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.

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