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Created on 10th September 2009


Are dangers getting overlooked as we flock to the needle? Caroline Tustain investigates

Botox has become a household name over the last few years and is thought by many to be a magical solution to the problem most of us face as we get older - wrinkles and frown lines. Not only are celebrities turning to the non-surgical treatment for their most important red carpet moments and television appearances, but a wider range of the public are throwing away the anti-wrinkle creams of yesteryear in favour of this non-regulated medication.

When administered correctly, botulinum toxin, a neurotoxin more commonly known under the brand name of Botox, can paralyse a muscle so that it is unable to contract for three to four months, and is commonly used to smooth the appearance of the face, resulting in younger looking skin.

In the 1970s Tupperware parties were all the rage, in the 1990s women had moved on to purchase sexy lingerie in their own homes, before Botox parties became the craze in more recent years. Perhaps the current economic downturn has caused people to seek a cheaper option, or perhaps as the treatment is so familiar to us all now it seems more accessible therefore more safe, but now it seems that women are going it alone in the search for younger-looking skin, and turning to the Internet to find the solution.

A recent report in the Daily Mail suggested that 'vain and gullible women' were being targeted to purchase DIY Botox kits. But is it really as easy as a click of the mouse?

Dr John Curran, past president of the British Association of Cosmetic Doctors (BACD), a not-for-profit organisation established for the advancement, education and practice of cosmetic dermatology in the UK, believes that not all is what it seems with online buying.

"How on earth do people know they're getting Botox? What skills do they have? It's highly unlikely that Botox is going to be sold on the Internet. Botox is an extremely expensive product and, if it was available, on balance you would receive more than you need for one patient. You are most likely being sold something you don't even know."

So what are you purchasing? It is true that typing into search engines that you wish to purchase Botox, brings up thousands of results. But how equipped are we to administer the treatment ourselves?

Gwen Davies, non-surgical manager of Transform Cosmetic Surgery identifies lots of potential problems. "You can never be quite sure of the actual product you're receiving. There are different strains and strengths of Botox which are available. Injecting Botox correctly and effectively is a skill built up via experience and time. If you're injecting yourself, this is a very high risk thing to do - how would you know which muscles to inject, etc?

"The product would also need to be diluted - an average consumer wouldn't know the correct way to do this."

She also added that, as the person administering the product is ultimately responsible for the outcome, the chances are that an experienced practitioner would refuse to inject it. The alternative is for the buyers to inject it themselves, which could have undesirable effects such as arched eyebrows or having one higher than the other. Injecting Botox incorrectly could also result in facial paralysis which could last up to six months. There is also no aftercare if something goes wrong.

But aesthetic imperfections are not the only possible outcomes according to Dr Curran. It could also result in much more serious consequences if the product is contaminated with live bacteria. "A medical practitioner in Florida bought some stuff over the Internet and gave it to relatives. Two of the patients ended up seriously ill in hospital, and the practitioner ended up in jail for 15 years."

Botox is not currently regulated by law, meaning that no independent body inspects the provider to check or make sure that their services meet standards of quality and safety.

Although statutory regulation is not currently in force, the Government has appointed the Independent Healthcare Advisory Services (IHAS) with the task of bringing forward a set of industry standards which the organization is currently working towards.

Sally Taber, director of IHAS, said: "There are no regulations except that Botox is a prescription-only medicine, and so the Medicines Act applies. We are in the process of bringing forward a set of standards for practitioners and introducing a shared regulation framework.

"Botox must be delivered in a safe environment and meet all the requirements of the Medicines Act. The giving of Botox must be restricted to appropriately trained doctors, registered adult nurses and dentists. We do not consider beauty therapists acceptable.

"We are trying to address the issue of inappropriate training, where certificates are given after a half day course for example. We are also strongly advising against buying Botox on the internet. It is highly dangerous to purchase any medication in this way.

"Who in their right mind would send for a syringe and a drug? The public have got to be more sensible and recognize the dangers associated with behaving in this way. There will always be people who are trying to get a quick buck and the public needs to be aware of this."

Ms Taber added that there is no place for Botox parties, where a group of (usually) women get together to socialize, where it is not only champagne and canapés on the menu, but also Botox. She stressed that giving injections to women who have been drinking wine is not the correct environment.

Dr Curran also warns against this craze: "Only qualified people (doctors, dentists or nurses with prescribing rights) can prescribe and administer Botox and they should not be doing this at a party. In the view of the General Medical Council it may be considered a medical malpractice for a doctor to participate in a Botox party. The BACD is grateful to receive details of anyone behaving in this manner. Each patient should be in a position where they're having an assessment by someone with experience and that this person practices by the legal parameters.

"If, for example, a beautician is giving Botox in a party environment and the patient has never seen a doctor, they are breaching the Medicines Act. This is a criminal act. If you wish to have Botox by someone who disregards the law, you can expect them to disregard the patient's safety. You should expect to have a treatment in a safe medical environment. Then if you have a reaction, even a small one such as fainting, you are in the right environment."

So it seems that trying to cut the cost of the treatment could be at the expense of your wellbeing.

The last meeting to discuss Botox and dermal fillers regulations was scheduled for the beginning of July. Ms Taber said: "We are behind with the self-regulatory model because the minister has changed, but we have already identified the third party that will take the regulation and inspection forward.

"We are asking ministers for funding to reduce subscription and to get the quality mark that recognises that these people are adhering to standards. We would like to have it up and running by the end of this year."
Until the self-regulation model is in place, people are urged to carefully consider all the options when contemplating Botox. Gwen Davies suggests the following:

  • Ensure that the medical practitioner is adequately experienced and skilled in administering Botox. Ask to see their credentials and ask how long they've been practising for
  • Have a full consultation so that you are aware of any potential problems/issues before going ahead. You will also get an idea of what the treatment can do for you which will give you a realistic expectation of the treatment
  • Make sure that you read up and assess the aftercare policy/follow-up procedure, should anything go wrong
  • Take your time making your mind up, and don't let anyone rush you into making a decision


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