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What to Expect When Botox® Wears Off?

Botox® is a toxin that is used by medical practitioners to lessen the appearance of fine lines and wrinkles. 

Botox® also known as Botulinum Toxin was approved by the FDA for cosmetic use in April 12, 2002. 

Formal trials were conducted and it was proven to be a success in temporarily improving the appearance of moderate to severe frown lines and the effects are not permanent.

Botox® injections are administered by Botox® certified physicians or nurses in controlled amounts to relax muscles and give the face a fresh and youthful appearance. 

Female patient receiving Botox injection inner brow

Once Botox® wears off, wrinkles begin to reappear and do not become worse after the treatment. 

However, since the patient has become used to smoother skin and a youthful appearance, it might come as a shock when the Botox® wears off. 

Botox® administrators should manage patient’s expectations in this regard.

What Happens to the Muscles When Botox® Wears Off

Botox® paralyzes the point where the nerves are attached to the muscles making the muscle enter a relaxed state for an extended period of time. 

After a few months, new nerve endings develop that are not affected by Botox®. When these attach to the muscles, the muscle contracts, causing the wrinkles to slowly reappear.

There are 43 facial muscles and each area requires a different dosage of Botox®. 

For example, 8 to 14 units are injected around the eyes to help correct crow’s feet. 

The glabella area, which is the space between the eyebrows, has much stronger muscles and needs around 18 to 36 units to help smooth out the lines. 

Similarly, how long Botox® effect lasts depends on the area of the face in question. 

Thicker muscles require more injections to achieve the desired result as compared to the thinner ones. 

It is standard procedure to use more injections for thicker muscles than injecting deeper into the skin to ensure the patient’s safety.

What to Do When Botox® Wears Off

Botox® is also like any other beauty regimen and the effects improve over time with repetitive use. 

Using it consistently produces much better results since the muscles responsible for the appearance of wrinkles weaken with each use making Botox® last longer.

If the Botox® dosage is not strong enough or the correct number of units is not administered the results will not last as long as expected. 

However, a skilled Botox® administrator can help reduce the appearance of wrinkles for up to six months by injecting the right amount of Botox® into the right areas.

Even though the timeline varies from patient to patient, the results can last for at least a couple of months. 

A larger dose is required for men than for women and some areas have a shorter tolerance for the injection.  

In most cases, 3 – 6 months is the average duration for which the effects of Botox® last. 

If Botox® is applied regularly then after a few years the patient can go up to 9 months and even up tp one year between treatments.

For first time Botox® users, Botox® injections usually wear off in less than 3 months. 

To get the facial muscles conditioned to the Botox® injections, repeated treatments are required. The results can lengthen after a few rounds of Botox® treatments.

How to Prolong the Effects of Botox®

Train the muscles through correct administration of the drug

When a patient first begins receiving Botox® treatments, their muscles are much stronger. 

To ensure the proteins present in Botox® are at optimal performance it is important to make sure that the proper dose is administered to the target area. 

Lesser units are required over time because the muscles get weaker and weaker. 

The glabella area between the eyebrows takes around 20 units to make sure the muscles are properly frozen. 

The muscle gets weaker with time and the duration between treatments increases while the number of units required decreases. 

What starts at 20 units for every 4 months could progress to 15 units every 6 months once the muscles are trained.

Take zinc supplements to help absorb the solution

Since Botox® is a member of the enzyme group which depends on zinc it is recommended that the patient take supplements to help the body absorb the Botox®. 

Phytase present in the zinc supplements may help improve the results produced by Botox® injections especially in those who have a zinc deficiency. 

A study showed that Zytaze, a compound of zinc and Phytase taken four days prior to the Botox® injections showed long-lasting results in the patient’s skin after receiving injections.

Apply a Retin-A topical on the treated area

Combining the Botox® treatment with anti-aging topical such as Retin-A can help produce the desired results in the upper part of the face. 

Botox® injections paired with a topical retinoid help prevent the need for a large number of Botox® units and helps prolong the effects of the treatment.

Avoid direct sunlight and strenuous exercise

Aside from the recommended protection against sun exposure, it should also be avoided prior to the Botox® treatment. 

Sunshine boosts blood circulations and causes the blood vessels to disperse the Botox® solution at a faster rate. 

The same applies to cardiovascular exercises.

Proteins need time to properly diffuse into the skin and affect the muscles in the targeted area after they are injected. 

Exercising vigorously after being injected with Botox® can cause the solution to metabolize before it has had the time to properly diffuse. 

This can reduce the effectiveness of the treatment. 

Even after the prescribed 24-hour waiting period, patients are recommended to be careful when they return to their exercise regimen. 

The facial expressions made while working out could make the muscles contract much faster and cause the effects of the Botox® treatment to wear off.

Botox® is administered into muscles in quantities that are suited to the body. 

However, it is important that the person who is performing the procedure be a licensed medical professional. 

The IAPAM recommends extensive training for all those who wish to become Botox® administrators and be prepared to answer all the patient’s questions and address their concerns.

Hands-on Botox® Training

Join +10,000 MDs/DOs, PAs and NPs from all medical specialties who have successful trained in our Successful Aesthetic Practice System™ at the Aesthetic Medicine Symposium.

December 3-6, 2021
Scottsdale, Arizona

Not ready for live hands-on training? Start with our online certificates with the IAPAM Learning Lab. View courses.

Botox is a trademark of Allergan Inc.

For more information, visit the the IAPAM’s Aesthetic Medicine Symposium with Botox Training website! 


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