The U.S. Food and Drug Administration has taken enforcement action against 18 websites illegally marketing unapproved and misbranded botulinum toxin products, commonly known as Botox, citing serious health risks including documented adverse events with botulism symptoms.
The warning letters, issued on November 5, 2025, target online entities selling these injectable drugs without proper authorization. Botulinum toxin products are prescription medications that block nerve activity in muscles, temporarily reducing muscle movement for both cosmetic applications like wrinkle reduction and medical treatments including chronic migraines and muscle stiffness.
Serious Safety Concerns Drive Enforcement Action
"Unapproved and misbranded Botox products carry serious health risks. Today we're taking action to protect American consumers and prevent online entities from selling these dangerous products," said FDA Commissioner Marty Makary, M.D., M.P.H.
The agency emphasizes that FDA-approved botulinum toxin products carry a boxed warning—the FDA's most serious warning designation—indicating significant risk of serious or life-threatening side effects. The boxed warning specifically addresses the potential for botulism symptoms, which attack the body's nerves and cause muscle weakness that can progress to difficulty breathing and even death.
Authorized vs. Unauthorized Sources
Several FDA-approved botulinum toxin products, including Botox, are available only through prescription from licensed healthcare professionals. The agency stresses that patients should ensure they receive these products exclusively from providers who are licensed and trained to administer such injections, using products obtained from authorized sources.
Products purchased from unauthorized sources present multiple risks, as they may be unapproved, misbranded, adulterated, counterfeit, contaminated, improperly stored and transported, ineffective, or unsafe. The FDA has documented adverse events associated with these unauthorized products, including symptoms consistent with botulism.
Targeted Websites and Safety Recommendations
The FDA issued warning letters to 18 specific websites, including acecosm.com, aesthetic-essentials.com, celestapro.com, cosmenic.net, cosmo-korea.com, derma-solution.com, dermaxshop.com, ellepharm.com, estaderma.com, filleroutlet.com, glamderma.com, glowface.store, glownestbeauty.com, koreafillerexperts.com, koreanfillers.com, maypharm.net, meamoshop.com, and mjsmedicals.com.
The agency advises patients to seek immediate medical care if they experience symptoms of botulism, including trouble swallowing or breathing, after receiving a botulinum toxin product injection. Healthcare professionals and consumers are encouraged to report adverse events through the FDA's MedWatch Safety Information and Adverse Event Reporting Program.
