Alerts regarding counterfeit Botox injections administered by untrained individuals are on the rise. The New York City Health Department disclosed on Friday that three individuals sought emergency care subsequent to receiving injections of botulinum toxin in various regions such as the face, neck, upper back, or armpits.
Following the injections, the trio experienced an array of symptoms within days or weeks, ranging from double vision and sagging eyelids to challenges in swallowing, breathing, and raising their arms.
Of the three, two required hospitalization, with one necessitating intensive care.
These revelations emerge as both the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) delve into additional cases of hospitalizations due to severe side effects post counterfeit Botox injections from unlicensed providers.
The CDC reported on Friday that at least 22 individuals across 11 states exhibited adverse reactions, such as slurred speech, respiratory difficulties, and blurred vision, subsequent to receiving counterfeit iterations of the anti-wrinkle treatment. No fatalities have been recorded.
All affected individuals are females aged between 25 and 59, predominantly around 40 years old. Notably, the injections were administered in "non-healthcare settings," including residences and spas, as per the CDC. Reports of symptoms potentially associated with fake Botox surfaced in early November 2023.
"Individuals should refrain from receiving injections at informal gatherings or from acquaintances," emphasized NYC Health Commissioner Dr. Ashwin Vasan in a press release on Friday. "Unusually low pricing or lack of comprehensive information on risks and side effects signal potential illegitimacy and health hazards."
The FDA underscored that genuine Botox, manufactured by AbbVie, is not implicated in any of the reported illnesses.
Botox employs a refined form of botulinum toxin, a neurotoxin inducing muscle paralysis. When injected precisely into specific facial areas, it effectively relaxes muscles responsible for wrinkles.
In correspondence with NBC News, the FDA affirmed its active collaboration with state and federal health agencies to trace the source of counterfeit Botox.
Dr. Adam Friedman, a dermatologist and chair of dermatology at George Washington University, posed the question, "Is this 'faux-tox' a singular entity, or are multiple entities producing distinct versions of it? This remains unanswered."
Dr. Kate Dee, a physician and founder of Glow Medispa in Seattle, attributed the recent health crises to unregulated medical spas, which have proliferated into a $15 billion wellness industry.
"The issue isn't genuine Botox inadvertently utilized by physicians. Physicians procure authentic Botox, adhering to legal and legitimate avenues," she clarified. "Rather, it's individuals within the med spa and esthetics sectors striving for profit through cheaper alternatives."
Instances linked to counterfeit Botox have surfaced in California, Colorado, Florida, Illinois, Kentucky, Nebraska, New Jersey, New York, Tennessee, Texas, and Washington. The CDC confirmed at least 11 hospitalizations.
Symptoms such as blurred vision and drooping eyelids manifested proximal to the injection site, while others, like fatigue and muscle weakness, were more generalized.
Additional troubling symptoms could encompass constipation, urinary incontinence, dry mouth, and difficulty in lifting the head, as per the FDA's advisory.
The difference in side effects from fake Botox
Typically, complications arising from authentic Botox injections stem from "inadequate technique," such as erroneous toxin placement in muscles or areas, Friedman noted.
"However, if patients are experiencing respiratory distress or failure due to systemic toxicity," he remarked, "that deviates from the norm in medical practice."
The FDA said there are several ways to identify counterfeit Botox products:
1. The outer carton and vial contain lot number C3709C3.
2. The outer carton displays the active ingredient as “Botulinum Toxin Type A” instead of “OnabotulinumtoxinA.”
3. The outer carton and vial indicate 150-unit doses, which is not a unit made by AbbVie.
4. The outer carton has language that is not English.
Dee advises patients to request visual confirmation of the toxin vial prior to undergoing injections. "At minimum, inspect the vial as authenticity can be gauged by its language—any language other than English indicates counterfeit Botox."
