Can You Build a Resistance to Botox?

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.

While there is no scientific evidence that a person can develop antibodies to Botox, I clearly see situations of resistance in my practice.  It is not uncommon for people to begin to notice that Botox does not work as well (or as long) as it did in the past. This may be a resistance, or it may be that there are now so many "bargain" injectors of Botox that the matieral is overly diluted, poorly stored, or even purchased from non-legitimate sources  such as overseas pharmacies.  In these situations, switching to Dysport (same neurotoxin but with slightly different proteins around it) seems to work.