Botox Resistance, Dosage, and Treatment Interval: Here’s How to Decide

Botox resistance, dosage, and treatment interval: Here’s how to decide.

Hello.

I am Lee Won-shin, a dermatologist with 22 years of experience.

"If you get Botox too often, won’t you become resistant?"

This is one of the questions I hear very often in the clinic.

If you have been receiving Botox regularly for wrinkle improvement or jawline reduction,

you may have worried about this at least once.

Today, I’ll talk from a medical perspective about the myths and facts surrounding Botox resistance,

as well as the proper treatment interval and dosage.

Table of Contents

1. Why does Botox resistance happen?

2. Two conditions that can cause resistance

3. Then how often, and how much, should you get it?

4. What if resistance has already developed? How to respond

5. Why does Botox resistance happen?

Botox resistance

Botox is a drug with a protein structure called botulinum toxin.

Usually, our body does not form antibodies against it,

but in rare cases, if the body recognizes this protein as an "antigen," antibodies can be produced.

When antibodies form this way, the effect of Botox gradually decreases,

its duration becomes shorter, and at some point it may stop working altogether.

We refer to this condition as having developed "Botox resistance."

2. Two conditions that can cause resistance

Botox resistance

So in what cases does resistance develop more easily?

There are two major conditions.

First, receiving the treatment too frequently.

If you get Botox repeatedly within a month,

the chance that your body will recognize botulinum toxin protein as an antigen increases.

Second, being exposed to too much at one time.

If you receive an excessive amount of Botox in a single session, the amount of toxin protein your body is exposed to increases, which also raises the likelihood of antibody formation.

Fortunately, the dosage used for wrinkle Botox or jaw Botox on the face is not large enough to cause resistance.

So if you receive Botox on the face for cosmetic purposes, you generally do not need to worry much about resistance.

3. Then how often, and how much, should you get it?

Botox resistance

For wrinkle Botox, the average duration of effect is about 3 to 4 months.

Therefore, if you receive treatment at 3- to 4-month intervals, you do not need to worry about resistance.

In fact, studies based on long-term data accumulated worldwide show that the incidence of resistance is known to be less than about 1%.

It has also been shown that there is not a major difference in the incidence of resistance depending on the type of product.

However, there is one thing to keep in mind.

For areas related to facial expression, such as the forehead, glabella, and eye area, using too high a dose can make your expression look stiff,

and especially in the case of the forehead, it may cause discomfort such as heaviness in the eyes.

So rather than aiming for a higher dose, I recommend receiving treatment with the amount that is most appropriate for you.

For body Botox, because a large amount is used at one time, it is better to avoid treating multiple areas simultaneously.

4. What if resistance has already developed? How to respond

Botox resistance

In practice, I meet one or two patients a year who have developed Botox resistance.

If resistance has already occurred, you can try two methods.

The first is to switch to a product from a different company instead of the one you have been using.

Some people do see results just from changing products.

The second is to stop Botox treatments for at least one year.

This is because, over time, as the antibody titer in the body gradually decreases, the resistance may slowly fade.

In closing,

Botox resistance

To summarize,

Botox used for cosmetic purposes on the face does not commonly cause resistance as much as you may worry.

The probability of resistance is less than 1%, and the most important thing is to keep the proper interval and appropriate dosage.

Please avoid getting it too frequently within a month, and I recommend leaving at least a 3-month interval between treatments.

If you have had vague fears about Botox, I hope today’s information was at least somewhat helpful.

Thank you for reading this long post.

This has been Lee Won-shin, Chief Director.

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