After COVID-19, many practitioners and patients alike started to notice a decline in the longevity of botulinum toxin (BTX) treatments, such as Botox Cosmetic®, Dysport®, Xeomin®, and Jeuveau®. One of the first experts to speak on this subject was Dr. Raj Acquilla, a global lecturer and trainer in the field of aesthetics. Featured in The Telegraph's 2021 article, Dr. Acquilla speculated the phenomenon being related to the body's inflammatory response after COVID-19 infection.
Later in 2022, a study was conducted on the effect of the COVID-19 vaccine on BTX duration by Dr. Shirin Azzam and published in the Journal of Cosmetic Dermatology. The 45 participants had received the COVID-19 vaccination anywhere from 3-5 times. Results showed a 22 day decrease in the longevity of BTX results. Researchers speculate that the immune response created by the vaccine could see the injected substance as a foreign substance in the body and attack it. If this is the case, BTX would wear off faster as antibodies in the blood stream fight it off.
COVID-19 itself may effect duration.
If the vaccine shortens duration via the above effect, the COVID-19 virus itself could cause a similar response. One study's findings demonstrate severe COVID-19 (also called long COVID) having long term effects on immune system stem cells.
Simply put, severe COVID-19 can change which genes turn on and off inside stem cells. After severe COVID-19, stem cells produce more white blood cells, thereby producing more inflammatory signals.
"Alterations in innate immune phenotypes persisted from months to one year after severe COVID-19 infection."
What can be done?
It could be beneficial to supplement with Zinc prior to BTX treatments. We have Zytaze available at our office. Zytaze contains Zinc and a digestive enzyme, phytase. When taken four days before treatment, as well as the day of treatment, one study showed an improvement in result duration of up to 30%. However, even though this is a supplement, we recommend consulting your physician before implementing this plan. You can read more about Zinc and its effects on BTX here.
Zinc Binding in the Activity of Botulinum Toxin
Botulinum toxins (BTX) (Botox Cosmetic®, Dysport®, Xeomin®, Jeuveau®, and Daxxify®) are a family of zinc-dependent metalloproteases. What does this mean? Essentially, BTX requires zinc to function.