Botox does not work anymore. Any suggestions?

I have gotten Botox for 6 or 7 years with no problems until last year it seems it has stopped working. Mainly in between my eyes.I have spent hundreds if not thousands at various dermatologists offices and MedSpas on Botox and Dysport and it seems to work for a few days and then I have movement again. I am soo upset. What do i do? Will Botox ever work for me again?

Doctor Answers 12

Botox no longer effective...

Thank you for your question.  For some reason in a very small subset of the population botox loses its effect over time.  For these people the appropriate first step to take is to try Xeomin as Xeomin lacks the complexing proteins at the end of the toxin that are thought to be the reason for this so called "resistance."  Xeomin is a pure neurotoxin and without the proteins you are not able to bind the toxin, leading to the lower likelihood of "resistance."  If you have similar results with Xeomin, Thermi has a procedure called ThermiRase which is a toxin free way of disabling frown lines.  It is a simple procedure performed in office.  Regards, Dr. Matt Elias


Fort Lauderdale Dermatologic Surgeon
5.0 out of 5 stars 5 reviews

Botox does not work anymore

I'm sorry you are having this problem.  I usually hear the opposite situation from patients that have had Botox for many years.  Usually they comment that they actually need less to get the same result.  I would check to make sure that you are not receiving diluted product.  I'm not placing blame on anyone, but this has been reported to happen from time to time.  Perhaps try a different doctor's office.  Best of luck!

Josh Waltzman, MD, MBA
Long Beach Physician
5.0 out of 5 stars 12 reviews

Botox not working anymore

Thank you for your question photogirl107. In a small percentage of people Botox stops working as they develop resistance to it. In these cases other neuromodulators are used. The only alternative available until a few years ago has been Dysport. We now also have Xeomin. This may be worth trying in cases when Botox and Dysport do not work. Once a person develops a resistance to Botox, it will likely not work again, but there have not been studies on this. I recommend speaking with a doctor who does Xeomin treatments. Good luck!

Alex Eshaghian, MD, PhD
Encino Physician
5.0 out of 5 stars 1 review

Botox injection does not work

It is important for us to know what dose you are getting and if the dose has been changed recently. Most cases of Botox "resistance" are due to under-dosing. However, if you do have resistance (rare), then I would try Xeomin. I would also consider combination treatment with Botox and fillers to see if you get a longer result.

Botox does not work anymore. Any suggestions?

Try seeing a PS to offer 20 units of fresh mixed Botox to the 11's ONLY to see the effect. Fee $450.

Botox not working try Xeomin

It Botox is not working you should try Xeomin as you may have developed antibodies to Botox and Dysport.  Please consult an expert.  Best, Dr. Green

Poor Results with Botox -- Try Dysport or Xeomin

For patients that do not have optimal results with Botox, I suggest trying dysport or xeomin. Please seek a board certified dermatologist. Best, Dr. Emer

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.9 out of 5 stars 165 reviews

Try Xeomin or Dysport if you are resistant to Botox. This will usually work well.

Most of the patient who have become resistant to Botox respond well to Dysport or Xeomin.  I agree with others who have given the same recommendation. 

Mark Taylor, MD
Salt Lake City Dermatologic Surgeon
4.1 out of 5 stars 17 reviews

Botox does not work anymore. Any suggestions?

Hello Photogirl107,

Although rare, some people can develop an immunity to Botox.  If that is what is taking place here, you can first try to use Xeomin which is another neurmodulator like Botox and Dysport.  If that doesn't work for you there is another drug called Myobloc.  It was specifically designed for people who were receiving therapeutic (not cosmetic) Botox and developed resistance.  Where as Botox, Dysport, and Xeomin are all derived from the A protein, Myoblox is from the B protein, which is why it can work in those with resistance.  The drawback is that Myobloc does not last as long as the other ones, and not many people offer it for cosmetic purposes.  

There are surgical options to also cut the muscles that move that area and surgical placed collagen called SMAS which can be safely placed in that area.  

I hope this helps and good luck.  

William Marshall Guy, MD
The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 25 reviews

Nonresponse to Botox

after many years and many injections of the toxin some people do become resistant because you are making blocking antibodies.  It will do no good to switch to Xeomin, although it is pure toxin that is what the blocking antibodies are to, not the proteins extraneously present. your alternative is fillers or surgery

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

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.