Has Anyone Besides Me Become Immune to Botox? Any Information/Alternatives?
Doctor Answers 5
Botulinum toxin and the use of development of immunity
The mechanizm of this is not well understood. It is not clear if a true tachyphylaxis has developed or some other process where the SNAP proteins have increased requiring more product. As others have mentioned use of Dysport may help but it is quite similar to botox and only myobloc is a different type of botulinum
Immunity to Botox
Immunity to Botox although rare can develop. I have a whole family of sisters and their mother with this problem. If you find that the effect of Botox becomes short-lived, try increasing the dose or switch to Dysport.
Overcoming "Immunity" to Botox
I have been using Botox for cosmetic purposes for twenty years so I have amassed quite an extensive experience with this product. In the course of these two decades I have encountered a handful of patients who, after a series of several treatments, began to exhibit less dramatic responses by their muscles of facial expression to therapy as well as shorter durations of response (between one and three months, as opposed to four or more months of response). In each of these patients, there had been no change in either the sites, amounts, or concentrations of the Botox injected that could account for this.
The medical literature does suggest the possibility that some individuals may develop antibodies to the complexing proteins that are bound to the actual Botox molecules and this may explain these rare cases in my own experience. New neuromodulator products, such as Xeomin, which recently received approval for medical indications and PureTox, which is currently in clinical trials, possess much smaller amounts of complexing proteins and are believed therefore to be less likely to engender antibody formation.
For the time being, however, I have found that simply increasing the concentration of the Botox or switching to the other currently available neuromodulator, Dysport, has worked satisfactorily in those few patients in whom I have encountered this kind of problem.
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Very very few patients become "immune" to Botox
In some very rare patients, it appears that the Botox does not last as long. It may no longer hold up for four months, but seem to go away after two or even one month. Switching from Botox to Dysport may make no difference. If Purtox becomes FDA-approved then the use of that may make a difference. Other Botulinum toxin products that are being used in other countries may also find their ways to the U.S. (Reloxin, Xeomin, and more).
Botox and immunity
I have not had this problem arise with my patients at this point- in fact the injected muscles should weaken over time and you may need less product. You may want to ask your injecting physician if there has been any change in the dilution of the product.