Spike in potentially fatal condition linked to ‘fake botox' sparks urgent probe

Independent

20-06-2025

Regulators are urgently investigating the suspected illegal sale of fake botox after dozens of botulism cases were reported in North East England.
Botulism is a potentially fatal condition caused by a bacteria-produced toxin, which attacks the body's nerves and can cause paralysis of the muscles and respiratory system. It is extremely rare, with just six cases recorded across England in 2023-24.
But – in the space of just a few weeks – 28 cases of botulism have now been reported in North East England, according to the UK Health Security Agency (UKHSA) – which warned that more cases may yet come to light.
The cases, most of which are in the Durham and Darlington areas, have all been reported by people who had recently undergone cosmetic procedures.
Reactions have included severe drooping of the upper eye lids, double vision, difficulty swallowing, slurred speech and lethargy, according to the UKHSA.
On one night in June, five of the people affected all ended up in the same A&E department in Durham, according to the BBC, which cited internal hospital communications in showing that the local stock of anti-toxin was nearly exhausted, forcing medics to request more from London as they 'braced' for more patients.
One of the five patients, Nicola Fairley – a mother of four from Bishop Auckland, in County Durham – told the broadcaster that she had received anti-wrinkle injections in the past, paying £100 for three areas.
But she then won a round of treatment from the same provider in a competition, using what she was told was a stronger type of botox and again had three areas injected, without realising the treatment was illegal.
While genuine injections should take several days to start working, the 37-year-old said her forehead became 'frozen' within two hours.
The business owner who gave Ms Fairley the injections has since apologised, she said, adding: 'I know she hasn't done this on purpose. I just don't know where people get it from – it's scary.
'There needs to be more rules and stricter guidelines on who can do it – not just anybody who can go and do a course and just do it. There's that many people who do it – it's part of your beauty regime like getting your nails done or your hair.'
The Medicines and Healthcare products Regulatory Agency (MHRA) is now understood to be investigating the spate of cases.
Dr Alison Cave, the agency's chief safety officer, said: 'Public safety is a top priority for the MHRA. Our Criminal Enforcement Unit works hard to identify those involved in the illegal trade in medicines and takes robust enforcement action where necessary. This can include criminal prosecution.
'Botulinum toxin (Botox) is a prescription-only medicine and should only be available in the UK under the supervision of a doctor or other qualified healthcare professional
'Buying Botox and other medicines from illegal suppliers significantly increases the risk of getting a product which is either falsified or not authorised for use in the UK.'
Dr Simon Howard of the UKHSA said that agency was still investigating the cause of the cases, and said the practitioners associated with most of the cases were no longer carrying out the procedures.
'However, that does not mean that we may not see more cases as symptoms can take up to four weeks to develop although we are now seeing the number of cases coming forward decreasing which is encouraging news,' said Dr Howard.
'We will continue to work with our partners to reduce the public health risk and would advise people to make sure they take precautions when seeking aesthetic procedures.
'Anyone who has recently undertaken an aesthetic procedure, and is experiencing any of the symptoms listed, should contact NHS 111.'
The Department for Health and Social Care said the government was looking into new regulations, with people's lives currently being put at risk by 'inadequately trained operators in the cosmetic sector'.
'We urge anyone considering cosmetic procedures to consider the possible health impacts and find a reputable, insured and qualified practitioner,' a spokesperson told the BBC.