Antibodies and Tox
In order to preserve our lifetime responsiveness to Tox (as much as possible), the best strategy is to limit the number of times your body is exposed to Tox. Each time we are treated with Tox, our body has the opportunity to make neutralizing antibodies against botulinum toxin itself. Antibody mediated resistance to Tox is a decades-long process, and research shows only 5% of people will become full-blown resistant to Tox. The other 95% will likely experience a reduction in responsiveness, such as shortened duration or poor set-up after decades of regular Tox treatments.
In the past it was thought that rotating brands of botulinum toxin product (especially Xeomin) would help slow the antibody resistance problem, but more recent research has eliminated this hope. It appears that our bodies make antibodies against botulinum toxin itself and not the proprietary accessory proteins associated with each brand of neurotoxin. (Xeomin famously having no accessory proteins - that’s been their claim to fame). Let’s take a look at a few situations related to the antibodies vs Tox issue.
Preventive Botox
We don’t recommend starting Tox treatments before you’ve ever had the chance to make a set-in wrinkle. There is some energy on Tik Tok targeting young people, encouraging prevention of wrinkles by starting Tox treatments in your early twenties. The problem with doing that boils down to antibody production. If you start building antibodies against botulinum toxin when you’re 22, fast forward 30 years, now you’re 52. THAT’s when you’re really going to need the Tox to work for you. If you already have 30 years of exposure under your belt, it’s likely that your tox treatments aren’t going to set up as firmly or last as long. We think it’s best to start your neurotoxin journey when you have wrinkle that’s present when you’re not moving your face, and you’re mad about it. That age varies from person to person.
Baby Botox
Also not recommended by Skinbeam. Baby Botox is a low dose Tox technique alledgedly preserving more natural movement, also made popular among young people on Tik Tok. Low dose Tox will likely set up initially just as firmly as regular dose Tox, but not last as long. Remember, when it comes to Tox, dose equals duration. You’ll still make antibodies. We don’t perpetrate Baby Botox.
Touch Ups
Sometimes they’re necessary. Especially when injector and patient are getting to know each other. As the relationship unfolds, though, it’s best to limit touch ups as much as possible for the same reasons as above. Each time you expose your body to botulinum toxin, it has the chance to build neutralizing antibodies.
Re-treating at less than 3 month intervals
Don’t schedule your next treatment before 90 days have passed. It’s easiest for us to treat you accurately when we can see the muscle’s full movement. Plus, antibodies. Lean towards 4 month intervals/3 treatments a year if you can. Yes, it will be completely worn off. Go with it!
I feel like I have some resistance - now what?
Don’t worry about this unless you have decades of loyally scheduled Tox treatments under your belt. If you do, the options are to increase the dose (at the usual schedule), or take a break. Rotating products (from Dysport to Botox for example) used to be a recommended strategy for this problem, but the latest research has shown it may not work. If you find yourself having trouble with duration, take 50mg Zinc by mouth for 4 days: the day before you’re treated, the day-of, and the two days following treatment. Zinc 50mg can make you nauseated, so you can take it with a meal, right at bedtime, or spread it out throughout the day. This Zinc regimen is also evidence-based to improve duration.
