‘Brotox’ and ‘slimming injections’: Thousands of illegal ads spruik cosmetic injectables

Thousands of ads spruiking Botox and dermal fillers have breached Australia’s health advertising laws, a revelation that comes as the medicines watchdog urges people to come forward if they have experienced complications from cosmetic injectables.

Advertising regulations prohibit the use of terms such as wrinkle-reducing injections, dermal fillers or colloquial names such as “tox” or “Brotox” (Botox treatment targeted at men) that could be seen to be promoting prescription-only medicines or substances.

Cosmetic industry researchers Michael Fraser and Maddison Johnstone from Operation Redress.Credit: Paul Harris

It is also illegal for websites promoting cosmetic injectables to publish the price of treatments.

Reporting by this masthead over the past two days has exposed concerns about patient safety within the booming injectables industry, with some doctors issuing scripts via telehealth in consultations that sometimes last under one minute.

The Australian Health Practitioner Regulation Agency said it was hard to see how a consultation of that length met its guidelines.

The revelations prompted the federal opposition to call on Health Minister Mark Butler to immediately establish a telehealth oversight group to improve governance of the booming sector.

Rules around advertising cosmetic injectables have been in place for many years, but the Therapeutic Goods Administration tightened them further last March. Despite this, the laws are being largely ignored, according to an upcoming report by industry researchers Operation Redress.

The researchers’ preliminary findings show “close to 100 per cent non-compliance across 100 cosmetic injector websites to certain TGA rules”.

Some providers were advertising prices for “slimming” Botox, “tox” or injections for the calves or shoulders.

Federal opposition health spokeswoman Anne Ruston accused the Albanese government of “turning a blind eye to enforcing its own rules” when it came to advertising of cosmetic injectables.

“Anthony Albanese and his health minister must explain why they are once again refusing to act on this issue to protect Australians,” she said.

A TGA spokesman said that last financial year it had requested the removal of more than 2000 unlawful cosmetic injectables advertisements. More than 95 per cent of these problematic ads had been removed from various digital platforms, the spokesman said.

“We have taken, and will continue to take, strong enforcement actions to address alleged unlawful advertising.”

In extreme cases, the watchdog has powers to block websites that unlawfully advertise cosmetic injectables.

In the six months to January 1 this year, the authority used its powers to block over 150 websites containing unlawful advertisements for various therapeutic goods. These therapeutic goods may include cosmetic injectables, the spokesman said.

No prosecutions were undertaken by the TGA in 2024, although it did send warning letters to businesses offering cosmetic injectables.

“Most of these [came] into voluntary compliance,” the TGA spokesman said.

As well as receiving reports about unlawful advertising, the TGA also receives reports about suspected side effects or adverse events related to therapeutic goods such as cosmetic injections.

“Anyone can report problems experienced as a result of a cosmetic injection, and they are encouraged to,” a spokesman said. “Monitoring and investigating reports of adverse events is an important role of the TGA to help to build a detailed profile of the safety of therapeutic products.”

A simple Google search on Australian websites of “cosmetic injectables” – a term prohibited in advertising – yields thousands of results.

Researchers Michael Fraser and Maddison Johnstone from Operation Redress, which has long examined the cosmetic procedures industry, argue that the TGA’s advertising enforcement is minimal compared with the scale of violations on social media and beauty clinic websites.

“We have been observing and analysing the injectables industry for years and are still waiting for a proactive regulatory response to the advertising of injectable medicines,” Fraser said. “The TGA has oversight of strict rules regarding the way injectable medicines are advertised, and yet it is not difficult to find many blatant breaches.”

He said the regulator had strong powers but had waited too long for the industry to voluntarily comply with advertising laws. “Injectors feel emboldened by a lack of visible action after the TGA was vocal about what is required under the law.”

Johnstone said patients seeking cosmetic procedures were “deciding which medicine is right for them based on unrealistic expectations promoted by injectors on social media”.

“These injectors promise anti-ageing, magical and youthful results while downplaying risks and making these medicines seem fun and safe,” she said.

“We have even observed injectors openly mocking the TGA rules, disregarding the purpose of protecting patients. This is an industry that does not respect regulations.”

Johnstone said injectors who stuck to the rules in their advertising felt less competitive. “Injectors who are willing to bend the rules are rewarded with more business.”

Federal Health Minister Mark Butler said that “cosmetic cowboys had been riding unchecked for years”, and that Labor had been shocked when it came to power federally in 2022 by “an industry that had come to resemble the Wild West”.

“Australians deserve to have confidence in the safety and quality of the cosmetic procedures industry and the changes that our government made will provide that confidence,” Butler said.

“Detecting and disrupting unlawful supply and advertising of unapproved and high-risk medicines and medical devices used in the wellness and beauty industries, including cosmetic injectables, is a priority for the TGA.”

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