Treatment with botulinum toxin has become an integral part of aesthetic medicine.

1) Botulinum toxin was not originally intended for the treatment of wrinkles

That’s true! In the 1980s, a research group led by Jean Carruthers and her husband actually set out to investigate the use of botulinum toxin in cross-eyed patients. During the course of the study, it became apparent that the patients were always happy to come for treatment and never missed a follow-up appointment. The researchers had never seen so much commitment from the test subjects before, and it became clear that the patients really appreciated the wrinkle-free image around their eyes as a nice side effect. This was the first time the cosmetic use of botulinum toxin was used to treat laugh lines (crow’s feet).

2) Interval therapy: does it make sense or is it no longer effective?

As with all important topics, there are many false facts about botulinum toxin circulating on the internet. It is claimed that the frequent use of botulinum toxin can lead to habituation or even antibodies, which means that the treatment no longer works as well.

Antibodies are the body’s own defence substances that are formed against a foreign substance on contact with it. According to current studies, however, antibodies are not directed against the botulinum toxin itself, but against a protein that is used by some botulinum manufacturers. These are known as ‘non-responders’. If this is the case for you, please talk to me about it. There are alternative preparations that can be ordered here so that you can still be treated with botulinum toxin.

When the question arises as to how often a botulinum treatment should be repeated, it depends on the region being treated. In the area of the masseter muscle (masseter treatment), it is not recommended to wait until the botulinum toxin has completely broken down so that the muscle cannot regain the same strength as at the beginning of the treatment. I generally recommend an interval of 4-6 months between botulinum toxin treatments in this area. Patients are often able to describe well when the muscle tension occurs again.

This is slightly different for the mimic muscles. In general, mobility of the treated areas is desirable in order to achieve a natural result. As the duration of the effect depends heavily on the patient’s metabolism and the treated area, I also recommend an interval of 4-6 months between treatments.

3) Zinc prolongs the effect

50 mg zinc 5 days before botulinum toxin treatment is said to extend the duration of the effect by 30 %. This statement was made by a study in 2012. Other studies only state that zinc is required as a co-enzyme in the metabolisation of botulinum toxin and that further studies are needed to investigate this in more detail.

In general, I think supplementing with zinc makes sense. Zinc is a vital trace element and supports our immune system, cell growth and various metabolic processes. I also like to recommend it for skin prone to blemishes.

4) Vitamin C reduces the effect

It has been proven that taking large amounts of vitamin C can negatively influence the effect of botulinum toxin. You should therefore refrain from vitamin C infusions in direct temporal connection with your botulinum toxin treatments. This also includes the use of vitamin C serums and retinol. These products should not be used for 4-6 days after botulinum toxin treatment.

5) A lot of sport can lead to faster degradation

Here, too, I have found it to be true. Patients with higher levels of sporting activity report a faster loss of effect of the botulinum toxin treatment. This can be explained by the increased metabolism and improved blood circulation. For me, however, this is no reason to give up sport. By using high-quality botulinum preparations, I personally experience an effect time of 5-6 months, and I try to exercise 4-5 times a week. So we can have both: Sport & botulinum toxin 😉