Understanding and Preventing Resistance to Neurotoxins in Medical Aesthetics
What is Resistance to Neurotoxins?
Neurotoxins, such as Botox, Dysport, Xeomin, Daxxify and Jeuveau, are widely used in medical spas to treat wrinkles, fine lines, and other signs of aging. These products work by temporarily blocking the nerve signals to the muscles, causing them to relax and smooth out the skin. However, over time, some patients may develop a resistance to these neurotoxins, resulting in reduced efficacy and shorter durations of the desired effects.
What Causes Resistance to Neurotoxins?
Resistance to neurotoxins can occur due to several factors:
- Antibody Formation: The most common cause of resistance is the development of neutralizing antibodies against the neurotoxin. The body’s immune system identifies the neurotoxin as a foreign substance after having it introduced repeatedly, and produces antibodies to neutralize it, diminishing its effects.
- Frequent Use: Too frequent use of neurotoxins can lead to the body becoming accustomed to the treatment, potentially prompting the immune system to respond. We recommend spacing neurotoxin treatments 3-4 months apart to prevent this.
- High Doses: Administering high doses of neurotoxins can increase the likelihood of antibody formation, especially if treatments are performed at shorter intervals. This can be especially noticeable in patients receiving Botox injections for migraines due to the high doses used.
- Product Purity: Impurities in the neurotoxin formulation can trigger the immune system, leading to antibody production and resistance. How to Prevent Resistance to Neurotoxins
Preventing resistance to neurotoxins involves several strategies:
- Choose the Right Neurotoxin: Selecting neurotoxins with low antigenicity (the ability to trigger an immune response) can reduce the risk of resistance. Xeomin, for example, is known for its purity as it contains only the active neurotoxin without accessory proteins, which may reduce the likelihood of antibody formation. Using a neurotoxin like Xeomin is especially important for those starting preventative neurotoxins in their 20s and 30s to prevent resistance.
- Optimal Dosing and Scheduling: Working with a skilled and experienced practitioner to determine the appropriate dosage and scheduling can help minimize the risk of resistance. Avoiding overly frequent treatments and allowing sufficient time between sessions can be beneficial. At PRISM, we recommend spacing out your neurotoxin treatments at least every 3 months apart to reduce this risk.
- Rotate Neurotoxins: Switching between different types of neurotoxins can help reduce the risk of developing resistance. Using different formulations may prevent the immune system from becoming overly sensitized to one particular neurotoxin.
- High-Quality Products: Ensure that the neurotoxins used are of high quality and from reputable manufacturers. This can reduce the risk of impurities that might trigger an immune response. At PRISM, we order directly from the reputable pharmaceutical companies that manufacture each individual neurotoxin.
- Monitoring and Customization: Regularly monitoring the patient’s response to treatments and customizing the approach based on individual needs can help maintain the effectiveness of neurotoxins over time. We recommend doing a two-week follow-up after neurotoxin treatments when you are new to PRISM so we can monitor your response to your neurotoxin treatment and make sure we are dosing you appropriately.
Which Neurotoxins are Best for Preventing Resistance?
When considering which neurotoxins are best for preventing resistance, it’s essential to look at their composition and clinical history. We use the following neurotoxins at PRISM Aesthetics:
- Xeomin (IncobotulinumtoxinA): Xeomin is often recommended for patients concerned about resistance because it is a “naked” neurotoxin, meaning it contains only the active ingredient without any complexing proteins. This reduces the likelihood of antibody formation and subsequent resistance.
- Dysport (AbobotulinumtoxinA: Dysport has a slightly different formulation and spread pattern compared to Botox, which can be beneficial for certain patients. It may also be used in rotation with other neurotoxins to prevent resistance.
- Jeuveau (PrabotulinumtoxinA-xvfs): Jeuveau is a one of the most recent neurotoxins to enter the market and is often referred to as “Newtox.” It has shown promise in clinical studies for its efficacy and safety, providing another option for those looking to prevent resistance.
Conclusion
Resistance to neurotoxins is a concern for many patients seeking aesthetic treatments. By understanding the causes and implementing strategies to prevent resistance, such as choosing the right neurotoxin, optimizing dosing, rotating products, and ensuring high-quality treatments, patients can enjoy the benefits of these treatments for a longer period. At PRISM Aesthetics, we are dedicated to providing personalized care and utilizing the best practices to ensure our patients achieve their desired results with minimal risk of resistance. Contact us today at 479-278-7166 to schedule a consultation and learn more about our neurotoxin treatments.