DIY Botox: Site Offers Injectable Drug Without Prescription — With How-To Video

A website that sells a prescription drug similar to Botox without requiring a prescription claims it has more than 2,000 customers. Some have learned how to inject the botulism-derived drug into their own faces from YouTube videos produced for the site.

Discountmedspa sells a variety of other DIY cosmetic treatments, including prescription Renova, and lip-filling gels. The botulinum toxin-derivative for sale on the site is Dysport, produced by the pharmaceutical company Ipsen and is a competitor of Allergan’s Botox. The site simply calls it “the Freeze.”

A Grand Prairie, Texas, woman, Laurie D’Alleva, who appears to be the site’s proprietor, performs treatments on herself in self-made videos posted to the site’s YouTube channel. In one video, D’Alleva pulls out a vial of what is presumably Dysport and a syringe filled with saline.

“It’s important to remember that you are mixing the potency of the botox,” she says, mixing the contents of the vial with the saline solution. She then injects her forehead and the areas around her eyes.

Ipsen received FDA clearance to sell Dysport in the United States a few months ago, but it’s a prescription medication. It’s the first direct competitor for the branded Botox, which is the most popular cosmetic treatment in America. Doctors did more than 2.4 million Botox procedures in 2008, according to the American Society for Aesthetic Plastic Surgery. In recent years, the vast amounts of money spent on the treatment have attracted scams and knockoffs, which the FDA has had to crack down on. In May, the FDA also ruled the drug needed a tougher “black-box” warning label to reflect an increased understanding of the small, but real risks of the treatment.

In the U.S., it is illegal for anyone but a doctor or nurse practitioner to prescribe drugs to patients and only pharmacists can dispense drugs to people. Yet drug sellers on the internet routinely flout the FDA’s regulations. A review published last month in the Annals of Family Medicine found more than 130 websites offering antibiotics without a prescription. The National Association of Boards of Pharmacy tracks thousands of sites that don’t meet its standards for brick-and-mortar shops. LegitScript, a private firm that works with the NABP, has database of 47,633 internet pharmacies; 46,570 of them aren’t up to snuff.

These sites are brazenly circumventing regulations that protect consumers from bad or fake drugs and ensure that the chemicals are used correctly. The laws were designed precisely to prevent Americans with little to no medical training from doing things like buying a form of toxin, mixing it with saline and injecting it into their faces. Yet, precisely that appears to be possible with the help of discountmedspa.com.

Wired.com was able to complete the ordering process on discountmedspa.com for the Freeze without being asked for a prescription. In fact, the word, “prescription” does not appear anywhere on the website.

The domain’s registration details are private, but medspacanada.com, which refers back to discountmedspa.com, is registered to Cristie Stone, with the same phone number and e-mail address listed on discountmedspa’s website. The physical address listed for medspacanada.com is the home of the Manitoba Society of Pharmacists, which has no record of Stone.

“Not only is Christie [sic] Stone not a member or the Society, I can honestly say that I have never heard her name before,” wrote Jill Ell, executive director of the society, in an e-mail to Wired.com.

Wired.com was unable to track down any trace of Stone anywhere, but did discover that D’Alleva’s maiden name is Stone.

Wired.com reached D’Alleva’s assistant, but had not heard back from D’Alleva at publication time.

The discountmedspa.com blog administrator, presumably D’Alleva posting under the handle Botox Queen, provided an explanation from a purported “long-time customer,” Tamara Lesley, explaining how the site is able to offer a prescription product.

“Laurie belongs to the Texas Medical Council and is licensed to sell these products to the women that want to use them and understand that it is their responsibility to use them safely,” she wrote.

Wired Science could not find an organization called the Texas Medical Council. It does not maintain a website and has not been mentioned in the press. A representative for the Texas Department of State Health Services had never heard of it.

Barry DiBernardo, a plastic surgeon from Mont Clair, New Jersey, had not heard of people home-administering Botox or Dysport, but did not think it was a good idea.

