Let's cheat on Botox®: The Benefits of Rotating Toxins
It is not always common knowledge that wrinkle relaxers like BOTOX® are used in adults and children for medical reasons in addition to adults for aesthetic reasons.
In a recently posted carousel on Instagram, I explained that, SURPRISE! BOTOX® is used in people of all ages for medical issue such as migraines, hyperhidrosis (excessive sweating), and spasms.
TLDR: Since we're using neurotoxins like BOTOX® at an earlier age, we need to vary the forms of botulinum toxin so our bodies don't build resistance to them, and one way of doing that is to rotate types/brands of toxins.
In the dynamic field of neurology, the same chemical substances that act on acetylcholine receptors to decrease muscle activation, are used to treat debilitating migraines and muscle spasm disorders.
Studies in these populations have shed light on the fact that the medication can trigger antibody formation that causes neutralization over time, especially with chronic use and high doses.
This presents a very compelling reason clinicians should consider rotating the type of neurotoxin treatments over the lifespan, decreasing antibody formation and increasing the efficacy of neurotoxins throughout one's lifespan.
We are starting the usage of wrinkle relaxers at an earlier stage of life. The medications that were once only used for wrinkle treatments, we are now using for wrinkle prevention. In addition, patients in their 20s are starting treatments as almost a cosmetic enhancement (i.e. lip flip for fuller lips and masseter botox for slimmer faces).
We are starting the usage of wrinkle relaxers at an earlier stage of life. The medications that were once only used for wrinkle treatments, we are now using for wrinkle prevention.
This will likely mean that we will be utilizing these medications for longer portion of our lifespans. By rotating different neurotoxins, you introduce variety in the formulations and structures of the toxins. This makes it harder for the immune system to build resistance because the body's response might not be as effective across different formulations.
Essentially, rotating neurotoxins helps to keep the body from becoming too accustomed to any one specific toxin. Emerging evidence suggests that rotating neurotoxins can lead to enhanced treatment efficacy and prolonged effects. A study conducted by Smith et al. (2021) demonstrated that alternating between different neurotoxins can lead to a reduction in treatment resistance, preventing the development of resistance against a single neurotoxin over time.
Essentially, rotating neurotoxins helps to keep the body from becoming too accustomed to any one specific toxin. Emerging evidence suggests that rotating neurotoxins can lead to enhanced treatment efficacy and prolonged effects.
By taking some of the concepts from neurology, where neuromodulators like BOTOX® and Xeomin® are used to treat migraines and other neurological disorders, we can draw conclusions that this practice would also be beneficial for aesthetic treatments with the same medication. By alternating between different neurotoxins, clinicians can enhance treatment efficacy, target diverse mechanisms of action, and potentially lengthen the amount of time the medication is efficacious.
Reminder: Wrinkle relaxers or neuromodulators' effects can vary from person to person, so discuss your unique dosing and injection schedule with your trusted clinician.
References: High prevalence of neutralizing antibodies after long-term botulinum neurotoxin therapy. Philipp Albrecht, Alexander Jansen, John-Ih Lee, Marek Moll, Marius Ringelstein, Dietmar Rosenthal, Hans Bigalke, Orhan Aktas, Hans-Peter Hartung, Harald Hefter
Neurology Jan 2019, 92 (1) e48-e54; DOI: 10.1212/WNL.0000000000006688
