Q&A: How to protect yourself and your patients from fake Botox
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Key takeaways:
- Last week, the CDC announced it will investigate cases of fake Botox that hospitalized four patients.
- Dermatologist offers tips on how providers can avoid fake Botox and practice safe injectable techniques.
Cosmetic dermatologist Karan Lal, DO, MS, FAAD, offered advice to providers on how they can protect themselves and their patients from the dangers of counterfeit Botox.
As Healio previously reported, the CDC is coordinating an investigation surrounding cases of fake Botox (botulinum toxin, Allergan) injections that have hospitalized at least four people.
In response, the American Society of Dermatologic Surgery Association called for states to enforce stricter regulations over cosmetic facilities, and the American Academy of Dermatology Association has warned consumers not to receive botulinum toxin injections from anyone other than a trained provider.
Following this news, Healio spoke with Lal, a double-board certified pediatric and cosmetic dermatologist in Scottsdale, Arizona, on how providers can protect themselves and their patients from botulism.
Healio: How can practitioners know if the Botox they are purchasing is counterfeit?
Lal: If your Botox is so inexpensive to the point that it doesn’t make sense compared with other people that are charging a different amount in your area, that means there is a problem. This could mean they are diluting the Botox, they are using counterfeit Botox or they are using Botox from outside of the U.S.
Botox, as well as other injectables such as Dysport (abobotulinumtoxinA, Ipsen) and Jeuveau (prabotulinumtoxinA-xvfs, Evolus), must also be refrigerated. If the product that you receive from someone is room temperature or not refrigerated, you are potentially using a product that is going to be ineffective or cause harm.
Lastly, if you are using Botox, Dysport or Jeuveau, you should be registered with the programs that give patients points such as All (Allergan), Aspire (Galderma), etc. I recommend to patients that if the provider they are going to does not tell them about these programs or doesn’t offer those programs, that may be questionable.
Healio: Where should practitioners purchase their Botox and why?
Lal: Providers should only be purchasing injectables from the manufacturer to ensure they are getting products that are held by the appropriate standards by the FDA. I would not recommend purchasing Botox from other providers or purchasing groups because you are assuming the responsibility of buying a product that is not from the manufacturer. Manufacturers are able to tell if you are not using Botox or injectables through them and, thus, if there’s a complication and it has to be reported to the company, they may not be liable to help you.
Healio: How else can providers ensure they are practicing safe injectable techniques?
Lal: In addition to making sure you have standard Botox that was stored correctly, you must also make sure that sterile techniques are used when preparing botulinum toxins.
It truly should be the responsibility of the provider injecting the Botox to reconstitute the product. I have seen complications when nonproviders are reconstituting the Botox including the use of hypertonic saline or lidocaine instead of bacteriostatic normal saline, because some of these bottles look very similar.
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