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Botox is a tried-and-true way to smooth away wrinkles for a more refreshed, snatched, and youthful look. But if your injections aren’t lasting as long—a phenomenon that’s become so common anecdotally, it’s known as ‘Botox resistance’—the secret to extending its results may lie in a pill. Rumor has it that taking a zinc supplement before routine neuromodulator injections may possibly extend their results by up to 20 to 30%.
But does the claim hold water?
While the Botox-zinc connection is an of-the-moment topic that’s trending on social media, Ava Shamban, MD, a board-certified dermatologist in Santa Monica, California, says the connection isn’t a total myth. “There is some legitimate biology behind it, but the online hype goes beyond what can be proven scientifically,” she says.
Meet the experts: Ava Shamban, MD, is a board-certified dermatologist in Santa Monica, California. Kseniya Kobets, MD, is a board-certified dermatologist and Director of Cosmetic Dermatology at Montefiore Einstein Advanced Care Cosmetic Dermatology Center in Elmsford, New York. Maryam Safaee, MD, is a board-certified dermatologist in Los Angeles.
Of course, it’s an appealing promise: Pop a pill to protect your cosmetic investment—a single session of Botox can cost in the thousands of dollars. To get to the bottom of just how zinc works its magic in this way, we polled cosmetic dermatologists like Dr. Shamban to get the answers.
Here’s what you need to know.
What is Botox?
For starters, Botox is a brand name—and has become a common household term—but it’s just one of the many muscle-freezing neuromodulators available. others of which include Dysport, Xeomin, Jeuveau, Daxxify, and the direct-from-Korea Letybo. They all work to smooth expression-related wrinkles by blocking the release of acetylcholine, a neurotransmitter that sends messages between the nerves and muscles.
Once the nerves and muscles can’t properly “speak” to one another, muscle contractions temporarily halt, stopping the repetitive movements that lead to wrinkles. On average, most injectable neurotoxins last about three to four months, although some, including Daxxify, are rumored to last a little longer. As the nerves begin to regenerate, the treated muscle regains activity and wrinkles slowly reappear.
Different muscles respond differently to Botox based on their size, strength, and level of activity, which is why Botox is more effective in some areas of the face than others. Larger, stronger, and more active muscles generally recover sooner from toxins than smaller, less active ones, explains Kseniya Kobets, MD, a board-certified dermatologist and Director of Cosmetic Dermatology at Montefiore Einstein Advanced Care Cosmetic Dermatology Center in Elmsford, New York. “But there isn’t a universal ranking because anatomy, muscle strength, dose, treatment goals, and injection technique all influence how long the results last,” she adds.
What is the zinc/Botox connection all about?
Yes, adding zinc to your supplement stack may potentially stretch out the duration of your Botox results—but there are no guarantees. Botox needs zinc at the cellular level to function optimally, says Maryam Safaee, MD, a board-certified dermatologist in Los Angeles. “If you think of Botox as a scissor that cuts the connection to the muscles we want to paralyze, zinc is the blade sharpener,” she says. “If you have deficient zinc levels, Botox may not be as sharp and therefore less efficient.”
While all botulinum toxin products can bind to the nerve and enter the cell without zinc, Dr. Kobets adds that if that zinc-dependent enzyme does not function properly, it also can’t effectively cleave SNAP-25, the protein that blocks the nerve signal and tells the muscle to contract. “That’s why zinc is biologically important. It’s essential for the toxin to perform the step that ultimately relaxes the muscle,” Dr. Kobets adds.
So, what happens if your zinc levels are on the lower side and you get Botox? In theory, increasing your zinc levels may help to some degree. “For someone who is truly zinc deficient or has borderline-low levels, correcting that deficiency with a supplement may potentially improve or optimize how a neuromodulator performs, but confirming this would require testing,” Dr. Shamban says. “While symptoms of a deficiency might subside in a few days to a few weeks, reversing a true deficiency can take months, so it’s not like eating a steak the night before your Botox appointment would really help.”
Some studies do show a connection between longer-lasting Botox results and zinc, but limitations also exist with the data. One paper published in the Journal of Drugs in Dermatology showed that of 77 study patients, 92% who supplemented with 50mg of zinc and phytase noticed an increased toxin duration effect of about 30%. Dr. Safaee says that translates, for someone whose Botox lasts three to four months, to results that extend an extra two to four weeks with added zinc. Despite the findings, Dr. Shamban calls them “hardly definitive, especially since so many factors influence toxin duration from patient to patient.”
Should you take zinc before your next Botox appointment?
