How to Make Botox Last Longer: 14 Best Practices (and Precautions) for Botox Aftercare

Facial aging is inevitable, but you can delay its signs to keep you looking young for a long time. Botox treatment is one of many cosmetic procedures that can help you achieve that aim.

Botox is a drug that weakens the facial muscles responsible for blemishes called “dynamic wrinkles.” It acts faster than topical skin treatments. Its effects are comparable to plastic surgery for the same condition.

Like other wrinkle treatments, this drug will not completely stop facial aging. However, you can make Botox last longer with some simple but scientifically proven measures.

To know how these wrinkle-smoothing strategies work, you must first understand why the effects of Botox are not permanent.

Why Is Botox Not Permanent?

Botox is derived from botulinum toxin, a nerve blocker produced by the canned food bacterial contaminant Clostridium botulinum. It can be useful for treating various medical conditions when given in small doses.

Botox accumulates in the nerve endings where it binds to vesicles or sacs containing a chemical called “acetylcholine.” This molecule has many actions in the body, including stimulating facial muscle contraction.

Botox prevents the vesicles from releasing acetylcholine into the nerve-muscle junction. The resulting paralysis reduces the occurrence of dynamic wrinkles—the skin folds formed by facial expressions. 

The neurotoxin is foreign to the body. The blockade it creates lasts only until the body breaks it down and flushes it out. Normally, digestive proteins in the nerve endings are responsible for its degradation. The process takes a few months, so in most patients, the treated facial muscles recover in 3-4 months.

However, a large molecule like botulinum toxin can sensitize the immune system. So, some people develop antibodies to it, reducing its efficacy or the duration of its effects. What makes individuals prone to Botox antibody formation remains unclear. However, some studies suggest that higher doses or frequent use of the drug may trigger its occurrence.

How Can You Make Botox Last Longer?

From the above, it is logical to think that prolonging Botox‘s effects requires the following:

• Keeping it bound to acetylcholine vesicles
• Protecting it from degradation

The first one is a cinch, as we shall explain later. Sadly, there’s not a lot you can do about the second. What do we do to help our patients deal with this challenge?

The most sensible move is to go back to the cosmetic condition that Botox is supposed to alleviate—facial aging—and treat it as a whole. That means combining Botox with remedies for “static wrinkles”—the fine lines arising from collagen loss—and developing habits that can keep you enduringly youthful from the inside out.

The steps that can help you prolong the effects of Botox are not complicated or pricey. I discuss them below.

#1 Good Pre-Treatment Preparation and Aftercare

Delaying skin repair processes after an injection produces not only visible blemishes but also substances that can accelerate skin aging. However, preparing well for your Botox cosmetic procedure helps you avoid this so you can recover quickly. For example, we advise our patients to avoid blood thinners for a few days so injection sites can clot and heal fast.

Meanwhile, refraining temporarily from activities that can cause flushing—such as exercise—after your session helps retain the drug in the target areas longer. Increased Botox absorption speeds up its interaction with acetylcholine vesicles and prolongs its action.

You may read our clinic’s full guide on what to do before and after Botox treatment to learn more.

#2 Schedule Regular Botox Injections

As with any other drug, topping up is the surest way to sustain the effects of Botox injections, so it is important to stay up to date with your maintenance treatments. The neurotoxin typically wears off after 3-4 months. In my practice, I advise my patients to book their next Botox appointment around that time.

There is no need to rush because muscle recovery is gradual. However, you shouldn’t wait too long, either, or your wrinkles will become noticeable again.

Botox and fillers only offer temporary results and thus diminish after a certain period of time. By keeping regular appointments, you’ll naturally train your facial muscles to move minimally and avoid overactivity. In our experience, this is one of the key ways to prolong the effects of Botox and hyaluronic acid-based dermal fillers like Juvederm and Restylane.

Your BHSkin Dermatology provider can create a Botox schedule that works for you and best fits your anti-aging needs. You may book a consultation to learn more.

#3 Do Not Receive Botox Too Frequently, Though

While it’s important to schedule regular Botox treatments, it is not advisable to have multiple sessions frequently. Receiving Botox injections at shorter intervals increases a person’s risk of developing antibodies to the drug. Moreover, it makes the skin prone to scarring and nerve or muscle dysfunction, which can contribute to facial aging.

Too many Botox appointments in a short span of time can make the facial muscles resistant to the drug. At our clinic, we select the lowest effective dose and give it at the longest possible injection intervals.

Patients needing more frequent sessions could be experiencing Botox antibody formation and, consequently, beginning resistance to the drug. In our practice, we take this as a sign to explore other wrinkle-smoothing cosmetic treatments.

