Fake Botox? This is what you should be careful of

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In 2021, police officers arrested a woman after she offered undercover agents counterfeit Botox injections in a makeshift medical office she had set up in a Los Angeles hotel room. A year later, a California-based doctor pleaded guilty to hiding from patients that the drugs she had injected them with were not name-brand Botox, but unapproved versions she bought online.

Now, federal and state health officials are investigating a spate of illnesses linked to counterfeit or improperly administered Botox that has sickened 22 people across 11 states.

“It’s like Groundhog Day,” said Timothy Mackey, a professor at the University of California, San Diego, who studies counterfeit medications. Since 2012, federal agencies have sent more than 2,000 warning letters to doctors or medical centers that purchased counterfeit or unapproved Botox for use in injections.

Experts said there were two key factors fueling the problem: Consumers often don’t know to check that what they are getting is real, and fake products are readily available.

“Our supply chain has been infiltrated with counterfeit Botox — historically, presently, and will be in the future,” said George Karavetsos, a former director of the Food and Drug Administration’s Office of Criminal Investigations.
How consumers can stay safe

The F.D.A. has released images of counterfeit packaging, warning people to avoid a certain lot number, as well as boxes that say they contain 150 units. The F.D.A. has said authentic Botox does not come in that unit.

Dr. Andrea Best, vice president of safety and clinical sciences for aesthetics and devices at AbbVie, which manufactures authorized Botox, said the company was working with regulatory and law enforcement agencies to investigate counterfeit products. She recommended that people ask providers to see the product and packaging before they get an injection, looking to ensure it has a tamper-evident seal.

But counterfeit products can sometimes be sophisticated and hard to spot even when you look at the packaging, Mr. Karavetsos said, which is one reason it’s essential to see a properly credentialed and trained provider.