It’s one of the most poisonous biological substances in the world – a neurotoxin extracted from the bacterium Clostridium botulinum, found in soil, plants and animal intestines.
If consumed in food, it attacks the nervous system and causes an array of alarming neurological symptoms. In high doses it can be deadly.
Yet purified, diluted and rebranded as Botox, 7.4 million Americans willingly injected this potent toxin into their faces in the last year alone.
They did so in the belief that the minimally invasive anti-aging treatment is ‘harmless.’ Indeed, for many more, the question is not if they should follow suit, it’s when.
But now, two decades after the FDA approved the toxin for cosmetic use, that comforting certainty has been cast into doubt as, the Daily Mail can reveal, a number of reports have emerged that link it to a host of horrifying and potentially deadly complications.
And the message from experts who spoke to the Daily Mail is clear: don’t do it. Because with time comes, if not wrinkles, then data.
Azza AbuDhagga, PhD, works for consumer watchdog, Public Citizen’s Health Research Group. She and her colleagues have been campaigning for the FDA to include stronger health warnings on the labels of Botox products for the last decade.
She told the Daily Mail, ‘We don’t recommend the use of these products for cosmetic reasons at all. It’s not worth the three months relief people can get from their wrinkles.’
Two decades after the FDA approved the toxin for cosmetic use, a number of reports have emerged that link Botox to a host of horrifying and potentially deadly complications.
It’s one of the most poisonous biological substances in the world – a neurotoxin extracted from the bacterium Clostridium botulinum, found in soil, plants and animal intestines. Yet purified, diluted and rebranded as Botox , 7.4 million Americans willingly injected this potent toxin into their faces in the last year alone.
The side effects of which AbuDagga speaks are not the all-too familiar Botox ‘fails’ – from an overly frozen forehead to ‘Golden Arches’ eyebrows, so-called because they hover in a formation that resembles McDonalds’s famous ‘M.’
No, according to AbuDagga, those who indulge in Botox are at risk of Iatrogenic Botulism, which happens when Botox spreads through the body beyond the intended site.
At its most mild this can cause drooping eyelids and temporary symptoms that last a number of weeks.
At its most severe, it can lead to much more serious, long-term issues. The toxin can travel along the nerves and lodge in the central nervous system, leading to difficulty swallowing, muscle weakness, paralysis, seizures and, ultimately, respiratory failure and death.
This week, the Department of Public Health in Massachusetts told the Daily Mail they were investigating 18 cases of Iatrogenic Botulism all linked to one beauty parlor in that state – Rodrigo Beauty in Milton.
In 2024, the Center for Disease Control (CDC) warned that 22 women across 11 states had suffered ‘harmful reactions’ to Botox – 11 were hospitalized.
Board-certified plastic surgeon Dr Bianca Molina told the Daily Mail that dangers can arise if patients overuse the treatment.
The CDC concluded that the incidents were caused by counterfeit or mishandled products, rather than a blanket issue.
But AbuDagga doesn’t accept that the most egregious outcomes can be simply dismissed as the result of human error or contamination.
She maintains that her organization has proof that problems can occur even when everything is done correctly.
And, although still rare, reports of people falling sick following Botox injections are on the rise.
‘We’re seeing that there are even cases associated with normal doses,’ AbuDagga said. ‘I identified 121 cases with botulism in the database of spontaneous reports that people submitted to the FDA.’
She continued, ‘There are studies coming out that people have developed seizures. There are also these people developing atrophy at the injection site. All these long-term risks that we just simply don’t know much about need to be factored in.’
She added, ‘These risks are not really clear in the label, sometimes it takes hours, days or even longer than that for people to see the spread of the toxin.’
AbuDagga is particularly concerned about potential longer term health risks, because most clinical trials only follow up on patients for six months, so they do not capture the effects of prolonged use.
In April 2015, a study on rats led by Frederic Meunier in the University of Queensland, Australia, found that, in high doses, Botox could travel all the way along nerve cells into the central nervous system with potentially devastating consequences including muscle spasms, seizures and paralysis.
Botox proponents are quick to point out that the doses used in such studies far exceed those used for cosmetic treatments.
AbuDagga is particularly concerned about potential longer term health risks, because most clinical trials only follow up on patients for six months, so they do not capture the effects of prolonged use.
Dr Howard Sobel, a cosmetic dermatologic surgeon at Lenox Hill Hospital, told the Daily Mail, ‘I don’t think anyone getting Botox should be worried about the side effects that they saw in these particular studies.’
Dr Sobel insists that if Botox is obtained from a reputable source and administered by a trained professional, there is ‘nil chance’ of serious side effects.
‘I have not seen in my practice, and I have not seen from any one of my colleagues, that it has had cumulative side effects like some of these people have had in these studies,’ he said.
At anywhere between $300 and $1,000 a pop, fans of Botox have long been prepared to pay a steep price for a wrinkle-free brow.
But, with more data emerging, even some of its proponents are starting to acknowledge that the treatment could come at a much greater cost.
A 2022 review in the Annals of Plastic Surgery noted that, with prolonged use, ‘changes in muscle composition, function, and appearance [can] persist for…years.’
Meanwhile, board-certified plastic surgeon Dr Bianca Molina told the Daily Mail that dangers can arise if patients overuse the treatment.
‘People who are getting frequent injections of a botulinum toxin, more frequent than recommended or a higher dose, there is a potential for a muscle wasting phenomenon,’ she said.
‘For instance, the forehead becomes a bit thinner because that muscle layer that we are trying to deactivate just becomes much thinner and more diminutive. And then, 20, 30 years after you’ve had Botox you may not actually have full functionality.’
