actually examining you, it's difficult to say what might be best. Also a surgical procedure could be performed to intentionally cut some of the muscles that create the #11 lines. I hope this helps. I am sorry that it did not seem to work well for you.

You say that you had Botox injected by five different doctors on five different occasions. This makes me wonder if you had all of your five treatments in a row, every three months, or whether you tried every 6 to 12 months. I ask this because you said you have fine lines between your eyebrows (frown lines) which aren't deep. But it is very possible that the Botox DID work..... to prevent you from frowning and folding the lines, but that the Botox wasn't in place long enough in a r more

Rare, but not unreasonable....however, from the wording of your question, the botulinum toxin you received never worked for you. I have had a few patients with the same issue....Recently I have treated these patients with a higher concentration of the medication and therefore a smaller volume which allows less migration of the drug and therefore has been more effective. I also think this limits the amount of effective drug needed and lowers the risk of immunity in the future...only theoretica more

There is about at 1 in 10,000 chance of developing antibodies to Botox.   I have seen two patients in my practice with this problem.  If you are concerned, your blood can be tested for the antibodies.  Also, there are other botulinum toxins, such as Myobloc, which can be used effectively in patients with immunity.  Good luck.

I've had a couple of patients develop immunity to Botox over the years.  They both responded very well to Dysport, which is a different type of botulinum toxin.  I would only used Dysport, however, on one of my own Botox patients.  There are a lot of injectors out there who do not inject deeply enough (especially between the brows where the muscles are deep) or who really dilute their Botox.  For patients who have not had good luck with Botox from another injector... more

It is possible to have antibodies to Botox.  If you have ever had botulism you would have antibodies.  People can also develop antibodies to Botox if they have received large doses of Botox (like for cerebral palsy treatments).  It is possible to have antibodies for no known reason, but quite unlikely. Keep in mind, that Botox directly affects nerves (and thus muscles), not the crease.  It is more likely that Botox is working, but you are not getting the indirect... more

It is possible, although unlikely, that you have antibodies to the Botox being injected into your body. If this is the case, Botox will not have the same effect on your body as it does in other patients. You will effectively be immune to the treatment. One option is to try a different strain of botulinum toxin, like Dysport, to see if this is any better in controlling the unwanted muscle movement.

Botox immunity is extremely rare but can happen you may be better off trying Dysport which is Botulinum toxin B as opposed to A.  This may do the trick.

Botox immunity is extremely rare. When discussing this with your doctors, go over how many units of Botox you are using and consider increasing the dosage. I would also focus on treating just one or two areas while you are working this out.    For more information on Botox or to schedule an iConsult, please visit us online at 

Immunity to BOTOX is uncommon, but possible. If you have been injected with the correct number of units and at the right depth by a dermatologist or plastic surgeon, and the results are suboptimal, it may mean that your body has formed antibodies against BOTOX. With cosmetic BOTOX use, this is very uncommon, & more common when used in large doses (e.g. for cerebral palsy). That said, you may benefit from the addition of a hyaluronic acid filler using a microdroplet technique to fill... more