Botox: the muscle and emotional paralyzer

Joan Rivers—A piece of work!
ABC News cameras followed her
for a year filming her daily life.
Photo credit: Click here
Interview with Joan: Click here

Botox is a popular cosmetic treatment. It freezes the facial muscles around wrinkled areas, is used to treat glabellar (frown) lines, and smoothes the skin. It results in a wrinkle-free face but it also inhibits facial expressions. Botox users are known for their inability to show emotion on their partially paralyzed faces; however, new research suggests that it also affects the ability to experience feelings in the first place.

What is Botox? [1]
Botox is a trade name for botulinum toxin A and is typically used as a medication. It is one of 7 types of neurotoxic proteins (labeled A through G) produced by the bacterium Clostridium botulinum. Botulinum toxin A (Botox) affects SNAP-25 (a protein essential for the release of acetylcholine or ACh) and blocks the signals that would normally let muscles contract. It attaches itself to nerve endings and blocks the release of ACh, the neurotransmitter responsible for triggering muscle contractions. If it attacks and paralyzes the chest muscles, it could have a profound impact on the ability to breathe, which could be fatal. If someone ingests the neurotoxins from Clostridium botulinum it could result in botulism, a type of food poisoning, causing paralysis and death.

Chemical structure of botulinum
neurotoxin serotype A.
Botox blocks the signals that
normally let muscles contract.
Illustration credit: Click here

Side Effects
Side effects from Botox in the body include dysphasia (impaired ability to communicate due to brain damage), ptosis (drooping eyelid), upper respiratory tract infection, headache, neck pain, bruising or soreness at the site of injection, and nausea. Botox is successfully used to treat conditions that involve spasms. It has also been used to treat writer's cramp, head and neck tremors, chronic neck and back pain, and hyperhidrosis (excessive sweating). Within a few hours to a couple of days after the botulinum toxin is injected into the affected muscle(s), the spasms or contractions are reduced or eliminated. The effects of the treatment are temporary and last about 3-8 months. By injecting the toxin directly into a specific muscle the risk of it spreading to other areas of the body is greatly diminished.

Botox Parties
The Food and Drug Administration (FDA) has warned against the potential hazards of "Botox parties." Whether used to treat medical conditions or cosmetic concerns, a Botox injection is a medical procedure that should be performed in a controlled medical environment. There is always a risk of adverse reactions or side effects after an injection, so patients should be in a medical setting equipped to handle an emergency situation. In addition, ingestion of alcohol at or around the time of injection could worsen any bruising at the injection site.

Botox paralyzes muscles that cause wrinkles
and compromises facial expressions, which
decreases the strength of emotional experiences.
Illustration credit: Click here

Botox Study [2]
Results from a recent study have shown that the inability to smile when you are happy sends feedback to the brain, which reduces the intensity of feelings or emotions. The subjects in the study who were given Botox injections experienced significantly less reaction to emotionally charged films than those who did not receive treatment. Researchers found that women who had been injected with Botox were slower at comprehending emotional sentences than those who had not had the treatment.

Phase 1: A total of 68 women were divided into 2 groups. They were all shown 3 video clips and asked to rate them depending on how strongly they reacted to them emotionally:

Clip 1: Video of a contestant on a reality show eating live worms (meant to provoke a strong negative reaction).
Clip 2: Funny video clip (meant to provoke a strong positive reaction).
Clip 3: Documentary about artist Jackson Pollock (meant to provoke a mildly positive reaction).  

Phase 2: Half of the women were given Botox injections and the other half Restylane (a cosmetic filler that does not affect facial muscles). Approximately 2-3 weeks after the treatment, the women were shown a similar set of videos and their reactions were tested again.

Results: Researchers found that those who had been given Botox showed a significant decrease in the strength of emotional experience compared with those who had been given Restylane. The results of the study support the idea that facial expressions are an influencing part of a feedback loop that heightens emotions. With Botox, a person can respond normally to an emotional event, such as a sad movie, but they will have less movement in the facial muscles that have been injected, which results in less feedback to the brain and a decreased emotional response. This information opens the door to further test whether facial expressions and the sensory feedback that result from them can influence emotions.

The results of the study are published in the journal Emotion and are backed up by a similar study published in Psychological Science. The data reinforce the theory that facial expressions can affect mood as well as being an indicator of it. For example, not being able to smile means you do not feel as happy as you could if you were able to form the facial expression. In the studies, Botox participants exhibited an overall significant decrease in the strength of emotional experience. This suggests that feedback from facial expressions is not necessary for emotional experience, but may influence emotional experience in some circumstances. These findings point to specific directions for future work clarifying the expression-experience relationship.

Botox temporarily paralyzes muscles that cause wrinkles, can inhibit the ability to perform certain facial expressions, and decreases the strength of emotional experiences. So, why would anyone want to have a botulinum toxin injected into their body? For an actor or celebrity who uses Botox, this could hinder his or her ability to show emotion, which may ultimately affect their career. But aesthetics win over--the less creases and wrinkles, the more youthful a person feels and the more marketable they presume they are. So what's the price for this fountain of youth? The average cost of one Botox injection is about $350, depending on the area of the face treated. The area near the eyes costs between $400 and $900 per injection. For large surface areas like the forehead, injections can be between $600 and $1300. Also, recall that there is another cost for this anti-aging service. And that is one that may leave you less sensitive to emotional experiences.
 

Copyright ©2010 Joyce E.M. Wall