“I’m not aware of that,” DiBernardo said. “You need to know where the muscles are, the depth, the dosage. That doesn’t seem good.”

Short of buying and testing it, there is no way to verify that the product sold on the site is the genuine article, but the site swears by it — and the legality of its practices.

In a blog post response to a customer’s skeptical query, Laurie provided the following explanation for the legality of her site and the provenance of her products.

I know there is much information out on the net about fillers and Botox ‘knock-offs’. This is not what I am selling! The products I have are from a company names Ipsen… I have a connection that allows me to get products that are not usually available in the states because I purchase other products in their line. Now the trick is I have to market it and label it under my own brand, to keep them and myself from getting into any legal trouble. It does take a leap of faith, but I assure you I have over 2000 customers now who love the products and are saving literally hundreds of thousands of dollars between us!

It’s unclear how D’Alleva obtains the drugs and then resells them. Ipsen did not immediately respond to a request for comment from Wired.com.

Ipsen also sells Dysport in Mexico, so it’s possible the drugs are purchased there and illegally imported into the U.S.

“If it’s prescription-only, it doesn’t matter whether it’s over the counter in Mexico or not,” said Carmen Catizone, executive director of the National Association of Boards of Pharmacy. “Offering a prescription drug without a prescription is illegal any way you phrase it.”

Catizone also cautioned that the drugs might not actually be real, though his organization had picked up some buzz about purchasing Botox and its competitors without a prescription.

“Sometimes, if the site offers Botox, they may not really be selling Botox,” Catizone said.

Users of the site, though, testify to a variety of experiences with the drugs that seem to indicate that the Freeze is actually a botulinum toxin-derivative, as discountmedspa.com’s proprietor claims. If the site’s comments are a con — it’s a very elaborate one.

In comments on the discountmedspa blog, users testify to watching YouTube videos of doctors doing Botox injections to learn techniques for making themselves look the way they want. Dozens of cosmetic surgeons show off their Botox procedures in videos made to promote their services.

Lesley offered a helpful hint on how to inject the Freeze to make the corners of the mouth turn up so you appear to be always smiling.

“I watched a Doctor on YouTube.com do this to a patient and he warned people not to inject below the eyes however I had to put a smile on my face too,” Lesley commented on a blog post. “The trick to this is to hold a pencil just at the corner of one side of your mouth and inject two units of Freeze at the very bottom of your chin. This will cause your [sic] very end of your mouth to turn up. Then do the other side the same way. If you don’t get it even you may have a crooked smile so be very careful that the injection is placed in exactly the same place as the other side.”

Her recommendation for another user is to “watch YouTube.com and you will learn a lot of some of the Doctors [sic] secrets to recreating your face the way you want to look.”

Other women describe mishaps with over-injecting the drug.

“My Dr. would never inject the crows feet. I did and got GREAT results!” wrote a commenter named Pat. “Unfortunately, I can’t read those little hash marks on the syringe too well and over injected above the brow on one side. A week later I’m now sporting a half closed and swollen eye, and look ready for Halloween!”

In January, Wired.com reported on other similar websites that sell Melanotan, a tanning drug that has not been approved by the FDA, which has cracked down on the drug’s manufacturers and distributors.

In response to queries from Wired.com, the Texas Department of State Health Services released the following statement, but would not comment further.

“The Texas Department of State Health Services is aware of discountmedspa.com through a complaint we received. That complaint status remains open and under review,” the agency wrote.

The complaint was made under the Texas Food, Drug and Cosmetic Act, which regulates the sale of prescription drugs like Dysport in the state.

“Botox is a prescription drug that must be dispensed or sold by a licensee pharmacy and only with a prescription from a licensed practitioner. Any over-the-counter sale of Botox is illegal,” the agency affirmed.

The Food and Drug Administration did not immediately respond to a request for comment about the illegal sale of Dysport, but asked Wired.com for the web address of the offending site.

By Alexis Madrigal for Wired  October 27, 2009

Original article with DIY Botox video can be viewed at http://www.wired.com/wiredscience/2009/10/botox-without-prescription/