If resistant to Botox, will others work? How long between treatments?

I have been using botox for a few years and loved the results. But the last couple of treatments haven't gotten much results. My practitioner even administered more a week later with hardly a change. Do you think Xeomin will work or are they all essentially the same and I should accept that I have a resistance to this. Also, if I am to try another, how long must I wait between treatments? Thank you for any advice.

Doctor Answers 11

Losing effect to botox

In patients who perceive to have lost duration of botox treatments, several options including higher dosing, different placement, or changing to dysport or xeomin may help.  There is no need to wait a certain amount of time between treatments.  There is no guarantee that switching will be the answer but it is definitely worth a shot.


New Orleans Dermatologic Surgeon
5.0 out of 5 stars 7 reviews

Botox not lasting as long

If botox isn't lasting as long, consider either higher dosing or a different product such as dysport or xeomin. Ensure that your physician is an expert injector such as a dermatologist as sometimes placement and proper dosing can play a huge role.

Benjamin Barankin, MD
Toronto Dermatologic Surgeon
4.9 out of 5 stars 44 reviews

Resistance to Botox

Resistance to Botox does occur although it is very rare. Xeomin is the exact same thing and Dysport is also botulinum toxin A. If one does not work neither will the others. You might try to see if your doctor can get botulinum toxin B which might work

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

Botox resistance

Thank you for your question and for sharing your concerns with us. Although resistance to Botox is very rare, it has been reported. I would recommend that you try Xeomin or Dysport before you give up on these procedures altogether.  

Resistance to Botox

It is usually recommended to wait 3 months between treatments  to prevent resistance. Sometimes patients do find they get a better response to trying  dysport or xeomin.  

Jean Keamy, MD
Westborough Ophthalmologist
5.0 out of 5 stars 5 reviews

If resistant to Botox, will others work? How long between treatments?

Hello jls2,

It is not common to develop resistance to Botox in the doses used for cosmetics.  To minmize the risk, it is best to avoid large unit injections at less than 3 month intervals.  If you do begin to develop resistance to Botox, you can consider using Xeomin or Dysport to see if you get a result.  If not, there is another product that is similar to those three but developed specifically for people with resistance (usually because they have a medical indication for Botox).  

I hope this helps and good luck. 

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

If resistant to Botox, will others work? How long between treatments?

Thank you for your question. It seems as though you had received a higher dosage of Botox without any results. It won't hurt to try Xeomin or something like. 

All the best, 

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 425 reviews

If resistant to Botox, will others work? How long between treatments?

Resistance to Botox is rare, but it has been reported.  There are two alternatives that you can try -- Dysport (has a different protein than Botox) and Xeomin (is free of complexing proteins).  You don't need to wait any particular amount of time between now and getting one of these new medications.  

I feel only "core" injectors should perform cosmetic injectables (facial plastic surgeons, plastic surgeons, dermatologists, or occuloplastic surgeons). This is because we all have a keen understanding of facial anatomy and the effects of injecting Botox/ Xeomin/ Dysport and fillers in different regions of the face. Be sure you are seeing one of us, and I wish you well!

Parker A. Velargo, MD
New Orleans Facial Plastic Surgeon
5.0 out of 5 stars 42 reviews

Botox and Resistance

It is very rare to be resistant to Botox at the dosage that you are receiving for cosmetic injections.  However, if it is not working then you can try Dysport or Xeomin to see if they will give you a better result.  There is no reason to wait if there has been no effect.  Please consult a board certified dermatologist to ensure the best results.  Best, Dr. Green

Resistance to Botox

Although resistance to Botox is rare, it does happen from time to time.  Xeomin is supposed to be very similar on a molecular level with the removal of the outer protein, so it is possible that Xeomin may work for you after building a resistance to Botox.  Best of luck to you.

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.