Plan to go in for beauty treatment? Beware
Are you going in for beauty treatment such as botox? Beware, you could become resistant, with the treatment having no effect whatsoever.
But here’s where leading Thai hospital Siriraj is stepping in to help. The hospital has “solved” the mystery of botox resistance by opening Southeast Asia’s first Botulinum Neurotoxin-A (BoNT-A) Immunoresistance Diagnosis Centre.
The lab will present evidence that some patients develop BoNT-A immunoresistance, resulting in the use of BoNT-A, also known as botox, having no therapeutic effect.
Apichat Asavamongkolkul, Dean of the Faculty of Medicine Siriraj Hospital, Mahidol University, said at the launch ceremony on Wednesday that the lab is a collaboration between the Dermatology Department, the Immunology Department, the Internal Medicine Department and Merz Aesthetics Thailand.
He noted that BoNT-A injections have grown in popularity in Thailand, resulting in many people going in for the procedure but with little knowledge, potentially increasing the risk of a patient developing BoNT-A immunoresistance.
This is a public health concern for patients who may require BoNT-A in the future for neuromuscular disease therapeutic treatments.
“We have known about the prevalence of BoNT-A immunoresistance for a long time and are determined to formally develop a body of knowledge in treating this condition for aesthetic practice,” Apichart said.
Rungsima Wanitphakdeedecha from the Dermatology Department pointed out that there is already an excuse in the aesthetic field when patients show no effect from botox after a long history of BoNT-A immunoresitance.
Fortunately, the Siriraj lab can now demonstrate that such symptoms do exist.
The centre has invented a test to detect the presence of antibodies or immunity in the blood of patients who have failed BoNT-A treatment, as well as a body of knowledge for physicians involved in the treatment to help prevent BoNT-A immunoresistance.
The general public can now access this knowledge and receive proper diagnosis with maximum safety and efficacy.
At the same time, aesthetics practitioners can gain a better understanding of the procedures, said Rungsima.
“The incidence of BoNT-A immunoresistance has been recognised for some time now but has not gained much attention among the medical community. This is largely caused by BoNT-A’s structural components stimulating body immunity,” she explained.
According to Yuvadee Pitakpatapee of the Internal Medicine Department, the public are aware that BoNT-A is used for facial reshaping and removing wrinkles. However, few people are aware of the significance of BoNT-A in the treatment of neurological diseases, particularly hemifacial spasms and neck muscle spasms.
The lab can determine which type of BoNT-A a patient has immunoresistance to, so that the doctor can prescribe the right type and amount of BoNT-A in terms of treatment efficacy and drug duration.
The most recent data from blood tests on 137 patients with suspected BoNT-A immunoresistance from 2011 to 2022 show that 79 of the patients tested positive, accounting for 58 per cent of the total.
Immunoresistance can be classified based on two protein structures of immunity: 48% is resistant to core neurotoxins, 18% to complexing proteins, and 8% to both core neurotoxins and complexing proteins.
Some cases with complexing protein resistance may still be able to use high-purity dosages of BoNT-A free of complexing proteins, but those with core neurotoxin resistance require time for antibody levels to drop.
Rungsima highly recommends treatments from trustworthy and quality aesthetic practitioners to reduce the risk and prevent potential BoNT-A immunoresistance.
“We recommended using a small amount once every 3-4 months,” Rungsima said.
Yuttana Srinoulprasert from the Immunology Department said the centre is an integration between a clinic and a pre-clinic that uses clinical data – a patient’s history of type, dosage, and non-responsiveness of BoNT-A injections to effectively select a suitable treatment or the right BoNT-A type so that patients can safely receive continued treatment.
The cost of the test is around 1,600 baht, said Yuttana.
Meanwhile, Siriraj Hospital has joined forces with Merz Aesthetics Thailand, a world leading manufacturer and distributor of Altera and pharmaceuticals for aesthetics clinics, to officially inaugurate the BoNT-A Immunoresistance Diagnosis Centre.
This collaboration aims to provide channels for Thais to conveniently access testing programmes. It also creates a network for data collection, including blood samples of patients who may develop BoNT-A immunoresistance and guides patients through professional assessment and management of the condition.
The network now has 40 partnered aesthetics clinics across Bangkok. The goal for the coming year is 100 aesthetics clinics.
Merz Aesthetics Thailand plans to open new communication channels for patients and customers to receive BoNT-A immunoresistance consultations in the near future, Kittiwan Rattanachandr, associate vice president of Merz said.
The centre is meant to enhance Thailand’s medical tourism.
The country’s aesthetics medicine market was worth US$1.52 billion (57.4 billion baht) in 2021, according to grandviewresearch.com, and is expected to grow by 9.7% from 2022 to 2030.
The shifting trend toward maintaining optimal aesthetic beauty is one of the major motivators for the use of aesthetic procedures. Additionally, rising medical tourism and an aging population are expected to propel market growth.
