Anti-wrinkle toxin injections are the most popular non-surgical procedure in the UK, with an estimated 900,000 procedures carried out each year. But what could be going on when your anti-wrinkle treatment stops working, and what, if anything, can be done about it?

Earlier this year I thought my love affair with anti-wrinkle injections was coming to a bitter end. It wasn’t that I had been tempted elsewhere, although I flirted with other treatments. I still loved them– but they no longer loved me back. The trio of injections to the forehead, frown lines and around the eyes no longer seemed to take effect, and the promising lift of any top-up treatments faded after a few days.

Could anything be done anything to get things back on track, or did I need to accept the end of my relationship with anti-wrinkle injections? I turned to Aesthetic Experts Dr Nestor Demosthenous and Dr Unnati Desai to find out what could be going on.

In my case, it seems I’m among the tiny minority who have grown resistant to the treatment. However, there are a number of much likelier explanations for anyone experiencing the same issue. Luckily for me, there is also a range of other treatments to rival my old go-to.

Check your expectations 

Etre Vous Expert Dr Demosthenous explains that sometimes the problem lies in a misunderstanding about what could be achieved with the treatment.

“When a new patient comes to my clinic and asks me, ‘why has my treatment elsewhere not worked?’ a whole series of questions come to my mind," he says. "What did they expect from their treatment? Were the efficacy and limitations of the procedure properly explained and understood? For example, a client may have expected one particularly deep crease on their face to disappear, which could never have been achieved with botulinum toxin.”

Treatment resistance is a thing, but is unlikely 

Medical trials have shown that as few as one in 10,000 clients have a true resistance to botulinum toxin. Dr Unnati Desai, Medical Director of Skinfluencer London, says, “Very rarely patients can develop antibodies to the neurotoxin protein. This is likely in patients who have high doses injected too frequently.

"As a general rule, the protein is in the body for around four months, so it is best to aim for repeat treatments no sooner than four months. Your clinician will advise you on what can be done in one sitting, as there is a maximum number of units that is recommended in a single treatment session.”

Were you under-dosed?

If anti-wrinkle injections have had little to no effect, Dr Desai believes it could be due to the dilute of the neurotoxin and number of injections to each area.

“Your clinician will need to ensure the neurotoxin injected is not overly diluted, and inject according to each patient's individual assessment for optimal results. We aim to soften movement to keep a natural look rather than the overly frozen look. Make sure to attend for reviews and top ups, as advised, because these follow-up appointments allow us to ensure you get the best results from the treatment.”  

Badly administered treatment

If you are not seeing any results from your treatment, it could be that it was not done properly. Dr Demosthenous says, “Sadly there are more and more unqualified practitioners unsafely administering anti-wrinkle injections. Treatments not working are the least of clients’ concerns when it comes to unregulated practitioners, unfortunately.”

To ensure your treatment is safely and effectively administered, always choose a registered and reputable clinic: all Etre Vous-approved practitioners are qualified aesthetic experts, registered with a recognised medical regulating body.  

Poor quality product 

Qualified aesthetic practitioners will be procuring their products from licensed aesthetic distribution companies. Dr Demosthenous warns that low grade products, which can be bought online from unregistered providers, will result in underwhelming results.

“Unfortunately, we are bombarded on Instagram and TikTok with so-called experts advertising injectable treatments, making it really confusing for people looking for reliable treatment," he states.

"Unqualified practitioners are more likely to source their aesthetic products from unregistered traders and, if a toxin is unlicensed, there is no guarantee that it meets quality, safety or effectiveness standards.”

Expert recommended alternatives to anti-wrinkle injections  

Hard working skincare 

First and foremost, aesthetic experts agree that great skincare starts at home. Invest in a good sunscreen, vitamin C and retinol to give your skin the best chance of vitality.

Polynucleotide injections 

This injectable treatment, made up of filtered, ultra purified, sterilised natural DNA fractions has been proven to increase collagen and create healthier skin within a month. Its additional anti-inflammatory effects make it a new gold standard amongst aesthetic practitioners.

Microneedling with growth factors 

Microneedling with the addition of growth factors such as platelet-rich plasma (PRP) injections, stem cells and exosomes, make this treatment a turbo-charge for skin and an EV Expert favourite.  

Laser treatments 

Used at varying depths, laser treatments can be used for relatively light-touch rejuvenation through to deeper laser penetration to reduce wrinkles.

Dermal fillers 

Injectable dermal fillers made of skin-plumping hyaluronic acid, are increasing in popularity for softening and smoothing facial creases and wrinkles.