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Published: May 7, 2021

Botulinum Toxin Use Associated With Improvements in Depression

The use of botulinum toxin for cosmetic purposes is associated with significant reductions in measures of depression, according to study findings published in the Journal of Cosmetic Dermatology. The primary determinants of improved mood following botulinum treatment include younger age, higher education, and prior experience with botulinum toxin, the study adds.

According to the investigators, the effects of botulinum toxin on mood may be partially explained by facial feedback. Previous observations show patients with major depressive disorder, for instance, often develop deep vertical frown lines, but injection of botulinum toxin can improve facial expression and lead to a subsequent improvement in self-perception and depression symptoms.

In this study, the investigators compared depression scores before and after botulinum toxin injection in 121 consecutive people (mean age, 35.72±4.78 years); 90.9% were women. The 0- to 62-scored Beck Depression Inventory II (BDI) questionnaire was used to evaluate depression status before the intervention and 1 month after. Higher scores on the BDI, particularly in the range of 28 to 63, were indicative of severe depression. Baseline patient characteristics were also collected and examined in relation to the intervention’s effects on depression.


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Approximately 88.4% of participants had a history of botulinum toxin use, including more than half (69.4%) who had previously been administered it more than once. At baseline, the mean depression score was 18.9±4.8 in 46.2% of people, suggesting nearly half had none or minimal depression. Mild depression, moderate depression, and severe depression were reported in 29.7%, 14.9%, and 9.0% of cases, respectively.

The overall mean depression score significantly decreased to 10.6±2.9 during the follow-up period and after injection (P <.001). Main determinants of depression score improvements in multivariable linear regression modeling included young ages (beta=- 0.541; P =.001), higher educational level (beta=0.595; P =.015), and prior experiences with botulinum toxin use (beta=1.072; P =.036).

Limitations of this study included the relatively short follow-up period as well as the heterogeneity of patients with different levels of depression.

Based on their findings, the investigators concluded that “improving the appearance or even correcting one’s view of appearance can prevent depression and even improve different degrees of depression in individuals.”

Reference

Khademi M, Roohaninasab M, Goodarzi A, Seirafianpour F, Dodangeh M, Khademi A. The healing effects of facial BOTOX injection on symptoms of depression alongside its effects on beauty preservation. J Cosmet Dermatol. Published online February 10, 2021. doi:10.1111/jocd.13990

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