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Introduction <p>Botulinum Neurotoxin A (BoNT-A) is clinically safe and effective, yet public discourse remains saturated with myths. This review investigates how misconceptions are produced and sustained within peer-reviewed literature and traditional media.</p> Methods <p>A narrative synthesis of English-language publications (2000–2024) from PubMed, Scopus, Web of Science (peer-reviewed) and ProQuest, Factiva, LexisNexis (media) was conducted. AI-assisted search, clustering (UMAP–HDBSCAN), and VADER sentiment analysis were integrated. Inter-rater reliability (<i>κ </i>= 0.87–0.94) and AI-human agreement (89.5%) were established. “Botox” is used as a generic term for all BoNT-A products consistent with public and social media discourse.</p> Results <p>Of 513 sources (186 academic, 327 media), myths clustered into eight categories. Media coverage showed strongly negative sentiment (mean − 0.58), while academic literature remained neutral (71% neutral). Safety/toxicity myths were 3.2 times more frequent in media (<i>χ</i><sup>2</sup> = 29.8, <i>p </i>&lt; 0.001). Psychological myths carried a mean sentiment of − 0.61 (Kruskal–Wallis H = 28.4, <i>p</i> &lt; 0.001). Geographic mapping identified misinformation spikes following litigation, celebrity disclosures, and regulatory advisories. Novel myths (e.g. immune suppression, “patchwork ageing”) emerged post-2019 (mean sentiment – 0.69).</p> Conclusion <p>A quantifiable asymmetry exists between scientific evidence and media framing of BoNT-A. Misinformation is culturally embedded, emotionally charged, and event driven. Bridging this gap requires pre-consultation educational tools, scripted clinical responses, and cross-disciplinary media engagement.</p> Level of Evidence IV <p>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors <a href="http://www.springer.com/00266">www.springer.com/00266</a>.</p>

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Botulinum Toxin A Myths, Evidence, and Global Media Narratives

  • 期刊论文

  • 发表日期：

    2026年7月10日

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  • Karim Sayed,
  • Marco Nicoloso,
  • Efthyvoulos Sokratous,
  • Maya Shahsavari

摘要

Introduction

Botulinum Neurotoxin A (BoNT-A) is clinically safe and effective, yet public discourse remains saturated with myths. This review investigates how misconceptions are produced and sustained within peer-reviewed literature and traditional media.

Methods

A narrative synthesis of English-language publications (2000–2024) from PubMed, Scopus, Web of Science (peer-reviewed) and ProQuest, Factiva, LexisNexis (media) was conducted. AI-assisted search, clustering (UMAP–HDBSCAN), and VADER sentiment analysis were integrated. Inter-rater reliability (κ = 0.87–0.94) and AI-human agreement (89.5%) were established. “Botox” is used as a generic term for all BoNT-A products consistent with public and social media discourse.

Results

Of 513 sources (186 academic, 327 media), myths clustered into eight categories. Media coverage showed strongly negative sentiment (mean − 0.58), while academic literature remained neutral (71% neutral). Safety/toxicity myths were 3.2 times more frequent in media (χ2 = 29.8, p < 0.001). Psychological myths carried a mean sentiment of − 0.61 (Kruskal–Wallis H = 28.4, p < 0.001). Geographic mapping identified misinformation spikes following litigation, celebrity disclosures, and regulatory advisories. Novel myths (e.g. immune suppression, “patchwork ageing”) emerged post-2019 (mean sentiment – 0.69).

Conclusion

A quantifiable asymmetry exists between scientific evidence and media framing of BoNT-A. Misinformation is culturally embedded, emotionally charged, and event driven. Bridging this gap requires pre-consultation educational tools, scripted clinical responses, and cross-disciplinary media engagement.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.