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Botox Stopped Working - San Diego, CA

I had Botox three times with great results, but...

I had Botox three times with great results, but the fourth time - nothing. It simply stopped working. My dermatologist - board certified, very reputable - invited me into his private office and called Allergan's representative on his speakerphone with me present, and Allergan's rep said about 10% of all cosmetic patients eventually become immune to it and it will never work again. The doctor did inject me three more times over the next two months for free, each time with a fresh vial of Botox, but there were never any results. I then tried two other board-certified dermatologist and once again, nothing. I wish Botox would work for me again, because it was great when it did.

The Allergan representative said that this is not a tolerance; it is an immunity, and further injections typically renew and increase the immunity. He said that although some people lose their immunity over time, if they initiallly develop it after only a few injections, they will quickly reacquire it once injections are resumed. He described it as akin to a vaccination against a toxin such as tetanus; some people develop antibodies against it, and some do not. I have a B.S. degree nursing and an inactive license as an R.N. (I changed careers), so I researched the topic in medical journals and he is correct. To find online articles about this topic authored by physicians, search for "botulinum antibodies." (Botox is a variant of botulinum toxin A, called onabotulinumtoxinA.) The free abstract of one such article is on PubMed; you can find it if you search Google for "Antibody-induced failure of botulinum toxin A therapy in cosmetic indications".

I have heard of people building up a tolerance to Botox, but it was my understanding the usual way to deal with it was to stop injections for a period of time (I'm assuming so the tolerance goes away) then resume treatment.

There was another review posted a while back titled "Botox Works for Some But Didn't Work for Me”. If you check out their review they talk about how they had botulism poisoning in the past, and that is why Botox wouldn't work for them now. I'm sure a pretty rare occurrence, but thought that was pretty interesting!

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