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Immune to Botox?

By December 19, 2007

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Yes, it's true. Your Guide to Plastic Surgery is one of those very rare specimens who is immune to the effects of Botox.

Alas, it wasn't always this way. In fact, many moons ago I had the magical elixir injected into the furrows between my brows that had come about as a result of a few too many trips outdoors without sunglasses. (all that squinting!) That first go-round was quite successful, and surprisingly long-lasting---over a year. I surmised that in the time I was unable to squint, I must have retrained my face to squint without furrowing my brow. I also started religiously donning sunglasses to go outdoors, even on overcast days.

Unfortunately, time marched on, and the furrows returned...So years later, imagine my surprise when my second attempt to botox-ify my furrows was remarkably unsuccessful.

A bad batch? Maybe, so the surgeon tried a new vial. No dice. Bad technique? Possibly, so I tried a new surgeon. Twice. Still the furrows persisted.

Take heart, readers. Immunity to Botox is very rare, although I'd love to hear from others who have had the same problem. Feel free to write and share your experiences...I know I can't be the only one!
February 16, 2008 at 11:02 pm
(1) Maggie says:

I am a dermatology nurse in Michgan and we have a patient who also is immune to Botox. She still comes in for other procedures, but after several trys.. no luck on the Botox. You are not alone.

February 23, 2008 at 12:54 am
(2) Diana says:

Me too! After the 1st injection it worked like majic, for about 3 years every 6 months. 12 months aago I had one , minnimal results and this past oct 1 injection every month and I could still move my brow. Bummer

February 24, 2008 at 7:20 pm
(3) Alexis says:

I tried botox for those frown lines between brows – first time had a slight sensation for a few days, stronger dose next time – nothing – one last dose – stil NOTHING. I was so disgusted and still hate the way it makes my otherwise young for my age face look tired or mad. I’ve even had a stranger walk up to me once and tell me to stop frowning and smile!

April 21, 2008 at 1:40 pm
(4) Kristie says:

Add me to the list! I have been injected on four different occasions with more units injected each time! It has never worked for me! Very frustrating as I would like the crater gone from between my eyes!

May 28, 2008 at 8:11 am
(5) John Payne says:

I had pain from ruptured discs in my neck for a few years. Had used neurontin to alleviate pain. Doctor then tried botox. First time worked wonderfully, was able to back off the “morontin” and I had 3 1/2 months of wonderful relief. Came back when it wore off three months later and absolutely no relief, doctor said I had built up an immunity to the botox. Will go back in three months for more to see if it is still the case. The doctor does not hold out hope. Oh well.

June 17, 2008 at 12:23 pm
(6) Hawry1 says:

have had the same experience with Botox. The first couple of times I was injected it worked fabulously. Then it became less and less effective. My doctor thought it might be a bad batch and each time she did injections from that time on she used a new, fresh bottle and still no results. She then contacted Allergan who said this was impossible either the botox had not been stored properly or her technique was wrong. Of course I was the only one of her patients to have this happen. Allergan then sent one of their reps to witness the injections as this doesn’t happen to verify the injection method, massive amounts of botox were used and three weeks later the rep came back to see the results and confirmed that there was nothing wrong with the method and that I had indeed become a non-responder. From then on my doctor has been in contact with Allergan and their medical department in order to examine this further. My case is being reviewed in order to determine why this is happening. Therefore my advise would be to have your doctor contact Allergan as this is not supposed to happen and apparently has not happenned to anyone else. The more people who come forward with this the more seriously Allergan will respond in examining why and how to overcome this. I was told by my doctor that Myobloc may work.

July 21, 2008 at 2:50 pm
(7) Linda says:

Unlike you my first treatment of botox to get rid of my unwanted brow lines did not work, so I got a second dose free – no dice. Visited a different practisioner who assured me that the problem must have been with the person injecting. Guess what, still no result. What a waste of money and I do think when you ask for treatment they should advise that there are people immune to botox and perhaps give statistics on what percentage botox does not work. Then at least you can make an informed decision.

July 22, 2008 at 1:47 pm
(8) plasticsurgery says:

I agree, Linda. They should tell you that it doesn’t work on everybody. However, the company that makes it is still saying that it’s not p[ossible to be immune to the effects! Like you, I beg to differ! I plan to contact the company for an interview soon… I’ll keep my readers posted on what I uncover!

