You Shouldn’t Trust Just Anyone


It is easy to understand why botulinum toxin is the most popular cosmetic treatment in the world. Apart from being safe, quick, and painless, this injectable treatment also provides lasting wrinkle reduction and prevention, helping patients maintain a refreshed and youthful-looking appearance.  

What’s the Deal with Counterfeit Botulinum Toxin Injections

But as more and more people continue to trust botulinum toxin for wrinkle management, incidents involving fake doses and unlicensed providers have also increased. Recently in the United States, counterfeit versions of a popular brand have been found across multiple states in the country.

What happens with fake botulinum toxin?

Botulinum toxin from unlicensed sources is said to cause adverse reactions. According to the US Food and Drug Administration (FDA) announcement, the symptoms of counterfeit products were similar to those when the neurotoxin spreads to other areas of the body. These include blurred vision, shortness of breath, difficulty swallowing and lifting one’s head, and hospitalizations. 

As of April 18, 2024, 22 people from 11 states reported “harmful reactions” after receiving injectables from unlicensed and non-medical settings/providers, such as spas and homes, the US Centers for Disease Control and Prevention (CDC) reported. 

  • All of the affected patients are female, between ages 25 and 29. 
  • Eleven were hospitalized, while six were treated with botulism antitoxin, an antidote that can stop damage to the body, because of the concern that the product has spread beyond the treatment area. 
  • All but two received the injections for cosmetic purposes
  • All patients reported receiving treatments from unlicensed/untrained injectors in non-healthcare settings, such as homes and spas. 

How to avoid counterfeit botulinum toxin

As it is likely for fake products to contain unsafe ingredients, serious complications are likely. A counterfeit product may: 

  • Contain low, incorrect, or high doses of the neurotoxin
  • Be diluted with other liquid
  • Be unpurified versions
  • Be a saline solution, water, or anything but botulinum toxin

This is why it is important to seek injectables only from reputable providers. Board-certified physicians, aesthetic doctors, plastic surgeons, and dermatologists have the training and experience to administer these treatments. They didn’t just go or undertake a week-long course.

How to spot counterfeit botulinum toxin

If it makes you feel safe, you can also ask your doctor to show you the packaging or see the unopened vial before it is injected. There are some signs to look out for that may indicate that the product is fake.

  • Indicates 150-unit doses – FDA-approved botulinum toxin for cosmetic purposes comes in 50- and 100-unit vials, and 200-unit vials for other purposes. AbbVie or Allegan, the makers of the popular botulinum toxin brand, does not produce 150-unit dose vials. 
  • Contains lot number C3709C3 (may be listed on the carton or vial itself)
  • The active ingredient is displayed as Botulinum Toxin Type A” instead of “OnabotulinumtoxinA” 
  • Packaging contains language that is not English

Where to safely get botulinum toxin injections

Cosmetic injectables are safely administered by a board-certified dermatologist, plastic surgeon, or aesthetic doctor in a medical setting, not in spas or homes. Other important things to keep in mind include: 

  • Choose a reputable provider – only see licensed injectors who use authentic products and follow safety protocols. 
  • Avoid botulinum toxin parties – never go to social events where people gather to get cosmetic injections. This is a non-clinical/medical setting and may lack proper medical supervision. 
  • Don’t skimp on quality – if the deal is too good to be true, it probably is. Avoid incredibly low-priced injections to avoid dissatisfaction and potential complications. 

For further reading: Leave it to the Pros: Don’t Trust Just Anyone to Administer Your Injectables

Book a consultation with us

Are you thinking of getting a botulinum toxin treatment or other cosmetic injectable? We at Cutis Medical Laser Clinics in Singapore have aesthetic doctors who administer the treatment. We also use authentic products and are transparent with our prices. Contact us today to learn more or schedule a consultation. 



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