The Surprising Reason You Could Become 'Immune' to Certain Injectables—and the One to Switch to If It Happens

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Some people say their wrinkle-fighting neuromodulators (specifically Botox Cosmetic and Dysport) “stop working” over time, but is this really the case? Or are other factors to blame? We’ve got the inside scoop from the experts.

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Yes, it can happen...
According to New York dermatologist Julie Russak, MD, some patients have said their neuromodulators, which work to temporarily paralyze the muscles that contract and cause wrinkles, have “stopped working” over time. “Your body can develop antibodies to a specific product, so your immune system resists it,” she says. “Luckily, there are a few brands—Botox Cosmetic, Dysport and Xeomin—that we can use interchangeably to combat this. In most cases, people build up antibodies to the accessory protein in Botox Cosmetic and Dysport, rather than the active molecule. If this happens, we can switch to Xeomin, which doesn’t contain this specific type of protein, to alleviate the problem.” Also, if you’re an avid exerciser, your body may metabolize injectables faster, which can cause the effect not to last as long.

It's not likely...
Purchase, NY, plastic surgeon Michael Suzman, MD, says it is exceedingly rare for someone to become “immune” to neuromodulators, and that most patients find them to be very effective at the same dose, even over many years. “If a patient sees a lessened effect after receiving their regular injections, it may be because they are so used to the smooth look they have achieved, but still continue to age normally over time, and therefore see less of a ‘youthful’ result,” he explains. 

Another reason for this “reduced effect,” according to Dr. Suzman: “The injection could have missed the strongest part of the muscle and concentrated between areas of muscle where it is less effective. A touch-up with product from a fresh vial should correct the issue.”

The bottom line: You can develop antibodies to certain brands of injectables, and can switch to another product to fix it, but you can’t become immune to them entirely.

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