Three women suffered transient neurological symptoms, including muscle weakness and blurred vision, after receiving unapproved botulinum neurotoxin injections at a Colorado medical spa. A joint investigation by the CDC and the Colorado Department of Public Health and Environment revealed the online-purchased product lacked FDA approval and was subject to improper storage and single-dose vial reuse. Authorities issued a stop-use order and filed a formal regulatory complaint against the facility's license.
Patient cases and adverse symptoms
- ▪Reported symptoms among the three women included numbness, tingling, muscle weakness, dysphonia, blurred vision, and neck stiffness, with none requiring hospitalization.
- ▪The three affected patients received injections in the upper brow, glabella, or upper lip from the same lot of unapproved botulinum toxin within one day of each other.
- ▪Three women experienced transient neurological symptoms after receiving unapproved cosmetic botulinum neurotoxin injections at a Colorado medical spa.
Unapproved product and online sourcing
- ▪The licensed provider at the Colorado medical spa purchased the unapproved botulinum neurotoxin product through an online supplier.
- ▪The administered botulinum neurotoxin product was approved for cosmetic use in other countries but was not approved by the FDA in the United States.
- ▪In 2025, the FDA issued formal warnings to 18 websites selling unapproved botulinum toxin products.
Investigation of spa procedural errors
- ▪An investigation revealed procedural errors at the Colorado medical spa, including improper diluent use, single-dose vial reuse, inadequate temperature monitoring, and expired product storage.
- ▪Public health investigators concluded potential causes for the adverse reactions included unknown product concentration, contamination, improper preparation, and faulty storage or administration.
Public health response and enforcement
- ▪The Colorado Department of Public Health and Environment issued a text survey to 52 patients treated between December 2025 and January 2026, uncovering two additional symptomatic cases.
- ▪Public health authorities issued a stop-use order against the Colorado medical spa and filed a formal regulatory complaint with the Colorado Department of Regulatory Agencies.
- ▪Rocky Mountain Poison and Drug Safety alerted public health authorities in January 2026 after a woman reported symptoms consistent with botulinum neurotoxin adverse effects.
Expert advice for consumers
- ▪CDC officer Pallavi Oruganti advised that individuals seek cosmetic botulinum toxin treatments only from licensed providers who administer FDA-approved products sourced from authorized distributors.
- ▪Dermatologist Anthony Rossi advised patients to verify injector credentials, confirm FDA approval of neurotoxins, and avoid choosing cosmetic injection facilities based solely on discounted prices.
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