#4 Avoid Using Abrasive Products

Over the years, patients have shared with us the numerous types of products they’ve used to fight the signs of aging. Naturally, many of them would like to use these products in combination with Botox to maximize their results. However, I usually recommend avoiding abrasive facial cleansers, masks, scrubs and toners, especially after your Botox appointment.

Too aggressive cleansing will not make Botox and fillers like Juvederm or Restylane last longer. In fact, it can disrupt the protective skin barrier, contributing to static wrinkling and rendering Botox ineffective. Additionally, abrasive skin care products may cause fillers to migrate to other areas and produce undesirable results.

#5 Avoid the Sun as Much as Possible

Limiting sun exposure helps prevent skin aging. However, there is another important reason for doing it after a Botox injection.

Like exercise, UV rays can cause flushing by dilating the facial blood vessels and increasing facial blood circulation. This enables Botox molecules to disperse at a faster rate, which can ruin the treatment by reducing the drug’s absorption in the nerve endings.

If, for some reason, a patient cannot avoid staying outdoors, we advise them to wear sunscreen that contains at least SPF 30. Wearing a wide-brimmed hat also offers protection. These two simple steps not only protect the skin from photoaging but also help Botox, Restylane or Juvederm last longer.

#6 Take Charge of Your Skin Care Routine

The anti-aging effects of Botox treatment last longer when combined with a good skin care regimen. I routinely recommend gentle cleansing and moisturizing twice daily to my patients. The first clears away skin impurities that can accelerate the aging process. The second enhances the skin’s glow and protective barrier function.

Some individuals may benefit from adding topical medications to their daily routine. Below are some examples:

• Antioxidants like niacinamide and vitamin C neutralize harmful particles left behind by UV rays, pollution and other environmental elements.
• Topical vitamin A-like drugs and glycolic acid exfoliate the skin, flattening wrinkles and exposing younger skin cells.
• Hyaluronic acid serums hydrate and plump up the skin, making it youthfully radiant.

Dermatologist-formulated sunscreen provides added UV protection. Active people must use them daily regardless of skin type.

Patients must have the optimum skin care regimen to complement the effects of their Botox treatment.

#7 Eat a Proper Diet

The diet can also affect the skin’s appearance. A well-balanced diet provides the skin with the nutrients it needs to function properly. Avoid processed foods and simple sugars, which can trigger premature skin aging.

Extreme weight loss, especially in the face, can reduce the effectiveness and longevity of Botox injections. For patients who are on a weight loss journey, we may recommend alternative anti-aging options.

In the last few years, there has been a bit of hype about increasing zinc intake to make Botox last longer. Currently, there is not enough evidence to support the efficacy and safety of such a measure. It is not included in the FDA-approved prescribing guide for cosmetic Botox or the AAD’s Botox aftercare recommendations.  

Zinc is a trace mineral in the body. The intestines and kidneys regulate its blood levels closely. Generally, people obtain all the zinc they need from the diet alone.

In healthy individuals, a zinc supplement will only stimulate the intestines and kidneys to excrete the trace vitamin faster. So it’s an additional expense you may not need. However, people with conditions that prevent them from eliminating excess minerals may develop toxicity signs like anemia and nerve damage from zinc accumulation.

A patient’s need for oral vitamin supplementation is typically evident during physical examination. In the absence of symptoms or documented zinc deficiency (i.e., by blood testing), supplementation is usually not necessary. A healthy diet and adherence to the prescribed skin vitamin treatment, if any, are enough to maintain skin health and enhance the effects of Botox.

#8 Hydrate Your Way to Healthy Skin

Drinking plenty of water is also good for the skin. Water helps flush out those unseen impurities that the environment creates in the body. Excellent long-term Botox results are only possible when a person has healthy skin.

Additionally, hydration boosts the rejuvenating effect of hyaluronic acid. This substance is naturally present in the skin and other parts of the body, though its amounts decrease with aging. It attracts and retains water particles. Hyaluronic acid-based serums and dermal fillers flatten wrinkles using this mechanism.

#9 Reduce Stress in Your Life

We also advise our patients to manage, if not avoid, emotional and physical stress. While stress is common, it can negatively affect your body in many ways. It can even weaken the long-term effects of your Botox treatment.

High stress levels stimulate the release of cortisol and other stress hormones, which can trigger inflammation and speed up the aging process. Notice how stressed people wrinkle up early and manifest other signs of premature aging?

To extend the life of injectable treatments, we encourage patients to consider practicing stress-relief techniques such as meditation and yoga.

