Olha Holubovska, infectious disease specialist and Doctor of Medical Sciences
The modern beauty industry has taught us to think of beauty injections as something routine, simple, and quick - almost like going for a manicure or having a morning coffee. Millions of people get Botox injections every day, achieve excellent results, and feel perfectly fine. Yet few people stop to think that behind that smooth, wrinkle-free forehead is one of the most powerful and dangerous toxins in the world.
And if safety rules are ignored in the pursuit of youth, an ordinary visit to a cosmetologist can end with a hospital bed and a diagnosis you would least expect to hear. Let’s talk about iatrogenic botulism - a disease that can appear when the desire for beauty outweighs common sense.
Let’s take a closer look at how it works. All those popular "beauty injections" are, essentially, the same botulinum toxin, simply used in tiny, carefully controlled doses. When injected into a facial muscle, it temporarily blocks nerve signals. The muscle relaxes, and wrinkles disappear. In other words, the anti-aging effect is achieved through a controlled, local micro-paralysis of the muscle.
In certified products, the concentration of botulinum toxin is precisely controlled, and the protein is highly purified. When administered correctly, it acts locally and does not cause a systemic illness. However, the risk appears when the injection procedure is performed incorrectly, the recommended dose is significantly exceeded, or counterfeit products are used.
Today, the grey market for cosmetic products is a major problem. Unfortunately, almost anyone can become involved in injectable cosmetology, including people without higher medical education. They may simply not understand facial anatomy, may not know the dangerous areas where blood vessels and nerves are located, and may have little understanding of how the human body actually works.
Counterfeit products are often transported and stored under severely improper temperature conditions. As a result, instead of getting a cosmetic treatment, a patient can develop classic iatrogenic botulism.
Its symptoms are almost no different from those of "classic" foodborne botulism. There is a common misconception that botulism following beauty injections is always mild. Indeed, compared with severe poisoning from contaminated fish, most cases of iatrogenic botulism are mild or moderate. However, extremely severe and even fatal cases can occur.
The most dangerous part is that making the correct diagnosis in these patients can be incredibly difficult. A primary care doctor or infectious disease specialist may not immediately recognize the cause unless the patient remembers - and tells the doctor - that they recently visited a cosmetologist.
I had such a case in my practice. A fellow infectious disease specialist called me and said:
"Olga Anatoliivna, I don’t know what else to do. I have a young woman here who has been treated unsuccessfully by neurologists for a month. She has already had a CT scan and an MRI of the brain - everything is clear. But she is unsteady when walking, she is weak, her coordination is impaired, and no one can understand why. But I look at her and see classic symptoms: she can barely open her eyes."
In medicine, we call this ptosis - when the upper eyelids droop.
The infectious disease specialist had enough experience to suspect botulism, so we hospitalized the patient. But the most interesting part was that the young woman herself remembered visiting a cosmetologist a month earlier only after she overheard our medical discussion near her hospital bed.
Until then, she had never connected the injections in her face with her terrible condition.
And this brings us to the next critical question: how is it treated?
Unfortunately, there are no specific official international protocols or recommendations dedicated specifically to iatrogenic botulism.
In mild cases, we sometimes have to manage patients without administering specific antitoxin. First, because too much time has already passed. Botulinum antitoxin or immunoglobulin is most effective when given within the first 72 hours after symptoms begin, while some patients seek medical attention a month later.
Second, there is a chronic shortage of this antitoxin in the country.
Managing a patient who has been experiencing the effects of the toxin for several weeks can therefore become a very difficult medical challenge.
Iatrogenic botulism is an extremely unpleasant and dangerous condition.
I always emphasize that success in infectious disease medicine depends on synergy: both doctors and patients need to understand the problem deeply.
That is why public health education - something people used to make fun of - is now vitally important. Because of the lack of information, we lose precious time.
People need to understand the risks.
If, after visiting a cosmetologist, you develop unusual and progressively worsening muscle weakness, do not simply blame it on stress, exhaustion, or the consequences of yet another night of shelling.
Of course, who isn’t exhausted these days?
But if you have been going from doctor to doctor for months, receiving treatment at outpatient facilities, and nothing is getting better, tell your doctor about any beauty procedures you have recently had.
The doctor needs to know:
- which clinic you visited;
- whether the specialist had medical training;
- which product was injected;
- and whether that product was properly certified.
Today, our country does not have the level of state oversight of the beauty industry that we would all like to see. That means the risk exists for everyone.
We live in an era when people use Ozempic without proper medical supervision or inject Botox in basements, without asking where the product came from or what qualifications the person performing the procedure has - and without thinking about the possible long-term consequences for their health.
Remember: the human body strives for balance and natural function.
Any rough, unprofessional, or unnecessary artificial intervention places enormous stress on the body, and sooner or later, the body may respond with a serious problem.
Be responsible. Choose only licensed clinics with qualified medical doctors.
And protect your health - and your life.
