Just like we’ve come to casually call all tissues “Kleenex” and every lip balm “ChapStick,” the brand name “Botox” has become the catch-all term for botulinum type A, the injectable neuromodulator known for relaxing wrinkles. If you read Allure regularly, you probably already know that there are numerous FDA-approved iterations of the stuff— Botox, of course, plus Dysport, Xeomin, Jeuveau, Daxxify, and Letybo—which you’ll find in the kits of qualified injectors like dermatologists and plastic surgeons. No other neurotoxin brands have been reviewed or approved by the U.S. Food & Drug Administration, and some questionable companies are counting on patients and unqualified injectors not knowing this—or worse, not caring.
On November 5, 2025, the FDA issued warning letters to more than a dozen companies for “[introducing] into interstate commerce unapproved and misbranded injectable botulinum toxin drug products.” In other words, these companies—most of which are based in Korea but also include businesses in America, China, and Panama—are accused of selling injectable formulas that purport to be botulinum type A. These brands have names like Liztox, Toxsta, Botulax, and Wutox, none of which are FDA-approved.
Funny as you might find those names, the experts aren’t laughing. “Botulinum toxin type A is a powerful neurotoxin, and without controlled studies on diffusion, dosing, and systemic effects, unapproved versions can be harmful,” says Palm Beach-based board-certified dermatologist Leslie Baumann, MD. That harm, according to Connecticut-based board-certified dermatologist Mona Gohara, MD, can include infection, facial drooping, and even paralysis.
And the substances in question might not even be botulinum toxin at all. “They should be treated as mystery liquids,” says cosmetic chemist Kelly Dobos. “It’s well known that these types of products are drugs and have a known degree of risk, so it’s rather unscrupulous for companies to be marketing these products in this way.”
How the hell could “mystery liquids” end up in patients’ faces? As Dr. Baumann explains, only licensed doctors, physician assistants, nurse practitioners, and registered nurses are allowed to buy FDA-approved injectable treatments, which they purchase directly from manufacturers and distributors that are also approved by the FDA (plus, they usually have to complete training specific to the brand of neuromodulator they’re administering). Dobos says it’s unlikely that any reputable, medically supervised facility would be using products like the ones the FDA sent warning letters about. It’s more likely, she adds, that they’d be used for what she calls “backroom Botox” procedures happening in salons, boutiques, or even in people’s private homes.