Immune to Botox? Is it possible that I have antibodies that would prevent me from getting results from Botox?

Hi DW,
Of the thousands of Botox patients that I have injected, I have never encountered a patient with immunity to the effects. There have been patients that require higher dosages, sometimes twice the usual amount.
The most popular Botulinium Toxin type A in use, and the one that you probably received from your 5 injectors is Botox manufactured by Allergan. You may consider using Dysport which will soon be marketed by Medicis as Reloxin. Mentor will be putting out another alternative called PurTox. There are two other forms Xeomin in Germany, and Prosigne in China.
If you have superficial lines in your glabella, a fractionated CO2 laser resurfacing is a great alternative, and a more permanent "fix". At age 53, you (like me) are showing other signs of aging like lax skin under the eyes, face and neck, hooding of the upper eyelids, crow's feet, and general sun damage of the skin. A single treatment with Fraxel re:pair, Active/Deep FX, or Mixto will give you overall skin rejuvenation, help you look years younger, rested, and healthy. If you choose to go with the fractionated CO2 laser, make sure to choose your treating physician most carefully. Be well.
Dr. P

It is possible to develop resistance to Botox,usually through your body making antibodies to the Botox. The number of units injected may account for decreased response. However, if you have developed a resistance, then Dysport or Xeomin may still work. Dysport, Xeomin and Botox are all preparations of botulinum toxin A which is a derived protein that works at the nerve-muscle interface to relax targeted muscles. Dysport and Xeomin have been around in Europe for a long time and more recently introduced in the USA. Note the dosage is not the same between the drugs though each works well in my experience.

Why not try a different type of muscle inhibitor, such as Dysport? If that doesn't work, then you an consider a different treatment such as fillers.

Rare, but not unreasonable....however, from the wording of your question, the botulinum toxin you received never worked for you. I have had a few patients with the same issue....Recently I have treated these patients with a higher concentration of the medication and therefore a smaller volume which allows less migration of the drug and therefore has been more effective. I also think this limits the amount of effective drug needed and lowers the risk of immunity in the future...only theoretical though. 

There is also recent information, and I am awaiting scientific data, to show that vitamin supplements (Zinc) may increase the effectiveness of Botox injections. We'll see....

Hope this helps!

Dr. C

johnconnorsmd.com

There is about at 1 in 10,000 chance of developing antibodies to Botox.   I have seen two patients in my practice with this problem.  If you are concerned, your blood can be tested for the antibodies.  Also, there are other botulinum toxins, such as Myobloc, which can be used effectively in patients with immunity.  Good luck.

It is possible, although unlikely, that you have antibodies to the Botox being injected into your body. If this is the case, Botox will not have the same effect on your body as it does in other patients. You will effectively be immune to the treatment. One option is to try a different strain of botulinum toxin, like Dysport, to see if this is any better in controlling the unwanted muscle movement.

There are cases of patients being resistant to Botox. Although it is not very common, we have seen it before. If you have been injected by five different board certified physicians, there's a very high probability that the procedure was done correctly more than once especially if you shared your previous history with the subsequent practitioners.
You still have a couple options. Given what you have described, perhaps Restylane, Juvederm or even laser resurfacing are a better option. In cases where the 11 lines are deeper, it is very common to inject a dermal filler. Not so common when the lines are not as deep, but maybe a good option for you given your lack of luck with Botox.
Dysport is also an option, but we are skeptical that this would make a difference for you.

Patients who receive dilute Botox at clinics, then come in frequently for touch-ups when the weak Botox fails can, I believe, essentially develop immunity to Botox. It is actually a growing problem.
Fortunately, if all the Botox is allowed to go away for a period of 6 months, and the patient goes to a reputable doctor who uses concentrated Botox, applied to the right muscles, most patients can return to a normal Botox injection cycle every 3 or 4 months.

There are rare situations where a person's body may not react to Botox as expected, and you appear to be one. As an alternative, you might want to try a filler for the number 11 lines such as Restylane or Juvaderm. Without actually examining you, it's difficult to say what might be best. Also a surgical procedure could be performed to intentionally cut some of the muscles that create the #11 lines. I hope this helps. I am sorry that it did not seem to work well for you.

In some rare cases, patients may not react or no longer react to botox.  Dermal fillers are a safe alternative in the hands of an experienced injector on the appropriate patient.