How Often Should You Get Skin Botox? Intervals and Resistance
At our clinic in Gangnam, Seoul, skin Botox starts to work after about 2 weeks and lasts around 3 months, although some people feel it fade sooner.
You can repeat it once 3 months have passed, but we usually recommend every 4–6 months. Botulinum toxin given too often, or in too high a dose, can lead to resistance, so we space treatments out instead of repeating every 3 months.
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Results and duration vary from person to person.
How is skin Botox different from regular Botox?
Regular Botox is injected directly into a muscle to reduce its movement, and it lasts longer than skin Botox.
Skin Botox uses the same type of toxin, but as a micro-dose placed lightly and widely in the dermis. Instead of strongly blocking a muscle, it works more gently, and we use it for fine lines, skin texture, oil production and pore appearance together.
| Skin Botox | Regular Botox | |
|---|---|---|
| Where it is placed | Lightly and widely in the dermis | Directly into the muscle |
| Main aim | Fine lines, firmness, oil production and pores | Reducing muscle movement to soften lines and reshape contours |
| How long it lasts | About 3 months | About 4–6 months, longer in some areas |
| Usual interval | From 3 months; usually 4–6 months | Usually 4–6 months; 3 months at the earliest |
Where a natural expression matters, such as around the eyes and forehead, some people soften lines with skin Botox instead of working on the muscle, and skin Botox alone may be enough to ease them. Deep lines or strong muscle movement may still need regular Botox.
Studies of botulinum toxin injected into the dermis have reported improvements in oil production, pores, wrinkles, skin texture and elasticity. The findings are not consistent between studies, and results vary from person to person.
How long does skin Botox last, and how often should you repeat it?
- About 2 weeksMany people start to notice the effect.
- About 3 monthsHow long it usually lasts. Some people feel it wear off sooner.
- From 3 monthsYou can repeat the treatment if you wish.
- 4–6 monthsWhat we usually recommend.
In one study that measured oil production, the effect was greatest 2–4 weeks after treatment and returned to its starting level at around 16 weeks.
If it lasts 3 months, why do we recommend 4–6?
We prefer not to repeat treatment the moment the effect fades. One study found a higher antibody response to botulinum toxin when it was injected into the dermis than into muscle. The level was not enough to reduce the effect, and evidence that it leads to clinically meaningful resistance is still limited. Even so, we think it is better to leave a gap between repeat treatments. Treatments less than 3 months apart are also cited as a factor that reduces the effect.
Planning skin Botox with regular Botox
We suggest timing the two together. When it is time to repeat regular Botox for lines such as the forehead or between the brows, we advise having skin Botox at the same visit.
- 1Planned visitRegular Botox and skin Botox together, if the total dose is appropriate.
- 2Around 3 monthsThe effect of skin Botox may fade. Other skin boosters can be used to look after your skin in the meantime.
- 3Around 4–6 monthsSkin Botox and regular Botox together again.
Rather than booking each area on a separate date and treating often, we prefer a single visit when the total dose is appropriate, and then keeping the interval. This is an example of our approach; the interval and plan vary with your treatment history and skin.
What we check before repeating treatment
We do not set the next date from the day the effect faded alone. We look at these together.
- 1When you last had Botox
- 2Your earlier treatments, including skin Botox and regular Botox
- 3How well the last treatment worked and how long it lasted
- 4How many times you have had it and the doses used
- 5The areas you need this time
What about regular Botox for wrinkles, jawline, trapezius or calves?
It depends on the area, but we usually repeat regular Botox every 4–6 months, and as early as 3 months in some cases.
Studies report that the effect on wrinkles lasts around 4 months, and that treatment for a square jaw can last 6–12 months after a single session. The right interval depends on the area, the amount of muscle and your treatment history, so we set it at your consultation.
We do not give a large amount in one visit. The larger the dose given at once, the higher the risk of resistance may be. We set the total for a single day at 300–400 units or less, counting all areas together. If you want several areas treated on the same day and the total would go over that, we recommend splitting the treatment across separate days. Units are defined differently from product to product, so they cannot be compared directly between clinics.
Please remember which areas you have had treated and the doses, and tell us at your consultation.
Can frequent Botox cause resistance? How can you tell?
It can. If Botox is repeated too often, or too much is given at once, the body may produce antibodies against it and the effect can weaken. It does not happen to everyone.
Repeated injections and high doses can trigger neutralizing antibodies, and there are reports of treatment effects being lost through antibodies after cosmetic treatment.
Signs that may suggest resistance
These signs are for regular (muscle) Botox. If two or more apply, we recommend a consultation.
- The effect is clearly weaker than before.
- It takes longer for the effect to appear.
- It wears off sooner (within a month).
- You need a higher dose for the same effect.
It is not always resistance
- Skin has lost firmness, so the effect is less noticeable than before.
- The effect is missing in one area only, because of anatomical differences or injection technique.
- There was no response from the start. This is uncommon, and a native resistance to the toxin is known to exist.
If resistance is suspected
- 1A rest periodIf the effect has only partly weakened, we advise resting for 6–12 months. If there is almost no effect at all, which suggests complete resistance, a longer rest may be needed for antibodies to fall. An expert survey and the literature have suggested 2–2.5 years.
- 2Restarting with a different formulationAfter a suitable rest, we advise trying a formulation without complexing proteins. A survey of Asian physicians also recommended restarting with a high-purity formulation free of complexing proteins and impurities.
- 3Other treatments in the meantimeWhile you rest, we advise looking after wrinkles with treatments other than Botox.
Please do not decide this on your own. We review your history at a consultation first.
What can happen after skin Botox, and what should you tell us?
Pain, bruising and swelling at the injection sites are the most common, and they are usually mild and temporary.
If the toxin spreads to an unintended area, your expression may feel unnatural, the area around the eyes may feel heavy, or your face may feel uneven. These usually improve with time.
Please tell us before treatment
- If you are pregnant, breastfeeding or could be pregnant
- If you have a nerve or muscle condition
- If you have an allergy to Botox
- The medicines you take now
- Any recent Botox treatment
If you notice anything uncomfortable or worrying after treatment, please contact us at any time.
Plan your interval with a doctor who reviews your history.
At your consultation, your doctor will review your Botox history and set the interval and plan that suit you.
Common questions
It has been less than 3 months, but my skin Botox already seems to be wearing off. What should I do?
Some people feel it wear off sooner than 3 months. If 3 months have passed, you can have treatment after a consultation. If not, please tell us when you had your last treatment and when you noticed the effect fading.
Are water-glow injections and Rejuran repeated on the same schedule?
No. How long the effect lasts varies from person to person, from about 2 weeks to 3 months, so there is no fixed schedule. We advise having them when the effect seems to be wearing off, as a top-up.
I had Botox at another clinic recently. Can I still have skin Botox?
We advise keeping an interval between Botox treatments even when the areas are different, so please tell us your treatment history first.
How much does skin Botox cost?
The cost depends on the treatment area and range, and we confirm it after an examination. Please message us on WhatsApp or KakaoTalk.
Related: Skin Boosters in Korea (Gangnam, Seoul): Types and How to Choose
One-on-one consultations · Your doctor personally plans and performs your treatment.
Questions about your Botox interval?
Tell us when and where you last had treatment, and we will help you plan.