Botox Isn’t Working Anymore

Have you found that your results from Botox treatments aren’t the same anymore? Keep reading to learn more.

What is Botox?

Botox is a purified protein that’s used to treat wrinkles caused by facial expressions. For example, when you frown, you can see vertical lines between your eyebrows called frown lines. You have muscles in your face to move your eyebrows and other areas. When these muscles pull your skin, you may see a wrinkle there. Botox works by relaxing these muscles so you don’t see the wrinkles. Most people notice results of their Botox treatment in a few days and enjoy their results for three to four months. Then it’s time for a maintenance Botox treatment.

Why does Botox stop working?

In some people who have been having Botox treatments for many years, something unusual happens. They receive the same dose as they normally get, but the results aren’t the same. Sometimes they notice that their wrinkles are softer, but not quite as soft as usual. Sometimes they see results in one area such as their frown lines, but not in another area such as their crow’s feet. There are two possibilities. First, especially if you don’t keep up with your maintenance, your muscles get stronger over time as you make more and more facial expressions. This is particularly true if your face is very expressive. The second, is that your body is somehow getting resistant to the Botox so you don’t see the effects like you did before. This happens more commonly if you get a low dose of Botox. When you get a low dose, your results don’t last as long so instead of getting a maintenance Botox treatment every three to four months you get one every six to eight weeks. This gives your body more frequent exposure to the Botox protein and more chances to develop resistance.

What should I do if my Botox stops working?

Fortunately, there are things that you can do. The first and easiest thing to do is to try getting a higher dose of Botox. This works well if your muscles are getting stronger. If this doesn’t work, then maybe your body is resistant to Botox. In these cases, you can try an alternative. For many years, there were no other options other than Botox. But fortunately, now there are many available in the United States and more coming soon. Overseas there are even more options. That’s because it’s very hard and expensive to get these products approved by the FDA in the United States; it takes years of clinical trials. The first alternative that was available was Dysport, and Xeomin was available shortly thereafter. About ten years after that Jeuveau was approved. And the newest Botox alternative called Daxxify was recently approved. It should be available within the next six months or so. There’s also Myobloc which is not approved for cosmetic purposes but is used for other muscles in the body. There are a couple of other companies (Galderma and Hugel) which will be coming out with even more Botox alternatives in the next year or two. The difference between Botox and these other alternatives is relatively minor. The results are almost identical. But since the proteins are slightly different and the purification process is different, your body may not be resistant to the alternative. So now you can try an alternative option.

The third possibility is that there may be more than just muscle activity. If your skin has a lot of sun damage, you’ll see wrinkles even if you don’t have an expressive face. This is from collagen loss or damage. Collagen is the protein in your skin that keeps it firm and tight. Over time, your body doesn’t make as much collagen and your skin can become loose and wrinkled. In this case, you’ll want to use sunscreen and skin care products to stimulate collagen, and have laser or other treatments to address the wrinkles.

Join our mailing list

Dr. Alex has performed over 10,000 cosmetic treatments with many satisfied patients. Contact us to schedule an appointment for a free consultation with Dr. Alex in our Encino, CA office.

Contact us Today

Our Location

Hours of Operation



10:00 am-5:00 pm


10:00 am-5:00 pm


10:00 am-5:00 pm


10:00 am-5:00 pm


10:00 am-4:00 pm