Botox

Can I use botulinum toxin if it is warm?

Can I use botulinum toxin if it is warm
13 May

What is botulinum toxin?

The active ingredient in any botulinum therapy cosmetic product is botulinum toxin. It is a complex protein molecule and many proteins are only stable within certain temperature limits. For this reason, botulinum toxin manufacturers always recommend temperature tolerance and refrigerated storage for their products.

But what are actually the temperature limits at which botulinum toxins remain effective? And what should you do if the product you ordered from the Meamo store arrives at your home warm? Will it not worsen the result and in general - is it not dangerous to use it? We will tell you all this in our article.

Table of Contents

How does Meamo ensure the quality of its products?

toxin

Our team takes special care to ensure that our warehouse is equipped to meet the strictest requirements of the FDA and cosmetic product manufacturers. We store all products containing botulinum toxin in special refrigerators at temperatures between 2°C (35.6°F) and 8°C (46.4°F). We monitor this temperature daily with high-precision temperature controllers.

We package each order in a thermally insulated box

We also try to maintain the temperature requirements as closely as possible when we ship the products to you. We package each order in a thermally insulated box with ice to maintain the temperature of the botulinum toxin as recommended by the manufacturer. The amount of ice is specifically designed to keep the product at the correct temperature for as long as possible.

Unfortunately, it is impossible to take into account every factor that affects the temperature inside the box. Therefore, occasionally the ice in a sealed package will melt before the botulinum toxin you ordered reaches your hands. This can happen during the hot season or when postal logistics are disrupted. 

What happens to the botulinum toxin when it is warmed to room temperature?

Virtually nothing. As mentioned above, botulinum toxin is a complex protein molecule. And the critical temperature at which proteins begin to break down is about +45°C (113°F).

Yes, the effectiveness of botulinum toxin can gradually decrease at room temperature, but it’s a very slow process. For example, there are scientific studies that show that these cosmetic products do not lose their properties if they are kept at a temperature of 25°C (77°F) for a week. And, of course, this product is not dangerous for your health. It can be used as usual (1, 2).

treatment (A and B)
Figure 1. Photographs of a 36-year-old female study participant at rest before treatment (A and B), at maximum contraction before treatment (C and D), and at maximum contraction 1 month after treatment (E and F). The patient’s right side was treated with the week-old room temperature–stored incobotulinumtoxinA mixture whereas the left side was injected with the freshly reconstituted product.
Figure 2. Average CFGS scores at maximum contraction at baseline and at each follow-up visit for 1-week-old room temperature–stored versus freshly reconstituted incobotulinumtoxinA.
Figure 3. Response rate at maximum contraction after treatment with 1-week-old room temperature–stored versus freshly reconstituted incobotulinumtoxinA to the crow’s feet area. Responders were defined as those with an improvement in CFGS score of at least 1 point.
Figure 4. Response intensity after incobotulinumtoxinA to the crow’s feet area with room temperature–stored and freshly reconstituted incobotulinumtoxinA, at maximum contraction, as measured with the CFGS.

Scientific research conclusions

  • Therefore, do not worry if a package of botulinum toxin was left at your house overnight or if your refrigerator broke down over the weekend.
  • Much more important to the efficacy and safety of the product is its shelf life. It usually ranges from 24 to 36 months, and specific dates will always be listed on the packaging. Be sure to check the expiration date before using botulinum toxin!

Do I need to do anything if my product arrives warm?

receive a package

You just need to place the vials in the refrigerator immediately and keep them there until use. Most manufacturers recommend storing botulinum toxin between 2°C (35.6°F) and 8°C (46.4°F). This is the temperature range of a typical household refrigerator. 

Please note, however, that you cannot freeze these cosmetic products in the freezer!

Can I store an open bottle of botulinum toxin in the refrigerator?

Botox refrigerator

Most manufacturers recommend keeping an open vial in the refrigerator for no more than 5 hours and then throwing it away. However, a scientific study was conducted to determine how much the effectiveness of botulinum toxin would deteriorate if it was diluted with saline solution and left in the refrigerator. The study showed that under these conditions, the properties of the product do not deteriorate for at least 4 weeks (2).

However, it is important that the temperature in the refrigerator is kept no higher than +4℃ (39°F). It is also important that the rubber cap is not removed from the bottle to prevent contamination with microorganisms (2).

Brief conclusion

The storage and use conditions for botulinum toxins recommended by manufacturers are considered excessive by scientists. The results of many scientific studies indicate that these cosmetic products are more resistant to temperature than previously thought (3).

Meamo tries to strictly follow the manufacturers' recommendations. However, even if your botulinum toxin arrived warm, scientific literature shows that it is still just as effective and safe.

List of scientific sources used:

  1. Park M.Y., Ahn K.Y. Effect of the refrigerator storage time on the potency of botox for human extensor digitorum brevis muscle paralysis. J Clin Neurol. 2013;9(3):157-164. doi:10.3988/jcn.2013.9.3.157.
  2. Soares. Danny J. MD; Dejoseph, Louis M. MD; Zuliani, Giancarlo F. MD; Liebertz, Daniel J. MD; Patel, Vivek-Sagar M. MD. Impact of postreconstitution room temperature storage on the efficacy of incobotulinumtoxin A treatment of dynamic lateral canthus lines. Dermatologic Surgery. 41(6):p 712-717, June 2015. doi:10.1097/DSS.0000000000000365.
  3. Trindade De Almeida A.R., Secco L.C., Carruthers A. Handling botulinum toxins: an updated literature review. Dermatol Surg. 2011;37(11):1553-1565. doi:10.1111/j.1524-4725.2011.02087.x
  4. Esme, P., Botsali, A., Erbil, H., Aksoy, O. A., & Caliskan, E. (2020b). Bioactivity of abobotulinum toxin is preserved till 2 weeks upon storage at room temperature: Half body comparative study on rabbit model. Journal of Cosmetic Dermatology, 20(5), 1367–1373. https://doi.org/10.1111/jocd.13836

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