The Massachusetts Department of Public Health is investigating four suspected cases of botulism potentially tied to Botox injections administered on the South Shore, raising public health concerns about unlicensed or improperly handled cosmetic procedures.

In a release on Thursday, the DPH warned healthcare providers to watch for signs of botulism following Botox injections, as iatrogenic botulism, though rare, is a serious potential complication of botulinum toxin products.

Botox is widely used for cosmetic purposes to reduce wrinkles and fine lines. While safe when administered by trained professionals, improper dosing, administration technique, or use of non-FDA-approved products can increase the risk of systemic botulism symptoms.

Initial botulism symptoms may include double or bl

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