Fake Botox Is a Reality. And It Could Happen to You.

Not all botulinum toxin treatments use genuine licensed products. Some use counterfeit preparations of unknown concentration and unknown origin. Here is what that means — and how to make sure it does not happen to you.

A problem closer to home than most people realise

When patients think about the risks of aesthetic treatment, they tend to think about results, such as an uneven lip, a frozen forehead, a result they are not happy with. These are real concerns. But there is a more serious risk that receives considerably less attention, and it is one that is growing.

Fake botulinum toxin, counterfeit or unlicensed products being administered in place of genuine licensed treatment, is circulating in the UK market. It is not a theoretical concern. It is happening on high streets, in beauty salons, and through Instagram bookings, right now.

Fake Botox is happening on high streets, in beauty salons, and through Instagram bookings, right now.

What fake Botox actually is

In the UK, only six brands of botulinum toxin are licensed for cosmetic use: Botox, Azzalure, Bocouture, Alluzience, Letybo, and Nuceiva. These are pharmaceutical-grade products. They are manufactured to precise standards, stored under controlled conditions, and supplied through regulated medical supply chains. The concentration of active toxin in each vial is precisely characterised, consistent and most importantly safe.

Counterfeit and unlicensed products have none of these guarantees. The concentration of active toxin is unknown. The formulation may be entirely inappropriate for injection into a human face. Storage and handling conditions may have been violated. And the person administering it may have no idea what they are injecting.

What happens when it goes wrong

The consequences of counterfeit botulinum toxin are not the same as the consequences of a poorly placed licensed product. They are the consequences of botulism — systemic poisoning by an uncontrolled biological toxin.

In the United States, the CDC has documented multiple cases of patients hospitalised following counterfeit botulinum toxin treatment. These are not isolated incidents. They are the visible tip of a problem that is considerably larger than the reported cases suggest.

Serious harm in the USA

In 2004, Dr. Bach McComb, a former Florida osteopathic physician (whose medical license had already been suspended at the time of the incident) administered a massive overdose of highly concentrated, unapproved raw botulinum toxin.

The Toxin Source: Instead of using standard FDA-approved cosmetic Botox, McComb obtained raw, research-grade toxin intended strictly for laboratory use.

The vial he used was estimated to contain up to 10 million units of raw botulinum toxin instead of Botox which contains 100 units per vial

The Overdose: McComb injected himself and three others. The solution was later calculated to be 40 times higher than a lethal dose

The Victims: The four victims included McComb himself, his girlfriend and two others.

The Hospitalization: All four individuals contracted severe botulinum poisoning and were hospitalized. They suffered systemic muscle and respiratory paralysis, requiring them to spend months on life-support ventilators to survive.

The symptoms of botulism i.e. blurred vision, difficulty swallowing, muscle weakness, and difficulty breathing are not a cosmetic complication.
They are a medical emergency.

Why it happens — and who it happens to

Counterfeit products tend to follow low prices. A treatment priced at the lower end of the market, or significantly below what you would expect to pay for a licensed product administered by a qualified professional, may be priced that way because the product being used is not genuine.

It also tends to happen with practitioners who are not medically qualified - those who do not source their products through regulated medical supply channels, who are not registered with a professional body, and who are therefore not subject to the oversight that would expose their product sourcing to scrutiny.

It can happen to anyone. It is not a risk confined to patients who are being reckless or naive. It is a risk that exists whenever the clinical and regulatory framework surrounding a treatment is absent — and in the current state of UK aesthetics regulation, that framework is not guaranteed by the treatment being offered on a respectable-looking Instagram page.

What you can do

The questions worth asking before any botulinum toxin treatment are simple and direct:

• Is my practitioner medically qualified?
  Are they registered with the GMC, NMC, or GDC? Can they tell you their registration number? A medically qualified practitioner sources products through regulated pharmaceutical channels and is subject to professional oversight that non-medical practitioners are not.

• What product are they using? A legitimate practitioner should be able to tell you the brand name of the product they will use, one of the six licensed brands listed above and confirm where it is sourced.
  Vagueness about this is a significant warning sign.

• Does the price make sense? The cost of genuine licensed botulinum toxin is not negligible. A treatment priced far below the market rate may reflect a cheaper or counterfeit product. This is not always the case but it is always worth asking why.

The honest reassurance

Licensed botulinum toxin, administered by a medically qualified practitioner using a genuine product sourced through legitimate channels, has an extraordinary safety record. In over thirty years of licensed cosmetic use, it has never caused a confirmed death. The treatment is safe. The framework around it is what makes it safe. Read Why is it One of the Safest Treatments in Medicine

The risk is not the product. The risk is what happens when the product is not what it claims to be, in the hands of someone who is not qualified to administer it. That risk is real, it is current, and it is entirely avoidable, if you ask the right questions before you book.

To find out more about our approach to patient safety, or to arrange a consultation, please visit our contact page or get in touch using the telephone or email links below.