T
he word “botox”, although a registered
trade name for a product, elicits
various types of reactions when
mentioned in conversation. It has become a
word of debate, a word often used in gossip
and gossip magazines; it can create excitement
and also aversion… or even scrutiny.
Medical professionals know from multiple
loads of research and studies that it is a safe,
legally registered and effective product.
But, the use (and overuse) of the product
by untrained professionals - or even ‘nonprofessionals’ - has contributed to its notorious
reputations by some. Slowly but surely, the
public has also started realizing it. However,
the debate and scrutiny behind it has never
deterred eager women and men from having
this treatment.
Initially used for neurological and muscular
conditions from the 50s, the indications for
cosmetic uses started to evolve rapidly since its
discovery for smile wrinkles in the 80s.
New studies and developments still attract
attention almost weekly.
The recent studies on the effect of the psyche
of the patients have attracted a lot of attention
from professionals, public and press.
Botox =Happy, Shiny People?
The first of these thought-provoking studies
started in 2006 where it was shown that
Botox® reduces depression when injected in
the frowning muscles.
A trial carried out by Drs Finzi and
Wasserman found that treating clinically
depressed patients with Botox® on the frown
lines of their faces actually got rid of their
depression.
Nine out of ten patients experienced a
resolution of their depression two months
after the Botox® treatment on their frown
lines. The tenth patient experienced only an
improvement in mood.
The researchers concluded that Botox®
treatment on frown lines may be an
effective treatment for patients with major
depression who have not responded to
routine pharmacologic and psychotherapeutic
treatment approaches.
A few similar or subsequent studies then
followed, explaining this phenomenon.
It was rationalized by the facial feedback
system where the specific facial expressions
that we make affect our feelings and mood.
This hypothesis that facial muscle and skin
movement may contribute to our mood and
emotion was suggested already in the 18th
century by German playwright, Gotthold
Lessing.
It emphasizes the fact that we should integrate
the outside (external appearance) to the inside
(our soul or emotions). It’s not just the facial
feedback that affects the emotions, but the
impression that we see in the mirror will affect
our feelings and our mood.
Literature by Charles Darwin in 1998 also
continued on this subject of expressions and
intensifying emotions. More literature in
the field of the psyche has elaborated about
the reduced ability to show expression of
grief or anger that reduces the intensity of
such emotions. This concept makes it very
attractive to go for Botox® injections as this
will make all of us happier, less depressed, less
aggressive and hopefully reduce our road rage!
This does not mean that we should stop doing
Botox® around the eyes, but it will probably
be wise to reduce the dosage and opt for
combination therapy instead.
Botox Blues
To keep science interesting a new study now
in 2013 showed that injecting Botox® in the
smile lines will do the opposite! It may induce
depression. So which study is true now?
Essentially both of the studies are correct.
The effect on the mood will depend on which
facial muscle or expression is relaxed.
For wrinkles around the eyes, Botulinum
Toxin (Botox®) is not the exclusive answer.
Wrinkles around the eyes do not form just
due to an overactive muscle, they form due to
a combination of thinning skin, dehydrated
skin, loss of volume, gravity and also due
to overactive muscle. Therefore, if you are
concerned about this possible effect on mood,
then it’s not only advisable, but also more
ideal, to do various treatments to achieve
satisfactory results.
This new study headed by Dr Michael Lewis
of the School of Psychology, Cardiff, Wales,
followed 25 people who had received Botox®
for facial lines around the eyes - and examined
the idea of facial feedback. Facial feedback, as
discussed already, refers to the occurrence of
the facial expressions affecting how we feel.
Dr. Lewis believes that people became less
happy because their “smiling faces” were less
“smiley” than before. This was seen in those
patients that received Botox® in the ‘smile
lines’ to relax this “happy” muscle.
Dr. Lewis explained: “The expressions that we
make on our face affects the emotions we feel;
we smile because we are happy, but smiling
also makes us happy. Treatment with drugs
like Botox prevents the patient from being
able to make this particular expression.
For example, those treated for frown lines with
Botox are not able to frown as strongly. This
interrupts the feedback they would normally
get from their face and they feel less sad.”
Now what?
Practically, what do these studies implicate to
doctors and to the patients wanting to reduce
wrinkles on the face?
These studies are important and revolutionary.
Aesthetic and Anti-Ageing Magazine
We know that relaxing the frown muscle with
Botox® or similar agents are the only effective
way to treat frown lines. We also know that it
reduces headaches, tension and also depression
now.
Alternative Solutions
Other treatments that are effective for smile
or eye wrinkles include fractional laser,
mesotherapy, fine line fillers, peelings, LED/
PDT, radiofrequency and also Botox®. These
treatments all focus on strengthening the skin
around the eye and improving collagen and
elastin quality and quantity.
Botox® can still be used (and will still be
used) for smile wrinkles, but limit the dosage
if you are concerned or at risk of depression or being treated for depression. A lower dosage
will reduce or even eliminate the effect on
your mood.
Besides, one also has to bear in mind that
this study was conducted on only 25 people.
Millions of people have been treated with
Botox® for smile wrinkles and the overall
impression worldwide has always been that
patients are very satisfied and happy due
to their improvement of appearance. So, a
study of 25 patients is really not sufficient
to convince doctors who have seen the
multitudes of very happy patients for years.
Just the fact that you look better after
treatment is more than enough to put you in a
good mood!
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