TABLE 3.
Perspectives, management and prevention in tolerance of botulinum toxin.
| Characteristics | Doctors (N = 673) |
|---|---|
| Real world experience of tolerance | |
| Yes | 363 (53.9) |
| Reasons why tolerance happened | |
| Short procedure intervals (less than 2–3 months) | 325 (48.3) |
| High dose | 147 (21.8) |
| Product containing multiple complex protein (ex. 900 kDa Botulinum toxin‐A) | 141 (20.9) |
| Intradermal injection | 50 (7.4) |
| Due to individual susceptibility | 10 (1.4) |
| Management of users who are tolerant to Botulinum toxin | |
| Replace the product with another product from different company | 294 (43.7) |
| Replace the product with 7S Botulinum toxin product which is known for reducing immune reaction | 178 (26.4) |
| Use the same product with higher dose | 160 (23.8) |
| Discontinue Botulinum toxin | 41 (6.1) |
| Expected rates of tolerance in botulinum toxin among users for aesthetic purpose (%) | |
| Less than 1 | 400 (59.4) |
| 1 ≤ rates < 25 | 242 (36.0) |
| 25 ≤ rates < 50 | 23 (3.4) |
| 50 ≤ rates < 75 | 7 (1.0) |
| More than 75 | 1 (0.2) |
| Preventive strategies for tolerance | |
| Ensure adequate treatment intervals for more than 3 months | 369 (54.8) |
| Use the product known as reducing the tolerance as possible | 316 (47.0) |
| Use effective minimal dose for the desirable outcome | 190 (28.2) |
| Ensure minimal frequency of re‐procedure for the desirable outcome | 100 (14.9) |