Evaluation of Self-Esteem and Depression Symptoms in Depressed and Nondepressed Subjects Treated with OnabotulinumtoxinA for Glabellar Lines


  • This study was supported by the Brazilian Center for Studies in Dermatology, a nonprofit organization, and through an unrestricted research grant from Allergan Inc.

Address correspondence and reprint requests to: Doris Hexsel, MD, Brazilian Center for Studies in Dermatology, 782 Dr. Timoteo St., 90570–040, Porto Alegre, RS, Brazil, or e-mail: doris@hexsel.com.br



Botulinum toxin type A (BoNT-A) injection has become the most popular cosmetic nonsurgical procedure, and it has been suggested that BoNT-A injections may improve emotional states when frown lines are treated.


To evaluate symptoms of depression and self-esteem before and after onabotulinumtoxinA (ONA) injections in the glabella in subjects with and without depression.


Twenty-five subjects with depression were allocated into one group and 25 subjects without depression were matched to those according to demographic characteristics. The Beck Depression Inventory (BDI) and Rosenberg Self-Esteem Scale (RSES) were used to assess depression symptoms and self-esteem, respectively. Patients were assessed up to 12 weeks after the intervention.


Patients with depression had significant improvement in depression symptoms after ONA injections. The maximum effect occurred within the first 8 weeks after treatment. A significant reduction from baseline in BDI score and significant improvement in self-esteem were also observed in patients with depression.


This research presents new data regarding BoNT-A as a potential treatment to improve depression symptoms in patients with Major Depressive Disorder. Self-esteem scores alone cannot explain the improvement in depression symptoms.