Am I immune to Botox?? Had 20 units in my forehead and have noticed no difference.

I had a light chemical peel and Botox on September 19th. First time for both.. I could tell the peel helped my skin - it was very smooth and soft. But I never really noticed any changes where I received the Botox. I had 20 units done in the middle of my brows and forehead. The most they usually give at a time is 25 units, but not sure if the extra 5 would really make a huge difference since I couldn't really tell?

Doctor Answers 6

Botox immunity

True immunity to Botox is possible, although rare.  I would ensure that an appropriate amount was used.  


San Diego Physician

20 units of botox between brows and botox

A light peel will help with skin texture. Botox, as you know, reduces movement of the glabella (area between your brow sometimes referred to as 11 lines) and forehead. 20 units total is a very low dose. Often patients get 20 units in each area. However, if its your first time, often you need less. It should work at least a little bit especially if it was your first time. These muscles can be strong and require more units. I would recommend returning to your physician to determine if they can increase your dose. I would also recommend that you always see a board certified facial plastic surgeon or board certified dermatologist. In addition, I would ask if what was used WAS in fact Botox brand (Allergan is the company) and if the botox was diluted to company standards (2.5cc per 100 units). Good luck!!

Lesley Rabach, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Botox not working

It is difficult to tell but 20 units is a very small amount for the frown area and forehead. You also must remember that the expertise of the injector is a factor as well. Be sure you are seeing a board certified dermatologist or plastic surgeon and that he/ she is experienced in the use of Botox

Melvin Elson, MD
Nashville Dermatologist
5.0 out of 5 stars 6 reviews

Non responsive botox

Hello ooolala3. It is hard to tell without looking at you but here is something you should know... Botox has a protein substance which your body could potentially develop antibodies to thus having suboptimal results. If that is the case, switching to Xeomin might help. Check with your injector to find this out. Hope this helps. Good luck! Cheers. 

Shoib Myint, DO, FAACS, FAOCO
Henderson Ophthalmologist

Am I immune to Botox?? Had 20 units in my forehead and have noticed no difference.

Thank you for sharing your question and I am sorry to hear of your results after Botox treatment. Unfortunately without a full series of photographs, or an in-person examination, it is difficult to offer definite advice.  Some patients have larger/stronger forehead and "between the eyes" muscles that require higher dosing to achieve a particular appearance and only through trial can this be determined.  In order to ensure appropriate treatment see an ASPS board certified plastic surgeon in consultation to discuss.  

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

Botox Alternative--Try Xeomin

This is tough to answer without before and after pictures. For patients that do not have optimal results with Botox or Dysport, I suggest trying Xeomin, it may give you better results next time. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 167 reviews

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