ReviewFrontiers in psychiatry2026
Beyond aesthetic outcomes: psychodermatological benefits of botulinum toxin treatment in the upper facial third. A narrative review.
Review in Frontiers in psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Botulinum toxin type A (BoNT-A) is widely used in aesthetic dermatology, particularly for dynamic wrinkles in the upper facial third. Beyond cosmetic effects, BoNT-A may influence emotional processing through the skin-brain axis. This narrative review synthesizes evidence on psychological and psychiatric outcomes of upper facial BoNT-A treatment, with a focus on mechanisms extending beyond aesthetics. Methods: A structured search was conducted in PubMed, Scopus, and Web of Science through January 2026. Search terms included "botulinum toxin," "upper facial third," "psychodermatology," "facial feedback," "depression," "anxiety," and "psychiatric disorders." Original studies, randomized controlled trials (RCTs), observational studies, systematic reviews, and meta-analyses assessing psychological, psychiatric, or neurobiological outcomes were included. Results: Upper facial BoNT-A is associated with clinically meaningful reductions in depressive and anxiety symptoms, and improvements in self-perception and social functioning. Inhibition of corrugator and procerus muscles modulates afferent signaling to limbic structures, supporting the facial feedback hypothesis. Neuroimaging evidence demonstrates attenuated amygdala activation after BoNT-A treatment. Psychosocial improvements may reinforce these neurobiological effects. Evidence in bipolar disorder and personality disorders remains limited and methodologically heterogeneous. Caution is advised in patients with body dysmorphic disorder. Conclusions: BoNT-A in the upper facial third provides psychodermatological benefits beyond aesthetics, improving emotional regulation and affective symptoms. It should be considered a complementary intervention within a biopsychosocial framework. Future large-scale RCTs with standardized psychiatric and neurobiological endpoints are warranted.
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