The paper presents a comprehensive view on the immunogenicity of botulinum toxin A products, analyzes the main causes of the immune response, its enhancing factors, and the further impact on the effectiveness of therapy. The overall statistics of resistance to various products both in clinical practice and when used in cosmetology are presented. The relationships between the composition of botulinum toxin A products, their immunogenicity, and the incidence of botulinum toxin resistance are evaluated; the main ways of overcoming it and minimizing the production of neutralizing antibodies are shown.

Keywords. botulinum toxin A, botulinum therapy, immunogenicity, neutralizing antibodies, therapy non-responsiveness