How Counterfeit Products are Stripping Trust from the Aesthetics Industry
Antonia Mariconda, founder of The Safety in Beauty Organisation, investigates how counterfeit aesthetic products are threatening consumer safety and the industry's reputation. From fake injectables to unregulated weight-loss treatments, she explores the growing crisis and the urgent steps brands and regulators are taking to restore trust.
The aesthetics industry is booming, driven by innovative treatments that promise to enhance natural beauty and improve overall well-being. Globally valued at £73.8 billion [1] and worth £3.2 billion[2] in the UK alone, there are many trusted brands and treatments ranging from devices and regenerative injectables to dermal fillers and weight loss solutions.
However, with the rise in demand comes a dark side – counterfeit products and devices infiltrating the market.
The surge in fake aesthetic products jeopardises not only consumer safety but also the credibility and reputations of legitimate brands and manufacturers. As counterfeits become more sophisticated, the industry faces an uphill battle to protect its reputation and ensure consumer trust.
The counterfeit crisis
It is estimated that 41.1% of practitioners have encountered counterfeits, and 39.7% have experienced patients with adverse events from them.[3]
The counterfeit problem in the aesthetic sector spans a range of products, from fake dermal fillers to unauthorised weight-loss injections.
These imitations often bypass regulated supply chains, finding their way to unsuspecting consumers through online platforms and unauthorised wholesalers.
The World Health Organisation (WHO) set up the International Medical Products Anti-Counterfeiting Taskforce (IMPACT) in 2006 to raise national governments’ awareness of medicine and medical device counterfeiting and to call for improvements to the legislation.[4,5] They believe counterfeit products represent about 10% of total market sales in some regions.[6]
In 2020, medicines ranked as the seventh most frequently seized product at the EU’s external border. Authorities observed that criminals mainly use postal and parcel services to distribute counterfeit pharmaceutical products, which are primarily sold online.[5,7]
As part of ‘Operation Pangea’, coordinated globally by Interpol each year to tackle the illegal online sale of medicines and medical devices, the UK’s Medicines and Healthcare Products Regulatory Agency (MHRA) reported that more than 113,000 illegally operating websites and fake online pharmacies were shut down globally, 43 of which were in the UK.[5,8]
Additionally, in 2023, the MHRA was involved in a joint operation with Greater Manchester Police where raids on commercial and residential premises in Bolton and Wigan seized unlicensed botulinum toxins and dermal filler products from an authorised beauty supplier.[5,9] While in 2024, thousands of pounds worth of unlicensed and un-prescribed products used in cosmetic injections were seized from a Glasgow warehouse.[10]
Counterfeit weight loss injections
The growing popularity of weight loss injections, including GLP-1 agonists, has also spurred a black market of dangerous counterfeit products.
One example of counterfeit-related damage is the recent proliferation of fake versions of Ozempic. The MHRA in the UK seized batches of counterfeit pens falsely labelled as Ozempic in 2023, raising alarms about patient safety.[11, 12, 13]
In addition, the MHRA took down 150 social media posts “actively” selling counterfeit weight loss drugs in 2024.[14]
Counterfeiters' strategies have evolved to mimic not only the packaging but also the performance of original products. The risks associated with these products are severe, ranging from allergic reactions and infections to long-term health complications and even death.
Case study: Lemon Bottle fat-dissolving injections
Lemon Bottle, a brand distributed by the South Korean aesthetic cosmetics manufacturer SID Medicos, has been widely talked about in the sector since it burst onto the scene. After shooting to popularity, encouraged by fans taking to platforms like TikTok, the Lemon Bottle story is an example of the significant impact counterfeits can have on brands.
The fat-dissolving injections gained popularity due to their scientifically backed ingredients, such as bromelain (derived from pineapple) and lecithin (a natural emulsifier in the body), which promote fat reduction with minimal side effects. Its success drew praise from experts like Dr Vahe Karimyan, a surgeon at King’s College Hospital NHS and visiting lecturer at Imperial College London, who remarked,
“I have been using Lemon Bottle in my clinic for over two years now. It was introduced as part of our treatment options when we recognised its potential based on its natural, scientifically supported ingredients.
