RESISTANCE TO BOTULINUM TOXIN TYPE A: COMPARISON AMONG THREE BRANDS IN AESTHETICS

Abstract

The use of botulinum toxin type A is a well-established practice in aesthetic medicine; however, differences among commercial formulations, particularly regarding complexing proteins, raise questions concerning immunogenicity and clinical resistance. This article compares resistance to botulinum toxin type A among the Botox®, Dysport®, and Xeomin® brands, analyzing formulation characteristics, immunogenicity profiles, and management strategies. This is an integrative bibliographic review conducted across PubMed/MEDLINE, Embase, Scopus, Web of Science, and Lilacs databases, covering clinical trials and cohort studies published since 2000. Results indicate that complexing proteins, while increasing stability, may elevate immunogenic potential, with purified formulations such as IncobotulinumtoxinA being highlighted for their lower protein content. Therefore, it is inferred that clinical resistance is multifactorial and that formulation differences impact immunogenicity, underscoring the need for therapeutic individualization and knowledge regarding brand alternation to maximize efficacy and safety.