9 Ways to Make Your Botox Last Longer

There is a special feeling when you look in the mirror and notice that your neurotoxin injections (aka Botox, Dysport, Xeomin and others) are starting to kick-in. It’s a mixture of excitement and pure joy to look at your reflection and see a younger version of yourself staring back at you. Many of you know the exact feeling I am talking about!

We want our cosmetic treatment results to last. What can be done to prolong the effects of neurotoxin injections?

First it is important to understand how neurotoxins like Botox work.

There are several different molecular forms of injectable botulinum toxin that vary slightly in their structure but function in the same way when used for cosmetic purposes. Botulinum toxin once injected binds to the neuromuscular junction inhibiting acetylcholine release from nerve endings which reduces neuromuscular transmission and local muscle activity in the form of blocking muscle contraction.

What does that mean? Basically, it stops the communication between nerve cells that cause muscle contraction. In the world of aesthetics, this equates to stopping the muscle contraction of facial expression which causes wrinkles.

Here are 9 ways to get the most out of your aesthetic treatments with neurotoxin.

1.  Using a medical grade or a prescription strength skin care regimen. Over-the-counter products are not sufficient if you want to achieve the full range of anti-aging benefits of retinoic acid also known as RetinA (tretinoin). Along with the proper molecular vitamin C serum these products are essential elements of restorative skin care that should be initiated to improve fine lines and wrinkles.

2. Sunscreen and ALL screens. The sunscreen may seem obvious, but you may not be on a high enough SPF to protect your skin if you are on a RetinA (tretinoin) or Retinol containing product. I recommend a mineral based SPF50 daily regardless of activity. Minerals like Titanium dioxide and Zinc oxide provide a physical barrier to the damaging UVA/UVB rays. We are exposed to ionizing radiation from our device emitting blue wavelength light all day and night too. Ultraviolet damage causes low levels of inflammation so add blue light filters on devices or blue blocking glasses to prevent thinning and breaking down collagen.

3.  Avoid alcohol. The impact of alcohol on aging is well studied. Alcohol suppresses the immune system reducing the body’s natural defense against skin cancer Acetaldehyde, is a major metabolite of ingested alcohol and a known carcinogen (cancer causing chemical). Acetaldehyde produces reactive free radicals and damages DNA leading to ineffective cellular repair, breakdown of collagen and premature thinning of the skin2.

4.  Do not smoke. Do not smoke. Do not smoke. Every single tissue, blood vessel and or organ in your body is affected by tobacco smoking. Nearly every preventable cancer is associated with cigarette smoking. Your skin is the largest organ in the human body and the effects of smoking are easily visible as premature wrinkles and skin thinning. Smoking and the chemicals in cigarette smoke cause inflammation of the small blood vessels that supply oxygen to the skin. Smoking also accelerates aging of the skin because the nicotine contained in cigarettes is a vasoconstrictor, which can decrease blood flow3.

5.  Hydration; apply and drink. Drink plenty of water every day. Our bodies are made mostly water. Dehydration leads to poor skin turgor and thinning of the skin which enhances wrinkles. Apply moisturizer to the skin especially during the winter months to protect and hydrate the skin.

6.  Zinc. Make sure you are eating a healthy diet containing unprocessed foods, fruits, vegetables and lean protein. If your diet is poor consider supplementing with a multivitamin containing elemental zinc.

7.  Exercise especially mild-moderate cardiovascular exercise is great way to rejuvenate the skin by increasing blood flow. Many experts have suggested that high intensity workouts speed up the metabolic rate by which you metabolize neurotoxin4.

8.  Avoid fluctuations in hormone levels. Hormone replacement therapy or HRT for women has improved the quality of life for many women who experience severe post-menopausal symptoms. Customized hormone replacement therapies often include supplementing with testosterone in addition to estrogen. Serum testosterone levels can affect the ability to achieve the desired results and the duration of your neurotoxin treatment. There is published evidence studying effects of serum testosterone on the motor neuron. Recall this is where neurotoxins like Botox work. Increased neuronal sprouting enhances communication and therefore muscle contraction in nerve cells. Patients may have incomplete effects after receiving their cosmetic treatment or patients will notice that the their injections are only lasting around 2 months instead of 3-4 months.

9.  Take deep breaths. Try to remember to take deep breaths throughout the day to reduce stress. Cortisol is a stress hormone is triggered by the sympathetic nervous system, released by the adrenal glands of kidneys when you are under stress to increase heart rate and blood pressure. When you take a deep breath, you activate the vagus nerve which triggers the parasympathetic nervous system, the relaxation part of the nervous system. This tells your brain that all is well and feel-good hormones are released which help you to feel good and relax. You may notice that after a few deep breaths your heart rate will also slow down.


There are many more internal and external factors affecting the duration of your neurotoxin injections. To make the most of the time in between your appointments try to implement at least one healthy change at a time and stay consistent with each change before adding another. I hope these tips have been a good reminder that healthy living and lifestyle choices are not just good for you; they are good for your Botox too!

By Dr. Kathryn Rawdan 




  1. Saladi RN, Nektalova T, Fox JL. Induction of skin carcinogenicity by alcohol and ultraviolet light. Clin Exp Dermatol 2009;35:7–11


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  1. Urbańska M, Nowak G, Florek E. Wpływ palenia tytoniu na starzenie sie skóry [Cigarette smoking and its influence on skin aging]. Przegl Lek. 2012;69(10):1111-4. Polish. PMID: 23421102.


  1. Crane JD, MacNeil LG, Lally JS, Ford RJ, Bujak AL, Brar IK, Kemp BE, Raha S, Steinberg GR, Tarnopolsky MA. Exercise-stimulated interleukin-15 is controlled by AMPK and regulates skin metabolism and aging.Aging Cell. 2015; 14:625–34. 10.1111/acel.12341 [PMC free article] [PubMed] [CrossRef] [Google Scholar]
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