#10 Exercise Your Facial Muscles

Another way to help Botox or dermal fillers last longer is to exercise the facial muscles. Facial exercises enhance the removal of toxins and drainage of fluids from the face, which can help slow down the aging process.

Additionally, facial exercises have been shown to speed up the onset of the effects of Botox treatment. In a study involving 25 female adults, 68% reported experiencing faster Botox onset when they did facial muscle exercises after injection.

Facial exercises are best done near the area of injection. For example, patients who had Botox injected in the forehead may try raising their forehead afterward. Those who had crow’s feet treatment may try smiling or squinting.

#11 Exercise is Okay After 24 Hours

Many of our patients go to the gym frequently and worry that their Botox and dermal filler injections will not last as long as prescribed. This is not exactly true.

Exercising regularly will not cause Botox or Restylane to wear off faster, but intense workouts immediately after receiving treatment can reduce the results. As explained earlier, exercise increases facial blood flow, which can accelerate Botox or dermal filler clearance in the injection site. However, patients only have to avoid it in the first several hours after the procedure when maximum drug amounts need to seep into the nerve endings.

We tell our patients that they do not have to stop their workout routines completely to enjoy the age-reversing effects of Botox. In fact, we recommend regular physical activity as part of overall health maintenance, which helps people stay young-looking. However, taking a day off after Botox injection ensures it doesn’t spread to other parts of the face, head or neck.

#12 Smoking and Vaping Gradually Undo the Effects of Botox Cosmetic Treatment

Smoking and vaping can counter the effects of any injectable treatment, Botox included.

• The act of smoking or vaping uses muscles around the lips that wrinkle up the skin, creating what are known as “smoker’s lines.”
• Smoking and vaping release nicotine, a powerful blood vessel constrictor. Narrowing of the blood vessels reduces the flow of water, oxygen and nutrients to the skin. Their depletion contributes to delayed healing, collagen loss and premature aging. Nicotine also resembles the actions of some stress hormones.
• Other chemicals present in cigarettes can reduce collagen production and accelerate the breakdown of this important skin protein. Both result in premature wrinkling, making any injectable treatment less effective. Cigarette smoking also increases your risk of developing any malignancy, including highly aggressive skin cancers.

As you can see, healthy lifestyle choices are essential to having smoother skin and looking young. Cosmetic procedures like Botox injection, chemical peel application, dermal filler injection, laser treatment, etc., will not work if patients don’t give up the habits that antagonize their effects.

#13 Be Patient

Another important reminder I tell my patients is to wait patiently, as it can take several weeks to see the full effects of Botox injections. Additional treatments will not help but rather do the opposite as they may cause adverse effects.

#14 Work With the Right Dermatologist

Last but not least, working with an excellent dermatologist is the biggest step patients can take to make Botox last longer. Only a highly experienced cosmetic Botox provider knows how to inject a nerve blocker without causing unwanted side effects. Additionally, a deep understanding of the skin and its dynamic processes allows the practitioner to give it optimal care like no other can. 

I’m proud to say that some of LA’s finest board-certified dermatologists work at BHSkin Dermatology and are available to you once you make an appointment. Nearly 4 million neurotoxin injections were performed in the U.S. in 2022, making it the most commonly performed nonsurgical cosmetic treatment in the country.

BHSkin Dermatology providers have safely administered Botox, Dysport and other neuromodulators to thousands of patients in LA. 

When you think about it, the secret to getting superb, long-lasting Botox results is not so huge at all. Healthy living, an effective skin care routine and choosing a good skin doctor can help you make the most out of this treatment and stay wrinkle-free for many years.

Recap: How to Make Botox Last Longer

Botox is a drug that gets rid of wrinkles created by repeated facial muscle movement. The body sees it as a foreign substance, so its effects are cut short by metabolic or immunologic processes.

Making Botox results last longer is easy. Healthy habits and good skin care are crucial. Most importantly, we highly recommend working with a trusted board-certified dermatologist. Only a bona fide skin care expert can guarantee the best outcomes from any skin treatment.

Book a Consultation in LA to Learn More

Achieve a youthful and radiant complexion with the help of Botox injections or dermal fillers. Whether you still have questions about making injectables last longer or simply want to book an appointment, BHSkin Dermatology is at your service.

Our priority is to help our patients determine the right treatment option for their skin’s needs. So take the first step and book an appointment today. Look and feel your best. The decision is in your hands!

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Author: Don Mehrabi

Don Mehrabi, MD, FAAD, is LA’s leading board-certified dermatologist who treats patients, builds the BHSkin clinics, and raises three kids. This blog builds on medical studies combined with Dr. Mehrabi's first-hand experiences from practicing in Encino-Tarzana, Glendale, and online