The American Academy of Dermatology (AAD) Association has released a statement warning patients of counterfeit or mishandled botulinum toxin (Botox) injectables. The U.S. Centers for Disease Control and Prevention (CDC) revealed that it is currently working with the U.S. Food and Drug Administration as well as state and local health departments to investigate cases of adverse reactions. The CDC explained that many of these counterfeit products did not have verified sources and were administered by unlicensed and untrained individuals in non–health-care settings. Across at least nine states, patient reports have detailed severe complications from the counterfeit injections, including blurry or double vision, drooping eyelids, visual impairment, blindness, difficulty swallowing, dry mouth, slurred speech, difficulty breathing, fatigue, generalized weakness, infections, diseases resembling botulism, and strokes. Further, 55% of the patients who had reactions to the counterfeit injectables were hospitalized. As a result, the AAD Association has cautioned patients considering Botox to ensure that injection procedures are being performed by board-certified dermatologists or appropriately trained nonphysician clinicians under the supervision of board-certified dermatologists in medical offices. Patients may also be able to search online for their provider’s license to administer the injectables. Health-care providers were advised to communicate the potential side effects of Botox to their patients prior to administration, and those who suspect their patients may be experiencing systemic botulism should immediately contact their state health departments or the CDC’s clinical botulism service.