The MHRA’s latest alert warned about the dangers of unlicensed and counterfeit botulinum toxin products. “We also strongly urge the public to avoid unlicensed products and seek treatment only from appropriately qualified practitioners,” Cave said.

The agency said that products obtained outside regulated supply chains “do not meet UK safety and quality standards and can significantly increase the risk of serious side effects”. The agency also said that anyone considering treatment should ensure their practitioner is appropriately qualified, and confirm that the product being used is authorised for UK use.

The MHRA said it had worked with manufacturers to update product information, including patient leaflets, so that the risk of iatrogenic botulism is more clearly highlighted. It urged the public to report suspected side effects through the MHRA’s Yellow Card scheme.