Does Botox stop working? (Photo)

I have had botox on my forehead approximately 3 times with good results. I have a lot of deep horizontal wrinkles. The doctor usually uses approx. 60 cc to get the result I like. The past two times, it didn't take at all. Not at ALL...I looked the exact same after two attempts. Why do you think this is? Same doctor and same product.

Doctor Answers 22

Botox stopped working?

I would try a different facility. It shouldn't stop like that. Some docs don't get their Botox directly from Allergan and there is potential for counterfeit Botox or that the Botox didn't get stored correctly during shipment. If you get no results from the other location, I would switch to Xeomin.

Panama City Facial Plastic Surgeon
4.6 out of 5 stars 27 reviews

Does Botox stop working?

It is very unlikely that Botox stopped working. The dosage does not sound correct. It is possible the Botox was wrongly reconstituted. I suggest that you try Dysport and see another physician for your injections.

Hardik Soni, MD
Summit Emergency Medicine Physician
5.0 out of 5 stars 23 reviews

Botox immunity

Although it is quite rare you can develop immunity to botox.  It is best to not get botox for one year and then try again.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 427 reviews


I would recommend following up with your injector as your current results are atypical. You could also try another neurotoxin like Xeomin which works great.

Botox no longer working

The short answer to your question is that there is some concern that Botox can stop working in some individuals but this would be in a situation where massive doses of  Botox are given for muscle spasticity.  In cases where Botox is used for cosmetic purposes the doses are significantly less.  I would follow up with your injector since you have already paid for the treatment and have had prior success with this injector.  If your doctor is reputable they are likely using legitimate Botox.  If they are not using FDA approved Botox your results can certainly vary.  

Philip S. Schoenfeld, MD, FACS
Chevy Chase Facial Plastic Surgeon
4.7 out of 5 stars 25 reviews

Does Botox stop working?

Hi there, It is difficult  to say exactly what happened.  I  doubt  you have antibodies to Botox. This is so rare. I would recommend that you wait a  month and then get Dysport.  Good luck Dr. Downie.    

Jeanine B. Downie, MD
Montclair Dermatologic Surgeon
5.0 out of 5 stars 3 reviews

Botox resistance… Is it frequent?

Thanks for sharing your question. I can appreciate your concern.

I would suggest to change your injector. this should give you a change to demonstrate that you are not resistant to the medication. an alternative is to try dysport.

Finally, make sure that you have a consultation with a board certified plastic surgeon.

Wishing you the best in your journey

Botox stopped working

It is possible you could be developing some resistance. A few things should be clarified first.regarding the Botox.

Are they buying it from Allergan or somewhere else? If from somewhere else it could be not stored or shipped properly or even worse counterfeit Botox. 

you could switch to Dysport...however I suspect you may have been given that because 60 units of Botox in the forehead is a lot of Botox. This would be the correct dosage for Dysport. They may be calling all the brands Botox.

Also, how long are they keeping their product? It is the most potent for 24 hours. If it is several days old since reconstituted it may not be effective.Find out their policy of using their Botox (if they will tell you)

Did they change their dilution?

Are you seeing a reputable injector? Also be wary of sales and discounts. The products are expensive for us to buy also. So if the price is too good to be wary and consider changing injectors to someone very experienced.

I hope this helps and you may need to switch to one of the other brands...we have Botox, Dysport and Xeonin

Esta Kronberg, MD
Houston Dermatologic Surgeon
5.0 out of 5 stars 29 reviews

Botox not working

This is not normal. Botox should not stop working after 3 treatment sessions. I would visit another Botox injector for your next treatment. Make sure that you are getting authentic Botox from Allergan. Here in Miami, where I practice, there is a problem with counterfeit Botox. Make sure the clinic is purchasing its Botox from Allergan. Finally, both storage and reconstitution can have an affect on Botox. See an expert and you should be fine. In New York there are plenty of good doctors. Email me if you need a recommendation.

Get more details from your provider

Like many have already suggested, I would not expect you to become resistant to treatment after only 3 uses. And, if I was concerned that the product was no longer working, I would consider switching you to Dysport. However, based on what you are telling us, it sounds like your doctor is using 60U (units, not cc) of "toxin". This is a bit high for Botox if you are treating the forehead alone. So, I also suspect you may be getting Dysport already--and they are just calling all toxins "Botox" to keep things simple. But you will have to clarify with your provider as to which product is actually being used. Lastly, product does lose its effect if it was reconstituted some time ago. Nobody wants to talk about an "old" bottle, but unfortunately it does happen when offices push the limit of how long ago the bottle was mixed and when it is being used because nobody wants to throw away product. So, I recommend to make sure patients see reputable injectors. And be very wary of botox "sales" or discounts that seem very generous because sometimes you may be getting the day old bagel. Best!

Miguel A. Gutierrez, MD
Torrance Dermatologist

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.