Popping zinc to help extend the results of your most recent ‘tox session isn’t necessarily a foolproof way to stay wrinkle-free for longer. While zinc supplements may increase the longevity of toxin-related results, eventually, the body will hit a ‘zinc ceiling.’ As Dr. Shamban explains, once the body’s threshold of zinc is met and there is a sufficient supply available, ingesting additional zinc would not exponentially enhance or further perpetuate the duration of a neuromodulator. “At a certain point, you hit the maximum benefits, and the extra is just a waste at best.”
It’s also worth noting that if too much zinc circulates throughout the body, it can do more harm than good, which is why routine blood panel testing is always advised. “Chronically high doses of zinc can interfere with copper absorption or may lead to gastrointestinal symptoms and even immune dysfunction,” Dr. Shamban shares. “So self-prescribing rogue doses beyond what is recommended of zinc, as well as other supplements, is never recommended.”
If you’re determined to attempt to get more out of your Botox injections by adding zinc into the mix, Dr. Kobets stresses that you should first discuss this approach with your physician and review any and all multivitamins, prenatal vitamins, or hair supplements you’re taking since many contain zinc. “We don’t want patients unintentionally doubling or tripling their intake.”
If your physician gives you the green light, she recommends trying a short course of a modest zinc supplement beginning several days to one week before treatment. Zinc picolinate, zinc citrate, and zinc glycinate are bioavailable forms of zinc, meaning they are more readily absorbed by the body. As Dr. Kobets explains, zinc should already be available when botulinum toxin enters the nerve cell and begins functioning as a zinc-dependent enzyme. “That’s why it makes sense to start taking them before treatment.” Then, briefly continue with the supplement after the treatment.
However, if you have a known copper deficiency, anemia, significant gastrointestinal disorders, malabsorption conditions, or are already taking multiple mineral supplements, it may be best to avoid taking zinc, especially in high doses. “Over time, zinc can interfere with copper absorption and lead to anemia, low white blood cell counts, and even neurologic problems,” Dr. Kobets says. “It can also interfere with the absorption of certain medications, including some antibiotics.”
What else can impact how long your Botox lasts?
Besides zinc, other factors are known to influence your Botox results and how long they last. “The five factors that should be considered when examining how long the effects of a neuromodulator last include dose, muscle strength, the product used, technique, and physical activity,” Dr. Safaee says. “The more units used, the longer the effects usually last. But not all toxins are created equal, and different brands have different efficacies. Plus, stronger or larger muscles will wear off the effects faster, and some studies have found that high physical activity can result in results fading sooner, too.”
She adds that placement of a toxin can vary from provider to provider. It’s also important to consider how much muscle activity there naturally is as well as product reconstitution and spread, which can impact the product’s results.
The bottom line: This is one trend you can probably pass on.
The toxin-zinc connection is what some dermatologists, including Dr. Shamban, call a very plausible partnership, but it’s likely just a very small part of the equation in the quest to get the best, longest-lasting results from an injectable. As the science around the pairing evolves, it may one day be considered a more definitive way to extend Botox results. Until then, it’s anyone’s guess. It may just be money down the drain.
Elise Minton Tabin is an award-winning beauty journalist, editor, and expert with 20 years of experience. She started her career in public relations before shifting to editorial. Elise rose the ranks at NewBeauty magazine from an editorial assistant to Executive Beauty Editor, overseeing and reporting on all things beauty, plastic surgery, anti-aging, health, and wellness. A prolific content creator and trendspotter, Elise always knows what’s new, what works, and who’s the best to go to for treatments and procedures. She contributes to media outlets including InStyle, NewBeauty, The Zoe Report, Byrdie, Beauty Independent, The Aesthetic Guide, Bazaar, and more. Elise has also been featured on Extra TV, WPTV, and WPLG, on satellite tours, and as a featured expert in Perricone MD infomercials. When she’s not unearthing the newest beauty trend, Elise spends her time consulting with beauty brands, writing, and creating Instagram and TikTok content for herself and beauty and wellness brands.
Brian Underwood is beauty director at Women’s Health, where he oversees content strategy for the brand across all platforms, including digital, print, and social. Underwood previously served as beauty and wellness director at Oprah Daily and O, The Oprah Magazine. During his tenure leading beauty content for the Oprah brand at Hearst, stories Underwood commissioned were awarded the Skin Cancer Foundation Media Award and a Fragrance Award for Editorial Excellence (his second). He was the launch Beauty Director of Dr. Oz THE GOOD LIFE, and has held additional editorial positions at Fitness, Organic Style, Good Housekeeping, Life & Style Weekly, and Woman’s Day and has written for Self, Shape, Seventeen, Redbook, Cosmopolitan, and many more. Underwood previously served on the Skin Cancer Foundation’s gala committee and as partnerships director of the Trans Beauty Clinic, a New York-based charitable organization that provided beauty services and workshops to the city’s trans community.