Anti-wrinkle injections of botulinum toxin type A (the 2 types of anti-wrinkle injections approved by the FDA that we use here at Cityskin) consists of proteins. All foreign proteins to the human body have the potential to induce an immune response . When an immune response occurs, it causes the body to block the effects of the anti-wrinkle injections. The higher the protein load per dose, the greater increase risk of producing antibodies. This is why one of the leading brand’s changed the protein load, since first developing the product. (Please note that we cannot name brand names due to the governing law in Australia).
There have been clinical studies where tolderance have developed, due to clinical use of botulinum toxin type A. What was found that the higher and the more frequent dose, the greater the risk of developing antibodies to the product. However, more studies need to be performed to assess the immune responses and to detect the underlying cause, as in this particular study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3872090/#!po=3.12500, all 5 cases developed antibodies after their initial treatment of recommended ‘standard’ dosing from the pharmaceutical companies, and has second treatment failure. In some cases, the patient was switched from using onabotulinumtoxinA to abobotulinumtoxinA and there was a slight response, but on the third treatment, there was no response.
In summary, the studies show that immune responses can occur even with low, infrequent doses of anti-wrinkle injections, and there needs to be more studies to conclude the true prevelance of resistance to anti-wrinkle injections.
At Cityskin, our motto is “fresh, not fake”, so we would prefer to inject less, give natural results and add more at the next treatment, generally 3-4 months after the initial treatment, as recommended by the pharmaceutical companies for repeat injections. This would lower any potential risk of developing antibodies to anti-wrinkle injections.