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:
1. 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.
2. 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.
3. 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.
4. 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:
1. 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.
2. 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.
3. 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.
4. 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.
5. 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:
1. 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.
2. 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.
3. 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.
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