A common theme I run into at my practice is patients saying things like “the last time I got my Botox done by my previous place, I felt like it didn’t last as long,” or “I felt like it did not work as good.” And patients are always curious as to why this is. Many patients right off the bat make an assumption that the last place they went to just over-diluted their Botox or did something wrong. While yes this can sometimes be true, there are still some other reasons that can be taken into consideration as to why someone’s Botox (or Dysport, or Xeomin) didn’t last as long or work as well as it has in the past.
Let me begin by saying that there is usually no one clear-cut answer, and many a times there are multiple factors all working together that contribute to the way each individual’s body reacts to neuromodulators (Botox, Dysport, Xeomin). With that being said, I will go ahead and begin to list some potential reasons as to why a person’s Botox doesn’t last as long or work as well as it once did.
- BOTOX RESISTANCE/TOLERANCE: For patients who have been getting Botox injections for a long time, they can eventually build up a Botox resistance/tolerance. This is when a patient has built up antibodies against the Botox. German researchers have found through studies that 1 in 200 Botox users develop antibodies, making the Botox injections less effective with repetition. Other British researchers have explained that repeated treatments can trigger an immune response which has the potential to lead to a non-responsiveness to treatment. Botox resistance/tolerance can also cause the body to metabolize the Botox quicker thus making the results not last as long. If it is suspected that ‘resistance’ is your specific problem, a potential solution is switching to one of the other neuromodulators like Xeomin or Dysport (if you have been using primarily Botox).
- PATIENT HAS A ZINC DEFICIANCY: If you got Botox injections (and you have not gotten them a lot in the past; at least not enough to have a tolerance/immunity built up) and notice that the Botox did little to absolutely nothing for you, you likely have a zinc deficiency that you are unaware of. While this is not super common, I actually have experienced this with a patient in my own practice. We treated her glabella (frown lines in between the eyebrows), and at her 2 week follow-up, the patient had full movement in that area, it was like I never even touched her let alone injected her with Botox. Furthermore, I mix my products meticulously and I never “over-dilute,” so I knew that the problem was nothing on my part, and the patient hadn’t gotten Botox enough to rule this situation a “tolerance” problem, so I figured she just might have a zinc deficiency that she doesn’t know about. While the only way to know for sure if zinc deficiency is in fact the culprit, this would require some work on the patient’s end (going to see her PCP and getting labs drawn to confirm the zinc deficiency) which usually patients don’t want to do. What I did with this patient was explain to her that she needed to go get a zinc supplement to start taking daily (to which she agreed) and we set her up an appointment to come back to see me in a week and a half, to try the injections again. The patient started taking her zinc supplement every day and then came back to see me to try the Botox again (this time loaded up on some zinc) and the patient’s Botox worked this time. This particular situation just goes to show that it is not always the injector’s/healthcare provider’s fault, sometimes it is the patient’s own body causing the issue, which is out of our control.
- METABOLISM; ARE YOU ATHLETIC? Everyone is different! Which also means everyone is going to metabolize things differently. If you work out or are pretty active, chances are your metabolism runs at a much higher rate compared to others, and your Botox results are going to fade quicker (because your body metabolizes the product faster). I personally have this issue as I am an athlete and work out on the regular, so do not worry- you are not alone in this struggle!
- IT IS YOUR 1ST TIME TO GET BOTOX: If it was your first time to get Botox (or Dysport, or Xeomin), you were probably a little confused when your Botox didn’t last the full 3 months. This is actually very common. Once you get repeated injections, your facial muscles will become more acclimated to the neuromodulator and begin to last you longer. Be patient.
- MEDICATIONS (STIMULANTS): If you are someone who is on any type of stimulant medications such as Adderall/Ritalin for ADD & ADHD (or even for Narcolepsy), or if you are on a stimulant weight-loss medication such as Phentermine, then it is not at all uncommon for your neuromodulator to wear off quicker. These types of medications are stimulants (cigarettes are as well), and stimulants speed up everything in the body and will cause your body to burn through Botox quicker.
- THE MANUFACTURER MADE A BAD BATCH: Believe it or not, sometimes the manufacturer of these products accidently make bad (less effective) batches of product. And what really is unfortunate about this is that it sometimes gets missed, or we don’t find out it was a bad batch of product until later on down the road, after several businesses have complained to the manufacturer about the same issue, on the same batch of Botox (confirmed by the same lot number on the product).
I hope this post was informative and helpful for many. If you would like to learn more about cosmetic injectables or book an appointment to discuss your options, give us a call! You can also visit our social media pages to see more of our before and after results!
Xoxo ~Align