Dangerous ‘Botox dupes' reportedly linked to botulism cases. Here's what to look out for.
Botulism is a medical condition that makes it difficult for people to move, see clearly or breathe. Its causes, in addition to certain contaminated foods, traumatic injuries and intestinal issues, can be traced to botulinum toxin type A, a chemical used in cosmetic neuromodulator injections such as Botox, Dysport and Daxxi, which blocks muscle movements to reduce wrinkles or alter facial appearances when administered properly.
These minimally invasive injectables are among the most popular beauty treatments in the United States, according to the American Society of Plastic Surgeons (ASPS), which describes Botox as a 'go-to treatment patients can't do without.' (The Botox brand is not the only injection that uses botulinum toxin type A, but it's arguably the best-known.) In 2024, over 9.8 million Americans got neuromodulator injections, the ASPS reported.
The growing popularity of such treatments has also seen the rise of non-FDA-approved injections, or 'dupes,' which can be purchased online. But these knockoffs can be dangerous.
According to the Centers for Disease Control and Prevention (CDC), mishandled or counterfeit neuromodulator injections can cause botulism in patients, which can require hospitalization.
The Massachusetts Department of Public Health (MDPH) is currently investigating 18 cases of botulism that were traced back to injections administered at a spa in Milton, Mass., a spokesperson for the organization told Yahoo. On the other side of the country, public health authorities in Multnomah County, Ore, issued a warning on June 18 after a resident was hospitalized with botulism symptoms on June 6 'following injections of possibly counterfeit or improperly handled botulinum toxin' from 'a person found to be unlicensed to administer the injections.'
The recent cases of botulism in Massachusetts and Oregon are not the first to be linked to counterfeit or poorly administered botulinum toxin injections this year. Around the same time last month, 28 cases were reported in northwest England, which have been associated with several unconnected practitioners in Durham County, a U.K. Health Security Agency spokesperson told Yahoo.
In April 2024, the CDC launched an investigation into 17 cases of botulism reported in nine U.S. states between Nov. 4, 2023, and April 11, 2024. Those cases resulted in 13 hospitalizations and no fatalities. The CDC's investigation, which was closed in December 2024, found that some patients 'received injections with counterfeit products or products with unverified sources,' while others 'received injections from individuals who did not follow jurisdictional (state or local) requirements.'
While the CDC's investigation focused on the 17 cases reported between Nov. 4, 2023, and April 11, 2024, the agency noted that it had also received 'reports of similar cases, including at least four harmful reactions in August and September linked to counterfeit botulinum toxin products. Some products were self-injected.'
'If in doubt, don't get the injection,' the CDC warned in the findings of its 2024 investigation.
The likelihood of getting botulism from neuromodulator injections is very low, the World Health Organization reported in 2023, especially if it's administered in a medical setting.
"If the botulinum toxin is manufactured properly and comes from a good brand, the strength is such that even if it spreads a little bit, it doesn't cause a huge amount of side effects," Ash Mosahebi, professor of plastic surgery at University College London, told the BBC in May 2024. 'However, the problem we've had is that there are dodgy counterfeit versions in circulation. They are poorly made and manufactured, and not well controlled."
A spokesperson for AbbVie, the company that owns Allergan Aesthetics, which manufactures Botox, told Yahoo that it has a security program for its supply chain to make sure all products are safe and sold through authorized distributors.
'We have no reason to believe that our product, Botox, is involved in the recent botulism incidents in the U.K., Massachusetts or other U.S. states,' the AbbVie spokesperson said in an emailed statement to Yahoo in. 'We also have no evidence to suggest that the clinics and practitioners identified by authorities are customers of Allergan or AbbVie.'
'We cannot stress enough the importance of receiving botulinum toxin injections only from licensed and trained medical professionals using FDA-approved products obtained from authorized suppliers,' Multnomah County Health Officer Dr. Richard Bruno said in the press release issued on June 18. Echoing the CDC's earlier warning, Bruno added: 'If in doubt, don't get the injection.'
Since the botulinum toxin targets muscles, common symptoms of botulism, according to the CDC, include:
Difficulty with vision — whether that's from drooping eyelids, double vision or complications moving the eyes
Slurred speech
Difficulty breathing
Muscle weakness throughout the body
The CDC recommends that anyone experiencing these symptoms within days of getting an injection should see a doctor or visit an emergency room immediately.
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