Does Zinc Make Botulinum Toxin Results Last Longer?

A person holding zinc pills in their hand while standing at a sink

Does Zinc Make Botulinum Toxin Results Last Longer?

If you’ve been wondering how to make botulinum toxin treatments last longer, you are definitely not alone. A quick Google search reveals thousands of articles, tips, social posts and videos on the subject. In recent years, zinc supplementation has received a lot of buzz as a way of boosting botulinum toxin efficacy and results duration, but does zinc really work? An honest, objective answer is “maybe”.

Many articles on the subject cite the following study:

Effect of Dietary Zinc and Phytase Supplementation on Botulinum Toxin Treatments”, April 2012,
John C Koshy 1, Safa E Sharabi, Evan M Feldman, Larry H Hollier Jr, James R Patrinely, Charles N S Soparkar.

Articles often paraphrase the study’s conclusion and results (quoted verbatim below).

“In seventy-seven patients, 92% of subjects supplemented with zinc 50 mg and phytase experienced an average increase in toxin effect duration of nearly 30%, and 84% of participants reported a subjective increase in toxin effect”.

“This study suggests a potentially meaningful role for zinc and/or phytase supplementation in increasing the degree and duration of botulinum toxin effect in the treatment of cosmetic facial rhytids, benign essential blepharospasm, and hemifacial spasm.”

As promising as this study’s results are, it’s one study amongst relatively few on the subject. Two reviews of studies, both concluded that more clinical trials are required.

In a 2023 review of clinical trials “Effects of zinc supplementation on duration and action of botulinum toxin applied to face muscles: A systematic review of randomized clinical trials”, the authors concluded that “Although zinc has a promising effect on BT [botulinum toxin] in facial muscles, [it] was not possible to affirm that zinc supplementation increases the duration of BT action due the low number of RCTs [randomized clinical trials], as well as important methodological errors observed in certain studies”. The review also concluded that the current scientific evidence doesn’t support the clinical practice of recommending zinc supplementation for improved botulinum toxin action in face muscles.

The reviewers searched RCTs in available databases for mentions of botulinum toxin and zinc. 165 were found. After excluding duplicates and selecting the most relevant trials by evaluating their titles and reading abstracts, just two RCTs could be included in the review. Those two studies were then evaluated for risk-of-bias, using a tool called the “Revised Cochrane risk-of-bias tool” (RoB 2). One RCT was evaluated as being of “some concern” for risk-of-bias while the second study was determined to have a high risk-of-bias.

In a similar 2023 systematic review, Botulinum Toxins and Zinc: From Theory to Practice-A Systematic Review, the review authors examined published studies on PubMed and Embase. From 260 articles, 3 randomized control trials and 1 case report used in the review, “three of them found a significant improvement with zinc supplementation in the toxin’s effect and longevity. This was observed in neurological conditions and cosmetic uses.”

The authors concluded that  “Zinc supplementation could be an interesting asset in the potentialization of botulinum neurotoxin effect and longevity. Larger clinical trials and objective measurement tools should be used to further defining the role of zinc in maximizing botulinum neurotoxin effect.”

Bottom-line: Zinc may increase the efficacy and duration of botulinum toxin, though more randomized clinical trials are needed to draw any definitive conclusions.

Should I Take Zinc to Increase Botulinum Toxin Results Duration?

Because anyone can buy and try zinc, ultimately, the choice is yours. While we don’t specifically recommend zinc supplementation to increase botulinum toxin efficacy and duration, we do recommend ensuring you have enough dietary zinc. The foods highest in zinc include meat, fish, eggs and dairy.

The recommended dietary allowance for zinc for people 19 years of age or older is:

  • 8mg/day for women (if not pregnant)
  • 11mg/daily if pregnant
  • 12mg/day if breastfeeding
  • 11mg/day for men

Most Canadians get enough dietary zinc. According to the Alberta Diabetes Foundation, 10-35% of Canadians have a zinc deficiency.

If you have symptoms of zinc deficiency, or would like to try a zinc supplement, consult your family physician. While zinc is “generally safe” according to Mayo Clinic, it can cause side effects such as nausea, vomiting, headache and diarrhea. Long term, high doses of zinc can cause copper deficiency.

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