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The Many Faces of Botox

Botox, a deadly toxin, is also a powerful drug and a so-called fountain of youth. But could it also become a weapon?

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In one recent episode of the NBC sitcom Will and Grace, Will decides to get Botox injections to get rid of wrinkles. After the procedure, though, he finds himself unable to move facial muscles to show expression. So when Grace tells him something exciting, she becomes angry when he appears nonchalant, even though he insists he is really happy about her news.

Will's frozen mug may be the stuff of comedy, but it's no laughing matter to health experts who say faces lacking emotion lose the ability to communicate with others.

"Not to be able to show pleasure, interest, or joy is devastating in terms of social relationships," says Doe Lang, PhD, a New York City-based psychotherapist. "People think you're hostile, unfriendly, and they think you don't like them."

Yet stiff faces need not be a consequence of Botox procedures. Lang says reputable plastic surgeons can perform treatments without damage. Also, she says she believes some people may think their face feels paralyzed after an injection because they're not used to paying attention to muscles in the area.

"A lot of people are totally unaware of what their faces usually do. So perhaps when they feel a little stiffness they get frightened," says Lang, who notes that wrinkles are evidence of how people use their face.

Reason to Frown?

Botox is made from a very small dose of botulinum toxin, the single most poisonous substance known. The toxin comes from soil but can be ingested through food that comes in contact with contaminated dirt. The poison paralyzes muscles and may prevent victims from being able to breathe on their own.

Diagnosis and treatment of botulism can be both time-consuming and a strain on hospital resources. This is the reason why the CDC has labeled the toxin as a "Category A" substance in its list of agents of concern, says Gigi Kwik, PhD, a fellow for the Johns Hopkins Center for Civilian Biodefense Strategies. Other Category A agents include smallpox and anthrax.

The Johns Hopkins center even considers the botulinum toxin as a potential major bioweapons threat. Kwik readily points out, however, that there is an extremely tiny amount of the poison in Botox, so the chances that it could be used as a biological weapon are slim.

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