Erasing your wrinkles without going to a doctor’s office? The temptation can be great, but above all it is very dangerous. This Thursday, October 23, the National Medicines Safety Agency (ANSM) published a new health alert after the discovery of several cases of severe botulism, linked to illegal botox injections. Since spring 2025, three new serious cases have been reported to health authorities, after eight cases recorded in 2024.
The patients experienced severe neurological symptoms. The Agency reports vision problems, drooping of the eyelids and muscle weakness. More seriously, they also suffered from breathing difficulties requiring hospitalization in intensive care.
Botox and botulism: the same toxic origin
Botulism is a rare but serious disease caused by botulinum toxin, the same substance used in botox. In botox, it is more precisely a neurotoxin derived from botulinum toxin type A, produced naturally by the bacteria Clostridium botulinum.
This substance blocks the release of a neurotransmitter (acetylcholine), temporarily paralyzing the targeted muscles. It therefore acts on the nervous system and can, in extreme cases, lead to death. When this toxin is used without medical supervision, the risks increase considerably.
An even more aggressive form of botulism
Unlike food botulism – linked to poorly sterilized canned goods – these recent cases are due to skin contamination. Viewed by True MedicalDr Gérald Kierzek, emergency doctor and medical director of the site, recalls the dangers of this practice.
“In the context of these illegal injections, botulism is transmitted by a different route: the skin route. This is the same pathology as that transmitted through food, after the consumption of defective canned food. It all depends on the quantity injected, obviously, but in this case, the contact of the spore with the nervous system is faster. And the consequences are therefore potentially more serious“.
Social networks, fertile ground for illegal injections
This is why the ANSM reminds, in its alert, that these injections must be carried out by authorized doctors – such as dermatologists, cosmetic doctors/surgeons, maxillofacial surgeons or ophthalmologists – and with products having marketing authorization.
Because the problem mainly comes from attractive offers published on social networks, such as Instagram or TikTok: promises of a “perfect” face at a knockdown price, which often hide unqualified injectors, using uncontrolled and potentially dangerous products.
In a previous article, aesthetic doctor Fatya Assadi recalled the rules to follow.
“It takes a minimum of training, and several years of study to know the anatomy, the gestures, and to be authorized to carry out this type of act. The difference between an illegal “injector” and a doctor is that the latter will not say that there is no danger, because every act involves risks. But he will be able to manage the complications. An illegal injector will be completely powerless in the face of these complications, because she does not have the necessary knowledge to react. We need a more drastic regulation on this subject, but on the networks, is this possible?”
As a reminder, advertising for a medication subject to medical prescription is also prohibited, as is the purchase of botulinum toxin on the Internet.
These signs that should alert you
Before any injection, several clues should give pause:
- The person offering the injection has no recognized medical qualification (for example: beautician, individual);
- The meeting place is not a medical office (private home, beauty salon);
- The promises are too good: “painless injection”, “no side effects”;
- The offer is relayed on social networks;
- Prices are abnormally low or “on promotion”;
- The product is offered for sale online.
All of these situations should alert you: they are illegal and dangerous. In case of doubt or unusual symptoms after an injection, it is urgent to consult an emergency department or contact a poison control center. And any adverse effects must be reported on the ANSM pharmacovigilance portal.