After two people were hospitalized in Louisiana following Botox injections, the Louisiana Department of Health is warning residents to avoid the cosmetic shots from unlicensed sources.

The two reports were unrelated, but both involved severe illness. One received injections of an unlicensed product ordered online, and another was injected by someone of unknown licensure in a non-medical setting.

Botox, which is shorthand for botulinum toxin, can smooth wrinkles and fine lines. It can also be used to treat chronic migraines, spasms and bladder dysfunction.

Botulism is a rare but potentially deadly illness caused by a toxin from Clostridium botulinum bacteria, which attacks the nerves and can lead to paralysis. Symptoms include blurry vision, drooping eyelids, muscle weakness and difficulty with swallowing, speech and breathing. It’s most often linked to improperly canned foods, contaminated wounds, or, in infants, ingestion of bacterial spores such as those found in honey.

Botox contains tiny amounts of those toxins, which paralyze facial muscles. In approved formulations of the product, injections are sterile and purified to standards set by the Food and Drug Administration. But counterfeit products do not meet the same standards, and may have been altered or improperly stored.

In 2024, the Centers for Disease Control and Prevention reported 17 cases of harmful reactions among people who received Botox injections across nine states. Many were in unlicensed facilities or ordered online. 

LDH emphasized that Botox injections should be administered by a licensed and trained medical provider in a licensed or accredited health care setting. Ensure the product is FDA-approved, obtained from an authorized supplier, and never purchase or self-inject products found online or on social media.