Wrinkle-Relaxer Injections: How to Avoid Counterfeit Toxin and At-Home Kits

Injections of botulinum toxin, often called wrinkle relaxers, are approved for the temporary improvement of frown lines, forehead lines, crow’s feet and neck bands.¹ Prices vary, and deals pop up at parties, spas and online. CDC reports from 2024 and 2025 show what can go wrong when the product or the injector isn’t legitimate.

What happened

• 2024: Seven women in Tennessee and New York City, median age 48, got sick after cosmetic toxin injections given mostly in homes and once at a cosmetic spa. Four were hospitalized. At least four had received counterfeit product.²
• 2025: Three women, aged 29, 50 and 59, injected themselves with toxin bought online, including from vendors found through social media and messaging apps. All three were hospitalized, one needed a breathing machine, and all received antitoxin.³

Symptoms included drooping eyelids, double vision, dry mouth, trouble swallowing, shortness of breath and weakness, starting a few days after the injections.²³

Even the approved product carries a warning

The FDA-approved label has a boxed warning that the toxin’s effects can spread beyond the injection site, causing weakness, double vision, drooping eyelids and swallowing or breathing problems hours to weeks later.¹ Units of one toxin product can’t be converted to units of another.¹ That’s one reason dosing belongs with a trained, licensed professional.

Checklist before you book

1. Ask who will inject you and what their license is. CDC advises licensed, trained providers, preferably in a licensed or accredited health care setting.²
2. Ask where the product comes from. CDC says it should be FDA-approved and bought from the manufacturer or an authorized distributor.³
3. Skip home parties and at-home kits. Most of the 2024 cases happened in homes.²
4. Never buy toxin online to inject yourself.³
5. Be wary of prices far below local norms and offers made through social media messages.
6. Share your health history, including nerve or muscle conditions and all your medicines.
7. Know the warning signs and where you’d go for help.

If symptoms start

Trouble swallowing, speaking or breathing after an injection is an emergency. Tell the emergency team about the injection, since doctors can contact the health department and CDC about antitoxin.³

Our checklist for at-home glycolic peels and guide to at-home microneedling cover other do-it-yourself treatments.

Try: “Before we start, can you tell me your license, where this product was purchased, and what I should do if I have side effects after I leave?”

Skin, Head to Toe includes a short-shelf planner and a 12-week SkinLog. Use them to record treatments, dates, who performed them and any reactions to bring to your next appointment. See the book.