August 12, 2008 at 9:41 pm
(9) jennifer says:

Injected every three months for two years. Very minimal results. It lasts for one month max. I get more units than any of my Dr.s pt.s between my brows, over my brows. I’m looking forsomething else. Any idea’s. I look stressed all the time.

August 13, 2008 at 6:28 pm
(10) plasticsurgery says:

To Jennifer, and all those looking for Botox alternatives to reducing or eliminating lines above and/or between the brows:

Of course, I am not a doctor, and I haven’t examined you…so a consultation with a good plastic surgeon would be your best course of action…

But from my experience, here are a few ideas which could help:

There’s corrugator muscle excision (aka corrugator myectomy), which disables (by cutting) the muscle that is responsible for making the furrows between the brows. Not all surgeons do this procedure, so if you consider it, find one who does them frequently. That won’t help the lines above your brows, though—only the ones in between.

The thing that might help the lines above your brows is a brow lift, and possibly a laser resurfacing together with the brow lift. This will also provide minimal help for the lines between the brows.

Hope this helps!

September 9, 2008 at 3:10 pm
(11) Lex says:

I also developed an immunity to botox. I was told by my plastic surgeon that he can order some other form of botulim toxin known under another name. It is apparently stronger too but not frequently used unless an immunity develops. I am going back to get that done in a month or so!

September 12, 2008 at 7:40 pm
(12) Carmen says:

I was also told by my dermatologist that I had developed inmunity to botox. It worked perfectly for 6 months the first time and then less and less each time. I just had a second treatment in August and I can already feel I can move my brow a little…I feel it is wearing off already. Can you share what is that other product your doctor is going to try on you? I’m 39 and have terrible lines on my forehead.

September 15, 2008 at 12:47 pm
(13) plasticsurgery says:

Ladies and Gentlemen – It’s finally here! Please join the discussion about botox immunity on the About.com plastic surgery forum.

Or read about what it means to be immune to Botox, and learn about Botox alternatives.

October 15, 2008 at 3:13 pm
(14) piggly says:

I’ve tried several times and the botox only lasts about 3 weeks. A doctor suggested type B Botox or Myobloc, which was exactly the same results. There is a product called dysport (there is also another name for it) but it is not FDA approved in the US which another doctor suggested. I love the effects but too expensive for only lasting 3 weeks!

December 2, 2008 at 11:47 pm
(15) Canadian chic says:

I have also developed an immunity to botox. 47 units used to freeze my forehead for 6 months. Now 100 units produces minimal results. My dermatologist denies there is such a thing as immunity and i had to inform him about myobloc. He keeps telling me to use more botox. His denial is perpetuated by greed. He chooses to be ignorant of the facts.

December 3, 2008 at 11:12 am
(16) plasticsurgery says:

Dear Canadian Chic,

Some doctors simply aren’t aware that this is possible, while others may be in denial about it, since it is still a pretty rare phenomenon. When I first contacted Allergan (the company who makes Botox), they told me immunity was not possible. Then with further research, they admitted that Botox “resistance” was possible for a small number of people. The irony about what your doctor is doing is that the larger the dose you receive, the more of a chance to develop resistance.

Here are a few articles I have written and a photo gallery related to this topic which you may find helpful:






Hope this helps!

February 6, 2009 at 2:51 pm
(17) Miles says:

i was in a car accident almost 10 years ago which left me knotted up and a permanent headache. i tried botox in my neck and scalp but it didn’t help. now almost 10 years later and i’m trying botox again in my shoulders. the knots will not loosen up. i’m trying to get preauthorization to try myobloc. we’ll see if it works. otherwise i’m out of options.

February 13, 2009 at 1:41 pm
(18) Sarah says:

I have TMJ! My doctor has injected me three times before in both cheeks and temples. The fourth time~ didn’t work! I was thinking it was a bad batch, did he do something wrong? Nope~ it’s my immune system in full swing! I’m frustrated because the botox A took away all of my pain. So, the next step, Botox B. Has anyone tried this yet?

March 18, 2009 at 7:27 pm
(19) Been There says:

Does everyone know about the effects that antibiotics, vitamins ie omega 3, fish oil & supplements, as well as anti-inflammatories have will have on botox in your system? My first injection great, second not so good, I was on antibiotics, third so so – probably due to vitamins I was taking! Beauty or Health, interesting choice.

March 24, 2009 at 1:14 pm
(20) plasticsurgery says:

Did your doctor tell you it was the antibiotics that caused the reduced effectiveness, or is that just what you surmised on your own? If you figured it out on your own, did you tell your doctor? If so, what was his or her response? Are you sure you haven’t simply developed a resistance to Botox?

