The UK Health Security Agency (UKHSA) has issued a warning after 38 cases of botulism poisoning were linked to unlicensed Botox-like cosmetic injections across England. The cases were reported between 4 June and 14 July 2025, initially in the north-east, with subsequent reports in the east of England and East Midlands.
Botulism is a rare but potentially life-threatening condition caused by toxins from Clostridium botulinum bacteria. Symptoms can include difficulty swallowing, slurred speech, and breathing difficulties requiring respiratory support. Dr Gauri Godbole, consultant medical microbiologist at UKHSA, noted that symptoms may take up to four weeks to develop after treatment and urged anyone experiencing signs to contact NHS 111.
Investigations suggest the use of an unlicensed Botox-like product. The UKHSA advises the public to ensure practitioners use licensed products and are appropriately qualified. Prof Meghana Pandit, co-national medical director at NHS England, emphasised that only registered professionals such as doctors, nurses, or pharmacy prescribers should administer these treatments.
Dr Alison Cave, chief safety officer at the Medicines and Healthcare products Regulatory Agency (MHRA), warned that buying Botox-like products outside regulated channels increases the risk of fake or unlicensed products, which can endanger health. The MHRA stressed that unlicensed products do not meet quality and safety standards.
The UKHSA continues to investigate and has advised medical professionals to watch for botulism in patients who have recently undergone cosmetic injections. Further guidance on choosing a practitioner is available on the NHS website.
