How Botox jabs can make you feel depressed… because you can't smile properly
Botox treatment works by temporarily 'freezing' muscles in the faceCuts off signals sent to brain when we smile which make us feel happyCardiff University psychologist says it may indirectly spark depression

Jenny Hope


23:53 GMT, 10 April 2013



06:39 GMT, 11 April 2013

Women who have Botox injections to get rid of laughter lines are more likely to feel depressed – because they can’t smile properly.

The treatment, which works by temporarily ‘freezing’ muscles in the face, cuts off the signals sent to the brain when we smile which make us feel happy.

It means the treatment may indirectly spark depression, according to Cardiff University psychologist Dr Michael Lewis.

Cosmetic injection: Botox treatment works by temporarily 'freezing' muscles in the face (file picture)

Cosmetic injection: Botox treatment works by temporarily 'freezing' muscles in the face (file picture)

Botox is one of the most popular drugs used for medical and cosmetic treatments, including the reduction of facial lines and wrinkles by regular injections.


Previous research by
Dr Lewis showed that treating frown lines left people feeling less
depressed. Because they could not frown easily, their mood improved.

His latest study looked at 25 women who had Botox jabs for frown lines or crows’ feet, or facial fillers.

They were asked to complete questionnaires, rating symptoms of depression between two and four weeks later.

Women who had their crows’ feet treated scored around 12 compared to an average of seven by women who had their frown lines treated – more than 50 per cent higher.

Dr Lewis said: ‘The expressions we make
on our faces affect 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 a 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.’

There is some evidence that people who have their foreheads treated become more gullible because they can no longer raise their eyebrows in surprise and scepticism, he added.

Dr Lewis plans further research to help people with Obsessive Compulsive Disorder who have heightened feelings of disgust.

By using jabs to reduce the facial expression of disgust – the wrinkling of the nose – he hopes to diminish the patient’s feelings, and therefore their symptoms.

Dr Lewis added that some women might be better off letting their laughter lines tell their own story.

‘They should be encouraged to celebrate the emotions they express and enjoy the laughter lines – they are there for a reason,’ he said.

Charles Nduka, a consultant cosmetic surgeon and a council member of the British Association of Aesthetic Plastic Surgeons, said he has seen Dr Lewis’s research in action.

Some of his work involves restoring facial animation to patients after a disease or stroke.

He said: ‘Enabling people to smile more has a beneficial effect on mood.

‘When I have operated on someone with facial palsy I do see an elevation of mood, partly because they feel better about their appearance but another positive effect is from the rehabilitation process which requires them to smile more often.’