By Charnicia E. Huggins

NEW YORK (Reuters Health) - Recent reports of "bogus Botox" injections that resulted in the deaths of several women has prompted the American Society for Dermatologic Surgery (ASDS) to issue a statement warning the public against seeking cosmetic treatments from non-physicians.

"Never have any injections done unless it's in a reputable physician's office, because it's unsafe," Dr. Rhoda Narins, past president of ASDS, told Reuters Health.

"You wouldn't entrust the care of your heart or kidneys to a non-physician, so why should your skin be any different?" she asked in the ASDS statement.

The recent report involved a Salinas, California hairstylist who may face charges of manslaughter for injecting clients with the counterfeit substance. The ingredients of the substance used are still unknown, according to police reports. Furthermore, the hairstylist, who solicited clients from her salon and conducted house calls to perform the procedures, was not medically licensed or trained to do so.

"People are drawn to non-physician offices because of price," said Narins, a private practice dermasurgeon and clinical professor of dermatology at New York University.

Yet, considering the high cost of the FDA-approved Botox versus the non-regulated less expensive alternatives, she said, "if something looks too cheap, it is too cheap."

Injections of the real Botox can also lead to serious health problems -- and fatalities -- if improperly used. Concern about potential dangers from Botox treatment performed by non-licensed professionals is not new, however.

In 2005, Britain moved to impose tougher regulations on the cosmetic surgery industry due to increasing safety concerns, according to a previously published Reuters report. According to those regulations, future Botox injections as well as other cosmetic procedures have to be performed by trained medical staff registered with the government as cosmetic surgery providers.

During the 2000 World Congress in Cosmetic Dermatology, Dr. Edileia Bagatin, from the Federal University of Sao Paulo, warned that inappropriate use of the toxin can result in severe facial paralysis and deformity.

"Getting anything injected into the body is dangerous," Narins said, citing the risk of impurities, infections, and overdose. "It's nice to look great, it's important to look great, but you need to do it without the risk," she added.

To avoid experiencing complications from Botox use, the American Society for Dermatologic Surgery advises potential cosmetic surgery patients to follow a few of the following Dos and Don'ts:

* Do make sure a board-certified physician is on site and immediately available.

* Do check the credentials of the person who will perform the procedure.

* Don't ever go to someone's home or a hotel room to have a cosmetic procedure performed.

* Don't rely on price as the determining factor.

* Don't be afraid to ask questions.

* Don't be afraid to walk away.

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