Dangerous Counterfeit Botox Injections Lead to Hospitalizations

The increasing prevalence of cheap, counterfeit Botox administered by untrained individuals in non-medical settings has resulted in a perilous situation, with over a dozen women hospitalized. The absence of proper medical oversight, combined with the use of unverified products, created a hazardous environment that led to severe health complications for the victims.

In one alarming instance, a woman’s condition deteriorated to the extent that she required mechanical ventilation to assist her breathing.

Seventeen women across nine states experienced a range of symptoms, including blurry vision, difficulty swallowing, and respiratory issues, after receiving what they believed were Botox injections intended to smooth fine lines and wrinkles. Thirteen of these women were hospitalized, with several requiring intensive care unit (ICU) treatment.

A recent report from the Centers for Disease Control and Prevention (CDC) highlighted concerning details of cases in New York City and Tennessee. One of the affected women, originally from Kentucky, was hospitalized in Tennessee. The ages of the affected women ranged from 26 to 55.

The CDC report noted an incident where four women gathered at a relative's home in Tennessee for Botox injections. Within three days, they began exhibiting symptoms. It was later discovered that the injected product was counterfeit and administered by an unlicensed individual.

Dr. Christine Thomas, a medical director at the Tennessee Department of Health and the lead author of the report, emphasized the gravity of the situation. "In some cases, providers were concerned about patients’ breathing to the point where they were admitting them to intensive care units to be able to monitor them more closely," she said. Dr. Thomas, who was an epidemic intelligence service officer at the CDC at the time, described the situation as a “perfect storm” of unlicensed individuals administering counterfeit products in non-medical settings.

One particularly distressing case involved a 49-year-old woman in Colorado who suffered from blurred vision and significant weakness after receiving what she thought was Botox. Nine days later, she was hospitalized with severe difficulties in swallowing and breathing, ultimately requiring intubation and ventilation. It was only after a family member mentioned her recent Botox injections that doctors identified the cause, allowing them to administer botulinum antitoxin, which prevented further damage. Grace Nelson, a disease intervention supervisor at the Denver Department of Public Health and Environment, noted that the woman’s condition had deteriorated so much that conducting an interview was initially impossible.

Medical professionals who are qualified to administer Botox express growing concern about the rise in such incidents, particularly with the increasing popularity of unregulated medical spas. Dr. Kate Dee, a physician and founder of Glow Medispa in Seattle, voiced her alarm: “I’m extremely worried. As more and more people order fake Botox off the internet, there could be anything in that vial.”

George Karavetsos, a lawyer and former director of the Food and Drug Administration’s Office of Criminal Investigations, explained that counterfeit Botox has been a persistent issue in the U.S. supply chain for at least two decades. “I have personally investigated and prosecuted cases of people who were either importing counterfeit Botox or formulating their own version of counterfeit Botox here in the U.S. to sell to the domestic market, to med spas and other clinicians,” he said. Despite efforts to combat the influx of tainted Botox, including targeting the individuals responsible for these products in other countries, success has been limited. Karavetsos emphasized the importance of consumer education in addressing the problem.

To safeguard against counterfeit Botox, several precautionary measures can be taken:

1. Verify the Vials: Misspellings on bottles are a common indicator of counterfeit products. The FDA has noted that counterfeit Botox products may display the active ingredient as “Botulinum Toxin Type A” instead of “OnabotulinumtoxinA,” indicate 150-unit doses (a unit not produced by AbbVie), or have packaging printed in a language other than English.

2. Ensure a Licensed Medical Setting: Only receive Botox in licensed medical facilities from licensed providers. Dr. Dee emphasized, “A cosmetology license is not a license to practice medicine,” and warned that receiving Botox in non-medical settings such as salons, homes, or hotel rooms is a significant red flag.

3. Check Provider Credentials: Before scheduling a Botox appointment, verify that the provider is appropriately licensed. Many state health departments, such as the Tennessee Department of Health, offer resources to search for licensed medical spas and facilities.

4. Beware of Unrealistically Low Prices: Deals that seem too good to be true often are. The average price for Botox is approximately $15 per unit, with typical charges ranging from $12 to $25 per unit. Prices significantly lower than this may indicate counterfeit or illegally obtained products. Dr. Dee warned that long-term business sustainability is unlikely at these low prices, suggesting illegal activities.

NBC News reported on one of the most concerning cases, highlighting the life-threatening impact of fake Botox. With the rise in popularity of unregulated medical spas, the risk of encountering counterfeit Botox remains significant. The healthcare community continues to advocate for consumer awareness and stringent regulations to prevent further incidents and ensure the safety of individuals seeking cosmetic procedures.