The Hong Kong Centre for Health Protection (CHP) of the Department of Health (DH) is today investigating a probable case of botulism after receiving injections of botulinum toxin locally, and again urged the public that such injections should only be prescribed and performed by registered doctors.


The female patient, aged 33 with underlying illness, has developed blurred vision, dizziness, generalized weakness and shortness of breath since July 16. She attended Caritas Medical Centre and was admitted on July 31 for management. She was found to have muscle weakness over her limbs, drooping of her left eyelid and facial muscle weakness upon admission.

The clinical diagnosis was suspected iatrogenic botulism and she has been in stable condition.

Initial inquiries revealed that the patient had received botulinum toxin injections at both calves in a beauty premises in Tsim Sha Tsui on July 12. According to the patient, the injections were given by a doctor.

“While investigations are ongoing, anyone who develops compatible symptoms following botulinum toxin injections is urged to seek medical attention immediately for prompt diagnosis and management,” a spokesman for the CHP said.

“When botulinum toxin is used for cosmetic purposes, its cosmetic effects after injections are temporary and will gradually disappear. If referred to a doctor for the procedure, customers should look for his or her full name against the list of registered doctors of the Medical Council of Hong Kong as well as his or her professional qualifications and relevant experience,” the spokesman added.

Due to the weakening of associated muscles and the fact that botulinum toxin may spread and affect other areas beyond the injection site, affected patients may have drooping of the eyelids, double vision or blurred vision, problems with chewing, hoarseness or even difficulties in swallowing, speaking or breathing, which may happen in hours, days or weeks after the injection.

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The DH urged the public to observe the health advice below before receiving botulinum toxin injections:

  • Injections should only be performed by locally registered doctors;
  • Understand the procedure, potential risks and complications before receiving injections. Consult a doctor for an informed decision;
  • Do not receive an injection in case of history of allergy to botulinum toxin, or infection or inflammation on the injection site;
  • Request the full name of the doctor in writing if referred by a beauty service provider for the procedure, as well as the professional qualifications and relevant experience; and
  • If symptoms develop, such as fever or feeling unwell, seek medical attention immediately.


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