Why consumers should consider the long-term safety of injectable-based treatments

BoNT-A is a purified protein derived from Clostridium botulinum. It works by temporarily reducing the signals between nerves and muscles, helping the targeted muscles relax. In cosmetic practice, BoNT-A is administered by trained healthcare professionals in doses tailored to the treatment area and the patient’s needs.

Currently, there are more than 40 BoNT-A products on the market, each with unique formulations. Studies published on the US National Institutes of Health’s (NIH) online platform have shown that repeated treatments with certain BoNT-A formulations may increase the chance of the immune system developing neutralising antibodies, which may reduce the treatment’s effect over time. However, real-world resistance risk depends on many factors, including total cumulative dose, injection intervals and individual patient physiology.

Merz Aesthetics’ XEOMIN pure formulation contains only the active neurotoxin that temporarily restricts muscle contractions in treatment, and can be just as effective as other BoNT-A, the company says. It is formulated without complexing proteins linked to BoNT-A resistance, which are often found in other formulations. According to studies published by NIH, those complexing proteins are thought to have no active role in the efficacy of treatment.

The risk of growing resistance to BoNT-A could also affect the efficacy of therapeutic treatments which use it as a prescription medicine to manage medical conditions affecting the salivary glands or muscles such as chronic migraines, an overactive bladder and post-stroke plasticity. It may also include chronic drooling, upper limb spasticity and eyelid spasms, according to a review on MDPI, a Swiss-based platform for scientific academics.

Therefore, long-term planning for regular toxin users should address not only when to treat but also which formulation to choose and how to manage lifetime exposure – particularly for younger adults looking to use BoNT-A for many years.

Building awareness

Dermatologists involved in developing the tool say it translates complex BoNT-A risk patterns into clearer talking points, enabling more focused discussions about long-term strategy in clinics.

“By highlighting how these symptoms may be a result of their treatment-seeking behaviours, the tool enables discussions in clinical practice on how patients should best move forward with their upcoming treatments,” Vachiramon says, who was part of the team that developed the tool.

Dr Niamh Corduff, an Australian plastic surgeon and lead author of research into the real-world implications of BoNT-A resistance, is also keen to stress the importance of meaningful and constructive dialogue between practitioners and patients: “Tools that help support these conversations ensure choices are thoughtful, transparent and build treatment plans well into the future,” she says.

The information provided in this article is for informational purposes and reference only, and is not intended to be and does not constitute any medical advice, pharmaceutical advice or any other advice. All content provided by the advertiser is purely its opinions, and SCMP does not warrant or represent that they are correct and will not be responsible for any loss or liability arising therefrom. Readers should consult your own doctors and seek medical advice for an informed decision instead of relying on the article. Any procedures involving injection should only be conducted by registered medical practitioners in Hong Kong.”