Lemon Bottle stands out because it does not contain phosphatidylcholine (PC) or deoxycholic acid (DC), which are known for triggering significant inflammation and discomfort in traditional fat-dissolving products. Instead, its all-natural ingredients deliver superior results without inflammatory responses, offering both effective fat reduction and firming effects. This combination makes it gentler yet more powerful than other products.
“The consistent positive feedback and results observed in patients since its introduction have further validated our decision to incorporate it into our range of aesthetic treatments.”
Unfortunately, counterfeit versions of Lemon Bottle began circulating, causing some confusion in the market. The situation escalated when Swissmedic, a regulatory authority in Switzerland, tested counterfeit samples, mistaking them for authentic products and issued a warning labelling the treatment as unsafe.[15,16] The fallout was immediate, with global media coverage damaging the product’s reputation. SID Medicos complained to Swissmedic that testing could have only included counterfeits, which Swissmedic has now acknowledged, but the harm to Lemon Bottle’s credibility was already done.[17,18,19,20,21,22] SID Medicos has since turned to the courts in Switzerland to help further clear up the matter. This case highlights the alarming sophistication of counterfeiters, whose products can deceive even trained professionals.
Genuine Lemon Bottle products feature a QR code sticker on the packaging that can be scanned to verify the product’s authenticity and should only be purchased from Lemon Bottle authorised suppliers and pharmacy chains.
Dr Karimyan emphasised, “Counterfeit products and devices have been a real issue within the industry for years, with falsified versions of products such as botox and dermal fillers infiltrating the market. These pose a risk to patients’ safety as the ingredients in them can never be guaranteed and often vary significantly, sometimes containing harmful substances. At the very least, the treatment the consumer is paying for will be less effective.
“The claims made by Swissmedic do not reflect the true formulation or performance of Lemon Bottle, as their findings were based on counterfeit products. SID Medicos, the company behind Lemon Bottle, has already identified the counterfeit batch codes in Swissmedic’s test report, a fact that Swissmedic has also acknowledged. Legal proceedings are currently underway to have the publication retracted and ensure transparency.
“As a practitioner, I’ve seen excellent outcomes with Lemon Bottle in my practice. Its natural, scientifically developed formula ensures safe and effective results without inflammatory agents like deoxycholic acid. I encourage clinics to trust the observed results and the trust Lemon Bottle has built amongst professionals who have seen the results first-hand, which speaks volumes.”
Case study: Hydrafacial’s Verified Provider Programme
Hydrafacial, a leader in advanced skincare, has faced its own counterfeit challenges.
According to Laurine Berard, marketing director for Hydrafacial UK & Ireland, “Across the UK, it's estimated that over 30% of clinics and providers claiming to offer Hydrafacial are infringing on the brand name. These services often use imitation devices that haven't undergone the same rigorous regulatory processes as Hydrafacial. They lack the brand’s efficacious serums, patented specialty tips, and unique boosters that ensure a personalised treatment.”
To combat this, Hydrafacial launched its Verified Provider Programme, which certifies clinics offering authentic treatments. This initiative protects both providers and consumers, ensuring that only genuine products are used.
To be involved, providers must meet strict criteria, not only performing Hydrafacial treatments with an authorised device but also offering Hydrafacial personalisation with add-on boosters, a key differentiator for the brand. In addition, they must follow official Hydrafacial treatment protocols and be up to date in their training.
Consumers can look for the blue tick badge in clinic and online and visit the Find a Provider [23] page to ensure they are booking a certified Hydrafacial treatment. Alongside this, Hydrafacial is heavily investing in marketing and legal actions to protect its brand, ensure patient safety, and support its authentic, trade-only providers.
Berard added, “ If you don't see the Hydrafacial branding on the device or serums, you may not be getting the authentic experience. Our efforts are focused on recognising and protecting the loyal Hydrafacial providers, as well as safeguarding our consumers who love Hydrafacial.”
The “grey market”
The grey market also presents a significant challenge by offering medical products through unofficial or unauthorised channels, often at a seemingly attractive lower cost.
Unlike counterfeit products, which are fabricated to mimic genuine items, grey market goods typically consist of authentic items that have been improperly sourced, discarded, or rerouted outside of official supply chains.
