The UK Health Security Agency (UKHSA) has issued a warning to the public after 38 cases of botulism poisoning were reported in England, linked to unlicensed Botox-like injections. The cases were first identified in the north-east, with subsequent reports in the east of England and East Midlands, occurring between 4 June and 14 July 2025.
Investigations suggest the use of an unlicensed Botox-like product. Symptoms reported include difficulty swallowing, slurred speech, and breathing difficulties requiring respiratory support. Botulism, caused by toxins from Clostridium botulinum bacteria, attacks the nervous system and can be life-threatening, though rare.
Dr Gauri Godbole, consultant medical microbiologist at UKHSA, advised that symptoms can take up to four weeks to develop after treatment. She urged anyone experiencing signs such as swallowing difficulties to contact NHS 111. “If you are considering having a cosmetic procedure, please make sure to check that your practitioner is using a licensed product,” she said.
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. “When these procedures go wrong, there is a risk of serious infections and permanent scarring,” she warned.
Dr Alison Cave, chief safety officer at the Medicines and Healthcare products Regulatory Agency (MHRA), stated that buying Botox-like products outside regulated channels significantly increases the risk of fake or unlicensed products. “Public safety is a top priority for the MHRA,” she said, adding that unlicensed products lack safeguards to ensure quality and safety.
