Use of unlicensed botulinum toxin products
Medicines and Healthcare products Regulatory Agency 15th July 2026
Botulinum toxin type A products: updated warnings regarding risk of iatrogenic botulism – GOV.UK
Use of unlicensed botulinum toxin products
The MHRA are cracking down on the illegal sale and supply of unlicensed and counterfeit botulinum toxins. Buying botulinum toxins from illegal suppliers, including from within the UK or importing them from abroad, significantly increases the risk of getting a product which is 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. Use of these products can significantly increase your risk of adverse reactions and can endanger the health of the people who take them.
The MHRA’s Criminal Enforcement Unit has launched a number of investigations linked to the use of unlicensed botulinum toxin products following a spike in hospital admissions seen last year.
How to reduce the risk of Botox treatment and use of counterfeits.
- Find a practitioner who has been assessed and verified to ensure that they are: appropriately trained and insured; using safe products and operating from a safe and hygienic clinic. Choosing who will do your cosmetic procedure – NHS
- Always visit a trained healthcare practitioner such as a doctor, nurse, dentist or a prescribing pharmacist. Non-surgical cosmetic treatments are medical treatments that can cause serious complications, and it is important that your practitioner is competent to identify and manage any complication should it arise.
- your administering practitioner (who should be appropriately trained and qualified) should verify that the product being used is licensed for use in the UK. Use of unlicensed or counterfeit products can significantly increase your risk of adverse reactions.
- Note the full name, credentials and contact details of the person treating you. Do not visit a practitioner who only operates on social media.
- Arrange a consultation and don’t be afraid to ask questions. Discuss your concerns and desired outcomes. Ask what products they use and what aftercare will be available.
- Botulinum toxin injections, such as Botox or Dysport, are prescription-only medicines. They can only be prescribed after a consultation between you and a healthcare professional, such as a doctor or nurse. The person giving the injections does not have to be the same person who gave you the prescription. But the prescriber must ensure that the person giving you the injections is trained and safe to do so.
- check that the botulinum toxin product is authorised for use and follow the product specific guidance in the product information for administration, dose and indication
In summary make sure you know:
- who the prescriber is
- who’ll be giving the actual treatment
- what training and experience they have
- what the insurance arrangements are
- Ask to see the unopened box of product/ medicine to be used and make a note of the brand and the LOT number (take a photo) for future reference, should you later see another clinician.
- Don’t be afraid to walk away If you do not feel comfortable.
You should seek immediate medical advice if you experience following signs and symptoms after treatment.
- symptoms of iatrogenic botulism typically occur between 4 and 8 days but can take up to 4 weeks to develop following treatment with botulinum toxin
- symptoms of botulism include, severe drooping of the upper eye lids difficulty breathing, speaking (slurred speech) and difficulty swallowing. This can be life threatening and is a medical emergency, and you should seek immediate medical help