What could be possible reasons for my botox not working?

I've used botox with wonderful results. Suddenly it stopped working. I've since went to other drs. too and the botox do not take effect. The last dr. I've been to, used botox and not Dyssport. It took effect on my crows feet area but not my frown and forehead. She injected more botox after 2 weeks, she thought perhaps she used too little units. After another 2 weeks she injected more, and now after another 2weeks, it seems that it still hasn't taken effect. Am I resistant all of a sudden?

Doctor Answers 10

Although rare, resistance to BOTOX® can develop.

Thank you for your question. Although not a common occurrence, it is possible to develop antibodies to the neurotoxins in BOTOX®. This can result in a resistance to the product and cause it to not be as effective as it normally is. You could try alternative neurotoxins such as Xeomin® or Dysport® but I suspect you would have the same resistance. As others suggested, you could stop using BOTOX® for a year or more and then try it again to see if you get better results.

Eugene Plastic Surgeon
4.7 out of 5 stars 16 reviews


Thank you for your question in regards to Botox. Developing a resistant to Botox is rare, although it is possible. Typically more units are recommended to achieve your desired goal. Also, depending on the dilution of the Botox could have an effect as well. To be sure, see two or more board-certified providers in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have treatment.
I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 182 reviews

Botox and Effect

It is rare but possible that you have developed antibodies to Botox.  I would try one more time with stronger units and if that doesn't work you can try Xeomin.  Please keep us posted.  Best, Dr. Green

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 76 reviews

Developing BOTOX Resistance Is Rare

Thank you for reaching out with your question. As others have said, it is rare for someone to develop a resistance to the effects of BOTOX. The situation you've described is a bit unclear. If you've had BOTOX injected by different providers, it may be that the technique used by one injector is the reason for BOTOX not working the way you expected. It's difficult to provide any definitive answer without knowing a bit more about your case or conducting a personal assessment. If you haven't tried either Dysport or XEOMIN, which are both similar products, that may be a good place to start. Good luck.

Suzanne Bruce, MD
Houston Dermatologic Surgeon
3.7 out of 5 stars 6 reviews

What could be possible reasons for my botox not working?

Thank you for your question. If you have had injections administered by a few doctors and have had no results, it can be possible that you are resistant. It may help to inject a larger amount. Always see a board certified plastic surgeon or dermatologist. 


Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 458 reviews

Resistance: Botox stopped working after multiple injections.

Developing a resistance to Botox is a rare occurrence. I have personally have never seen it, as the patients I see have all responded to a reinjection with more units of Botox. 

It is described as occurring in patients who have had many, frequent, and high-dose treatments. The idea is that your body has produced antibodies that inactive the medication by binding to it. 

Some recommend switching from Botox to Dysport or Xeomin. Some recommend taking a break from injections. Neither are supported by published research. 

I would recommend collecting all of your records and reviewing them with a trained specialist in your area. They can help confirm the resistance to Botox. 

Victor Chung, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

Botox - suddenly stopped working

Thank you for asking about your Botox.

If you have had Botox with wonderful effects - and now it does not work.
And you have had the same doctor injecting you -
And then tried other doctors and other neurotoxins without much effect -
You are probably resistant.
Sometimes this is permanent -
Other times if you stop using Botox for 1 - 2 years, and try again, it will work.

Always see a Board Certified Plastic Surgeon.
Best wishes - Elizabeth Morgan MD PHD FACS

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Why is Botox not Working?

It is possible that you have developed a resistance to Botox, but the most common reason is technique dependent. If some areas worked but others did not, it sounds like it may have to do with the technique or number of units used. Best option is to see a doctor who performs a lot of treatments with Botox and other neuromodulators and discuss how many units are being used for each area. Good luck.

Andrew Kaufman, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 16 reviews

Botox resistance

It is possible that you have developed resistance to Botox--it is rare but it does occur after many uses and I have only seen it once. changing to Dysport of Xeomin will not make any difference

Melvin Elson, MD
Nashville Dermatologist
5.0 out of 5 stars 4 reviews


You don't mention how many units you received and to what areas.  How many times have you had botox in the past?  I have had a few patients where they develop an immunity and in those instances I switch them over to Dysport or Xiomen. 

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.