These goods often bypass critical quality control measures and regulatory standards, leading to potential risks for both practitioners and patients. For instance, products obtained through grey market suppliers may lack proper storage conditions, such as temperature control, which can compromise their effectiveness and safety. Additionally, grey market suppliers frequently fail to provide essential documentation, such as certificates of authenticity or batch tracking, making it nearly impossible to verify product integrity.
Engaging with the grey market not only jeopardises patient safety but also exposes practitioners to legal and ethical consequences while undermining the trust and accountability essential to the aesthetics industry. This lack of accountability also increases the risk of counterfeit products entering the market unnoticed.
Recognised distributors, on the other hand, ensure that products meet safety standards, provide traceability, and offer post-sale support, making them the reliable choice for maintaining professional integrity and patient confidence.
Spotting and avoiding counterfeits
Counterfeits harm the entire aesthetics ecosystem, from manufacturers and distributors to clinics and consumers. While they are becoming harder to detect, there are several red flags practitioners and consumers can watch for:
Cheaper products: Fake or counterfeit products may be sold at a cheaper price than authentic versions. Look out for highly discounted prices.
Check packaging: Authentic products often include holographic seals, batch numbers, and QR codes for traceability.
Verify the source: Purchase only from authorised distributors or manufacturers’ official channels.
Inspect product details: Ensure instructions, patient information leaflets, and regulatory markings (e.g., CE or UKCA) are intact and legible.
Inconsistent branding: You may be able to spot inconsistencies in branding or even spelling on the packaging of fake products.
POMs being sold without prescriptions: Prescription medications, including weight loss meditations and botulinum toxin, should not be sold directly to consumers online or without a consultation with a prescriber.
The economic and legal costs of counterfeits
Counterfeit products undermine the economic stability of the aesthetic industry, affecting manufacturers, distributors, clinics and ultimately patients.
Additionally, using counterfeit products can invalidate insurance policies. Practitioners who unknowingly use fakes may face lawsuits, financial losses, and damage to their professional reputations. The MHRA advises reporting counterfeit products via the Yellow Card Scheme, which helps track and mitigate the risks posed by illegal goods.
Fighting back
To address the growing counterfeit crisis, aesthetic brands and regulatory bodies have implemented several initiatives:
Authentication technology: Companies like Teoxane and IBSA Derma have incorporated holographic seals, QR codes, and LOT numbers into their packaging. Genuine Lemon Bottle products have a QR code sticker on the packaging that can be scanned to verify the product’s authenticity. These features enable real-time verification and ensure traceability across the supply chain.
Regulatory collaboration: Global efforts, such as Interpol’s annual Operation Pangea, have shut down thousands of illegal websites and seized millions of counterfeit products.
Industry collaboration: Manufacturers, clinics, and regulatory bodies need to work together, sharing information to identify and eliminate counterfeit operations.
Educational campaigns: Brands like Hydrafacial are investing in consumer education, teaching patients how to recognise authentic treatments and avoid scams.
Provider certification: Programmes like Hydrafacial’s Verified Provider initiative offer a blueprint for ensuring safety and authenticity.
Strengthen regulations: Governments and regulatory bodies must crack down on counterfeiters and enforce stricter penalties.
Dr Karimyan comments, “Counterfeit products are a problem that requires everyone in the industry to work together to address, and clinics can play an important role in preventing counterfeits from reaching patients. My advice to practitioners is to only ever purchase products from licensed pharmacies or certified suppliers. Being stringent by carrying out due diligence checks on stock received can also help ensure the integrity of the products being used in treatments. Many manufacturers will have a process in place so the authenticity of the product can be checked, such as batch numbers.
“Manufacturers can also play their part by ensuring that their packaging is as secure as possible. Additionally, transparent labelling and marketing regulations can play an essential role in preventing misleading claims and help to guide the safe use of these products.”
A shared responsibility
The battle against counterfeit aesthetic products is far from over. From protecting consumers to preserving the reputations of trusted brands, the industry must act decisively.
As Dr Karimyan noted, “By staying informed and prioritising evidence-based practices, we can confidently provide innovative treatments while protecting the integrity of our field.”
Ultimately, the success of this effort depends on collaboration. Manufacturers, clinics, regulators, and consumers must work together to combat counterfeits, ensuring the aesthetic industry continues to thrive with safety at its core.
