2025 AAD: Physosocial Implications of Neuromodulator Injections

The “Botulinum Toxins: The Latest Updates” session at the 2025 American Academy of Dermatology (AAD) Annual Meeting concluded with Vince Bertucci, MD, FAAD, discussing the topic of “Physosocial Implications of Neuromodulator Injections.”  

Dr. Bertucci explained the facial feedback hypothesis.  

“Our facial expressions are not just passive reflections of emotions—they actively shape them,” Bertucci said during his presentation.  

As a result, the implications suggest botulinum toxin treatments may do more than just enhance appearance. The treatments may influence mood, mental health, and overall well-being.  

Dr. Bertucci discussed three research studies addressing the psychological impact of different neurotoxins. 

“These results emphasize psychosocial benefits of aesthetic treatments beyond just cosmetic improvement,” Dr. Bertucci said.  

The results also suggest natural-looking results leading to enhanced self-perception and emotional well-being, and help address common patient concerns about unnatural results, potentially increasing acceptance of botulinum toxin treatments.  

Dr. Bertucci also discussed several clinical trials that have evaluated antidepressant effects of neuromodulators in major depressive disorder (MDD). The key message was determining if there could be a role for neuromodulators as a nonsystemic treatment option for MDD, but ultimately more data is needed.  

One of the study’s results suggests targeting the glabellar rather than crow’s feet area may be more effective for alleviating depressive symptoms—possibly via modulation of facial feedback and central neuromodulation—than injecting more peripheral sites.