MINDFOOD PROMOTION
Skincare has come a long way, but there’s little that currently rivals the complexion-smoothing effects of injectable botulinum toxin treatments.
The treatments, which are used to reduce the appearance of facial wrinkles and fine lines by temporarily relaxing movement in the muscles that cause them, have grown in popularity over the years. Plenty of us have embraced the possibilities, booking regular appointments for ‘top-ups’ to help keep that strong frown line, creased forehead or crinkly crow’s-feet at bay.
But did you know that consistency and dedication can play a part in your face being less responsive to treatment over time? Research has shown it’s possible to develop resistance to the effects of botulinum toxin, the active ingredient in anti-wrinkle injections. [1]
In New Zealand, one option is seeking treatment with XEOMIN®, an anti-wrinkle treatment containing purified botulinum toxin which may reduce the risk of developing resistance. [1,2]
What is botulinum toxin resistance?
Botulinum toxin resistance is one reason you might not be seeing the long-lasting results you used to see, or you are needing higher doses of botulinum toxin to try and achieve the same desired effect.
It’s important to understand that there are a number of different brands of muscle-relaxing injections made of botulinum toxin available. You should understand which ones your treatment provider is offering, and why.
Although they act in the same way, the different products may vary in their potency and their level of non-essential proteins such as complexing proteins and other bacterial components. [4] Resistance stems from the development of antibodies by the body, which attach to, and deactivate botulinum toxin, preventing it from working as intended. [2]
Specifically, complexing proteins and other bacterial components may encourage the attention of the body’s immune system, falsely recognising the complexing proteins and other bacterial components as harmful together with the active botulinum toxin. This causes the body to produce antibodies to clear the body of all foreign proteins, including the active botulinum toxin. [1]
The immune system has a mechanism to ‘remember’ active botulinum toxin and complexing proteins and other bacterial components, and will continue to produce antibodies, resulting in a continued block of the active botulinum toxin. [1]
Resistance can affect the efficacy of botulinum toxin treatments, resulting in reduced or no response to treatment. [1]
What are the signs of resistance to botulinum toxin?
There are four main signs of resistance to botulinum toxin that you the healthcare professional treating your can look out for. These include:
Increased dosage requirement: As the body develops antibodies against botulinum toxin, it may take higher doses of the product to achieve the same level of effect. This can increase the cost associated with botulinum toxin treatments.
Reduced duration of effect: The effects of botulinum toxin usually last for 3 to 6 months, depending on the product and the individual. However, if resistance develops, the effects may wear off sooner and require more frequent injections.
Reduced intensity of effect or partial response: The effects of botulinum toxin may also become less noticeable or pronounced over time, as the body becomes less responsive to the toxin.
No response: In some cases, over time, there may not be any response to treatment at all.
What can you do to avoid botulinum toxin resistance?
There can be a range of reasons your treatments are not as effective as they used to be and this can be nuanced, and can also include things such as your perception changing, and sub-optimal treatment placement, so it’s very important to seek experienced, professional guidance from a healthcare professional.
If you’re considering treatment, you should seek information from healthcare professionals about the benefits and risks of treatment, including the potential for developing resistance.
The healthcare professional should have taken a comprehensive health history prior to your first treatment and if you are seeing a new treatment provider, they should ask you for details of your treatment history, including past botulinum toxin treatment.
You should be comfortable that you are seeing a treatment provider with experience and that they have a good understanding of how to recognise clinical signs of botulinum toxin resistance so they can make informed decisions on options for management.
The risk of developing resistance is thought to be lower while using the lowest possible dose and avoiding frequent ‘top-ups’, so be sure you and your provider are sticking to the guidance on how much, and how often.
One option available is XEOMIN®, a type of botulinum toxin that is free of complexing proteins and has a lower risk of triggering an immune response. [1,4]
What is XEOMIN®?
XEOMIN® is a purified botulinum toxin, developed by Merz Aesthetics.
Developed by Dr Jürgen Frevert, a biochemist with over 30 years of toxin research, XEOMIN® undergoes an additional purification step during production to remove the complexing protein. This means the end product contains only the pure, active part of the botulinum toxin. [4]
When injected, XEOMIN® acts on the nerve endings in facial muscles and prevents them from contracting. The reduction in muscle activity temporarily softens the lines in the face, such as crow’s feet, forehead creases and frown lines, with the intention of giving you a natural, well- rested appearance.
Being free of complexing proteins and other bacterial components is the reason why XEOMIN has a low risk of an immune response leading to botulinum toxin-neutralising antibodies, with no known case reports of resistance attributed to XEOMIN when used for aesthetic purposes. [1]
XEOMIN® is available from selected healthcare professionals around New Zealand. If you are interested in treatment, you should seek expert advice and your treatment provider should take into account your health history and any relevant exclusions.
You can learn more about XEOMIN® at xeomin.co.nz.
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Ho WWS, Albrecht P, Calderon PE, et al. ‘Emerging Trends in Botulinum Neurotoxin A Resistance: An International Multidisciplinary Review and Consensus’. Plast Reconstr Surg Glob Open. 2022 Jun 20;10(6):e4407.
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XEOMIN. Consumer Medicine Information. 11 July 2023.
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Ho WWS, Chan L, Corduff N, et al. ‘Addressing the Real-World Challenges of Immunoresistance to Botulinum Neurotoxin A in Aesthetic Practice: Insights and Recommendations from a Panel Discussion in Hong Kong’. Toxins (Basel). 2023 Jul
12;15(7):456. -
XEOMIN. Healthcare Logistics. Data Sheet. 21 May 2021.
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Kerscher M, Wanitphakdeedecha R, Trindade de Almeida A, Maas C, Frevert J. IncobotulinumtoxinA: A Highly Purified and Precisely Manufactured Botulinum Neurotoxin Type A. J Drugs Dermatol. 2019 Jan 1;18(1):52-57.
TAPS MR10649
Xeomin ® (Incobotulinumtoxin A) 50, 100 Units is a Prescription Medicine. Indications: In adults, for the treatment of cervical dystonia; blepharospasm; spasticity of the upper limb; upper facial lines: glabellar frown lines, lateral periorbital lines (crow’s feet), horizontal forehead lines. Xeomin has both risks and benefits, consult your doctor if Xeomin is right for you. Further information on the risks and benefits of Xeomin can be found in the Consumer Medicine Information (CMI) available from www.medsafe.govt.nz or by calling 0800 822 310. Use strictly as directed. If symptoms continue or you have side effects, see your doctor, pharmacist or health care professional. Common side effects include: Headaches; nausea; tenderness, swelling, redness, numbness or bruising of the skin; dry eye; heavy feeling of eyelid/eyebrow/forehead; face/brow not symmetrical, dropping eyelids/eyebrows. Serious side effects are rare and include allergic reactions. Xeomin is an unfunded medicine, prescription charge will apply. Normal doctor charges will still apply.
Copyright © 2023. Pharmacy Retailing NZ Limited t/a Health Care Logistics (HCL) 58 Richard Pearse Drive, Mangere, Auckland 2022. All rights reserved. Xeomin ® and Merz Aesthetics are registered trademarks of Merz Pharma GMbH & Co. KGaA.. Date of preparation: June 2024.
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