Some Vancouver-area medical spas are ignoring Health Canada regulations that Botox be prescribed and injected by a physician, a CBC News investigation has revealed.
CBC News went undercover, targeting clinics that advertise Botox Cosmetic without mentioning the name of a doctor to prescribe and inject it.
A CBC producer made an appointment at Queen's Park Laser Skin Care Centre in Richmond, B.C., and was told she would see a doctor.
Eddie Lee, who admitted he is not a doctor despite certificates on the wall bearing the name "Dr. Lee," told the CBC producer he could make her cheeks thinner with six injections of Botox for $450.
"Yes, you need to be a doctor [to inject Botox]," he said. "I'm not a doctor … so is not illegal, and is also not legal either."
Botox, or onabotulinumtoxinA, is made from a neurotoxic protein that in large doses can cause the paralytic illness botulism. It is best known for its cosmetic uses, including its ability to counter the appearance of frown lines between the eyebrows and around the eyes, but is also used to fight chronic migraines and excessive sweating.
'If you know what you're doing, then just do it'
According to Allergan, Inc. — the only worldwide manufacturer of Botox — only a licensed, trained medical professional can administer the injections.
But Health Canada goes further, saying, "As described in the Botox product monograph, Botox should only be prescribed and administered by a physician. If Botox is used in any way other than that described in the product monograph, it would be considered to be a contravention of the Food and Drugs Act."
Lee told CBC News he may not be a medical doctor, but maintained he has been trained to inject Botox.
"I've been to a lot of seminars, I been trained by a few doctors around the world to do Botox," he said. "If you know what you're doing, then just do it."
When asked if he was misrepresenting himself, Lee denied telling patients he was a doctor and said he didn't know anything about staff telling patients they would see a doctor.
When asked if the certificates on his wall claiming he was a doctor were misleading, he said, "I can put anything I want on the walls as long as I am not hurting anybody."
But the College of Physicians and Surgeons in B.C. said the term "doctor" and its abbreviation is reserved for the exclusive use of college registrants.
'Thousands of clients'
At EuroCharm Medical Spa in Vancouver, a CBC reporter was told a doctor would prescribe and inject her with Botox.
Irina Kolesnikova prescribed 68 units of Botox to the reporter, but no Botox was injected because Kolesnikova admitted she was not a licensed physician when questioned.
"I used to be doctor like in the Russia … Here, I'm a naturopath."
When asked if she has injected Botox before, Kolesnikova says, "A lot, a lot. I have thousands of clients."
Kolesnikova refused a request for an interview with CBC News, but said in an email she has "never made statements regarding my education and credentials contrary to the ones published on EuroCharm’s website."
The company's website lists her as a paramedic, doctor of naturopathic medicine, naturotherapist, cosmetologist and esthetician.
However, CBC News learned Kolesnikova is not a licensed naturopath, and naturopaths are not allowed to give Botox injections in B.C.
'Lucky to be able to open my eyes again'
At least one patient complained to the Better Business Bureau after she went to EuroCharm Medical Spa for a brow lift. The patient claims one eyelid collapsed, leaving her eye swollen shut for weeks.
"It's a misapplication of Botox injected too low," said Dr. Lee Thompson, the patient's doctor.
His patient was too embarrassed to go on camera, but told CBC News, "I have no idea what she injected into me. I did not sue because I know how lengthy and unproductive lawsuits can be. I considered myself lucky to be able to open my eyes again. Lesson learned. I had no idea that there were fakes [injections] out there."
Thompson has been trained to prescribe and inject Botox. The patient sought treatment from him following her Botox injection at EuroCharm Medical Spa.
"This lady has used something to treat this patient and it was inappropriate," he said. "I don't know where she would have got it from."
The patient says Kolesnikova broke open glass ampoules prior to the injection, but real Botox comes in a bottle bearing a hologram with the name of the drug company that makes it, in order to distinguish it from the many fakes available online.
In a written statement, Allergan confirmed EuroCharm Medical Spa and Queen's Park Laser do not purchase Botox from them.
"There is always a potential danger," said Thompson.
"There is a good reason why things are approved in Canada, or not approved … There's lots of knock-offs, if you like, that are available around the world. And people use those at their peril."
With no official medical training and no medical licence, Eddie Lee at Queen's Park Laser told CBC News he orders his Botox from pharmacies in Turkey and Mexico.
CBC News asked Allergan to run the serial numbers on Lee's Botox boxes to ensure they are not knock-offs. The company has not yet responded.