The UK Health Security Agency (UKHSA) has issued a warning after 38 cases of botulism poisoning linked to unlicensed Botox-like cosmetic injections were reported across England. The cases, first identified in the north-east, have since been recorded in the east of England and East Midlands, with all incidents occurring between 4 June and 14 July 2025.
UKHSA 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, can be life-threatening, though a purified form is used in licensed Botox products for cosmetic purposes.
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 immediately. “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 prescribe 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), highlighted the dangers of buying Botox-like products outside regulated channels. “Unlicensed products have no safeguards to ensure they meet quality and safety standards, endangering public health,” she said.
