UK health agency warns of botulism poisoning from unlicensed Botox injections
The UK Health Security Agency (UKHSA) has issued a public health warning following reported adverse reactions to cosmetic procedures in England. The investigation so far points to unlicensed Botox-like products causing the complaints, although it is still ongoing and not yet confirmed.
Recently, in the North East region, 38 cases of iatrogenic botulism — a man-made form of botulism following cosmetic injections — were confirmed between June 4 and July 14. The UKHSA’s warning comes as additional cases of botulism have been reported.
Bolutism is a paralytic illness caused by a nerve toxin. The reactions reported include difficulty swallowing, slurred speech, and breathing difficulties requiring respiratory support.
According to the UKHSA, no link has been found between the most recent cases and those previously in the North East region.
The government agency has advised clinicians nationwide to be alert for botulism in people with a recent aesthetic procedure so that proper anti-toxin treatments can be provided.
“Botulism related to aesthetic procedures is rare, but it can be serious. It is caused by toxins produced by the bacterium Clostridium botulinum. These toxins (but not the bacteria) are the active ingredient in Botox and similar products,” says Dr. Gauri Godbole, consultant medical microbiologist at the UKHSA.

“We are working closely with our partners to reduce the public health risk and would advise people to make sure they take precautions when seeking aesthetic procedures.”
Godbole explains that symptoms of botulism can take up to four weeks to develop.For public health
Godbole explains that symptoms of botulism can take up to four weeks to develop. She advises consumers who have had a recent botulinum toxin (Botox-like) procedure and are experiencing any symptoms should seek medical treatment or consultation from the National Health Service immediately.
Meanwhile, Dr. Alison Cave, the chief safety officer at the Medical and Healthcare products Regulatory Agency (MHRA), states that public safety is a top priority. The MHRA’s criminal enforcement unit is working to identify those involved in the illegal trade, and they may face criminal prosecution.
“Botulinum toxin is a prescription-only medicine and should only be sold or supplied under a prescription given by an appropriate practitioner such as a doctor or other qualified health care professional,” says Cave.
“Buying botulinum toxin in any other circumstances significantly increases the risk of getting a product either falsified or not licensed for use in the UK. This means that there are no safeguards to ensure products meet the MHRA’s standards for quality and safety.”
Earlier this year, England banned remote prescriptions of cosmetic injections for increased safety. The ban took effect on June 1, ensuring prescriptions take place face-to-face, as previously they could be given online without the customer needing to consult a medical practitioner, which raised regulatory and safety concerns.