I ask because in all my research (and I’ve done a lot), I have never heard of this cause-and-effect relationship between Botox and antibiotics, etc. I can see how it would be possible, though, and I’m interested to hear your answers.

April 22, 2009 at 2:11 pm
(21) Sue says:

I tried Botox and nothing happened. I went back and the doctor did it again, assuming the first try was due to bad Botox. Again, nothing. After three tries, he determined that I’m one of the few who is immune.

September 12, 2009 at 11:45 am
(22) Sunny South says:

I too am immune! My doctor was surprised and he
re-applied it. Still did not work.

They questioned me extensively as they wanted to understand it.

Now there is a nurse there who is also immune. We may not be so rare after all. Their office now routinely tells patients “It may not work on you.”

September 20, 2009 at 10:59 pm
(23) Anne says:

I have tried Botox twice with no results! the first nurse injected me three different times two weeks apart. I had no relief from the frown lines. I just tried Dysport and still no results. It’s true you can be immune! Most of the practitioners who are injecting these poisons haven’t a clue that you can be immune and it doesn’t work for everyone. I hope that more of them become educated on this matter! I called the makers of Botox and they said “yes” it’s true it doesn’t work for everyone. I have looked into GFX as an alternative treatment for the frown lines but its so expensive. I am hoping that the price will drop.

September 21, 2009 at 9:29 am
(24) plasticsurgery says:

Anne and others:

You all raise valid points. Doctors absolutely SHOULD be telling their patients that Botox does not work on everyone. Also, before they jump to Dysport, they should make patients aware that if your immune system is such that it developed a resistance to Botox, it is not unlikely that you will develop the same type of resistance to Dysport.

As for alternatives, there are some. Besides trying Dysport, there is GFX, which Anne mentioned. It is also known as REX, or Relaxed Expressions. While it may seem more expensive, its effects last much longer than Botox, so the cost ends up averaging out to about the same or even less.

For even longer lasting (permanent) results, there is a surgical procedure known as a corrugator myectomy/corrugator myotomy. This technique can only be used to treat the vertical lines between the brows, though (not for crows feet or other expression lines).

November 26, 2009 at 2:11 am
(25) LovedMyBotox says:

It has been determined that I too have an immunity to Botox. The odd thing is that I have had successful cosmetic treatments using Botox for 14 years!!! In July, when my routine Botox didn’t take, nor did the touchup a few weeks later, I chalked it up to bad Botox. I waited until early November and was reinjected from a brand new bottle. Nothing. She had never seen or heard of anything like this before. The manufacturer was called and reported what I had suspected. It appears that I have developed an immunity. Ugggh

December 19, 2009 at 10:32 am
(26) deborah davy says:

Hi over the last 3 months i have had botox injections without any effect from start to finish, i am a single parent and saved for a year for the treatment only to be told yesterday that in my lifetime i must of had a bacteria similar to that used in botox that has caused me to be immune, no refund or alternative was offered, i am very angry to know that i have to put up with this wrinkly old face for ever!! does anyone know how or who i should possibly contact to complain and request some answers, its very wrong to give a lot of false hope as i was never told there was a possibility it wouldnt work, if i was i certainly would not of risked the procedure and the cost, any ideas please i am so unhappy!!!! xxx

December 20, 2009 at 7:01 pm
(27) plasticsurgery says:

Deborah, I feel you pain. It is simply wrong that the doctors do not warn patients that there is in fact a small chance Botox will not work for you. However, if they only tried injecting you once and it did not work, it is possible you are not immune. It could be that it was simply a bad (counterfiet, or not fresh) batch of Botox. If this is the case, they should absolutely inject you again for free.

Another point I want to raise, though, is if it took you a year to save for injections, Botox may not be the right choice for you anyway, because its effects last only 3-6 months on average. Please see my response to “Canadian Chic”, above, for articles on other Botox alternatives.

January 19, 2010 at 4:08 am
(28) deborah davy says:

thankyou for your response, i actually had botox injections on 4 different occassions and it did not work at all and its only the first time i had to save for it as my bf said if i liked the results he would continue to pay for future treatments but alas the result was naff ziltch an have appeared in the daily mail talking about this subject!!! x

February 26, 2010 at 2:22 pm
(29) mj says:

I wish I had known about this ahead of time. I have had botox injected twice now and it has not worked. I agree that greed and denialpreventr drs. from telling their patients this important fact…some people are immune.

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