Botox didn't work. I did botox 4 times, first 3 times were amazing like 85% decrease in sweat and the effect happened in 4 days?

Question

but last time I did it, didn't work for me, it was different doctor she told me we'll give you a discount if you keep coming back here for botox I told her no because I'm moving in two months she said will you might need to come back in two weeks for a touch up, and it's not free she did 50 units per arm and it cost me 1500$ now it's been 10 days and I'm still sweating severely my question is why did it work the first three times but it didn't work the last time and what should i do?

Dana Goldberg, MD · Answer

I’m sorry to hear that your recent injections didn’t give you the result you were expecting. There are a few reasons Botox doesn’t work. Your body is constantly changing, so you may need different amounts each time to get the same result. That said, it’s usually small changes in the number of units, so I don’t think that applies to you. They may have used “old” product (mixed for longer than 24 hours). However, I have used Botox on myself that is 3-4 weeks old, and it still works, so that usually isn’t the problem either. Although Botox is rigorously tested, occasionally there is just a bad vial because of improper handling before delivery to the office. I have had this happen twice in 9 years at my practice. It’s possible that the office improperly mixed your Botox. This is unusual since most offices want people to come back and want to avoid bad reviews, but it does happen. Finally, it is rare, but some people seem to develop a resistance to the product. This usually happens over a larger number of injections, but you could try Dysport or Xeomin to figure that out.

Jason Emer, MD · Answer

Botox combined with glycopyrrolate can be used to treat sweating. Treatment will last 3-6 months. Multiple areas may require nervous system surgical treatment.  Please see an expert for evaluation. Best, Dr. Emer

Quenby Erickson, DO, FAAD, FACMS · Answer

Botox is an exceptionally great treatment to reduce sweating. It is highly unusual that it did not work for you. I would recommend that you return to the doctor and ask for a starch Iodine test so that she can see where you are still sweating.  Not all physicians are trained in this procedure, so moving forward, please seek out a board certified dermatologist who has experience with this treatment. Finally, although botox is a very fine treatment for this, I would highly recommend that you consider Miradry, which is a permanent reduction in the sweat glands with minimal downtime. Most people get an 80% reduction in axillary sweat from two treatments.

Jean M. Casello, MD · Answer

You say that you had botox previously an it worked but did not work when injected by a new provider.  there are many reasons this may have happened. Was it diluted properly and how was it injected.  There are many other reasons why this may not have worked. You should go back to your provider and discuss your concerns.  The dose that you had should be effective.

Jared Mallalieu, DO · Answer

Thanks for posting. I would express your concerns with your provider. I'd also recommend you stop this treatment and consider MiraDry. This treatment results in permanent sweat reduction (up to 82%). It would be much more cost effective. Best, Dr. M

Melvin Elson, MD · Answer

There are severl possibilities and from what i understand you had a different doctor and it is either she is not experienced or the Botox was old or not diluted properly,. 50 units is enough that you should have results

Leonard Grossman, MD · Answer

There could be many reasons as to why your last treatment has not worked for you. 10 days is definitely long enough to see the Botox work. But I would rather not discuss the possibilities and simply have you visit with your treating physician and discuss it with them in person. Good luck from New York City

Darryl J. Blinski, MD · Answer

Something does not sound right. Might be old mixed BOTOX, or under treated in true amount of units. I always use 100 units per axillae or more. Plus the fee also sounds rather low. Either ask fir round and seek only true injection MDs or boarded PS/Derms. Ask first least 100 units per axillae with fee from $2,500...

Justin Harper, MD - Account Suspended · Answer

Hi Abdullah_as, I'm a bit concerned that there is so much emphasis on keeping you as a client. However, you do need to go back and see your doctor. The effect is usually gradual but if that does not happen for you, there are many things to consider - from over dilution, expired Botox or poor technique.All the best,Justin Harper, M.D.

Botox didn't work. I did botox 4 times, first 3 times were amazing like 85% decrease in sweat and the effect happened in 4 days?

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