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關注使用肉毒桿菌素進行美容療程

本會關注近日有市民注射肉毒桿菌素後產生不良反應，需入院接受治療。近年來，注射肉毒桿菌素作美容用途大為流行，不少人會用它消除皺紋、瘦臉、小腿塑型、除狐臭等。但市民必須清楚了解注射肉毒桿菌素的潛在副作用和風險，並應徵詢醫生的意見，判断是否適合注射，否則可能未達個人期望之餘，亦可能造成身體上的損害。

肉毒桿菌素是一種天然、經高科技純化的蛋白質，能抑制神經肌肉間之傳導，使過度收縮的肌肉舒緩。初期用於改善眼瞼痙攣和斜視，其後廣泛應用在不同的醫學治療上，例如：頸部肌張力障礙、賁門失弛緩症、腦癱、多汗症、痙攣等等。

漸漸地，肉毒桿菌素亦應用於非醫學用途，如美容塑身。但一如其他藥物及治療，使用肉毒桿菌素有一定的潛在風險。副作用包括眼皮或眉毛下垂、局部疼痛、發炎、感覺錯亂、感覺遲鈍、觸痛、浮腫、紅斑、局部感染、出血或瘀傷等。若劑量、位置掌握得不準確，甚至會影響咀嚼、吞嚥、說話或呼吸。肉毒桿菌毒素亦可能擴散，影響注射部位以外的其他範圍，引致聲音沙啞、眼瞼下垂、重影或視力模糊等。嚴重者甚至會死亡。

坊間的美容療程五花八門，不少涉及高風程序。政府已於二零一三年月十一月按區分醫療程序和美容服務工作小組的建議，推出指引。當中列明，一切涉及注射的程序，包括以針刺穿皮膚，或用氣壓槍以無針方式注射化學物質或藥物，只應由註冊醫生施行。另外肉毒桿菌素屬受管制藥物，需要由註冊西醫處方使用。任何不合資格人士使用有關藥品即屬無牌行醫。雖然指引有一定阻嚇性，但長遠應盡快就規管入侵性醫療程序立法，減少同類醫療事故發生，保障市民健康。

醫學會呼籲香港市民：

• 徵詢醫生的意見決定是否適合注射；
• 在注射肉毒桿菌毒素前，應先了解效果、程序、潛在風險和可能出現的併發症。；
• 如到香港以外地區接受注射，須確認人員合資格或已向相關當局註冊執業；
• 須了解肉毒桿菌毒素是不是管理局批准的產品，不能只以價錢高低作考慮
• 如在注射肉毒桿菌毒素後出現不適，應立即求醫。

二零一六年六月五日

編輯備忘：

香港醫學會成立於一九二零年，旨在聯繫政府、各公立醫療機構、大學及私人執業的醫務工作者，交流意見，團結一心。醫學會致力將最新的醫療資訊及醫務發展傳遞與會員，提倡會員遵行專業操守，進而服務社會，維護民康。

PRESS

RELEASE

5 June 2016

Concern for botulinum toxin jabs for beauty procedures

The Hong Kong Medical Association is concerned that several Hong Kong citizens developed undesirable side effects and required medical treatment after receiving botulinum toxin injection.  The use of botulinum toxin for cosmetic purposes, such as soothing facial lines, improving face or calf muscle contour, eliminating body smell etc, is increasingly common nowadays.  Before taking any injection, the public is advised to learn about the potential side effects and risk of botulinum toxin and seek medical advice on suitability. Save yourself from any physical harm and disappointment.

Botulinum Toxin is a natural protein purified by technology.  It blocks neuromuscular conduction and soothes contracted muscles. It was first used on blepharospasm and strabismus, and later for many different kinds of medical treatments, for example, Cervical dystonia, Achalasia, Cerebral Palsy, Hyperhidrosis and Spasticity.

Botulinum Toxin is also used for non-medical purposes, such as cosmetic and body sculpting. Potential side effects include Ptosis of lid or brow, localized pain, inflammation, paresthesia, hypoaesthesia, tenderness, swelling/oedema, erythema, localized infection, bleeding and/or bruising associated with the injection. It sometimes affects chewing, swallowing, speaking or even breathing if the dosage or the injection is not properly handled.  Since Botulinum toxin may spread and affect other areas beyond the injection site, resulting in hoarseness, drooping of the eyelids, double vision or blurred vision. Death may be caused in serious cases. 

With all sorts of beauty treatment on shelf, many of them are associated with high-risk procedures.  The Government rolled out a set of guidelines according to the recommendations drawn by the Working Group on Differentiation between Medical Procedures and Beauty Services in November 2013.  It was stipulated that procedures involving injection of chemical substances or drugs, either by penetration of the skin by means of a needle or needle‐free injections via the use of jet injectors, should ONLY be conducted by registered medical practitioners.  Besides, Botulinum toxin is a prescription-only drug and must be prescribed by a qualified doctor.  Anyone without the required qualification and using the drug on patient can be prosecuted of practicing medicine without a license. In the long run, the Government should introduce legislation to regulate high-risk medical procedures as soon as possible in order to protect the health of the public.

HKMA strongly advise Hong Kong citizens：

• To consult a doctor to determine suitability for receiving injection;
• To understand the functions, procedure, potential risks and complications before receiving botulinum toxin injections;
• To ensure injection is administered by qualified medical practitioners if one must receive injections outside Hong Kong.
• To understand whether the botulinum toxin is approved by relevant authorities; price should not be the sole consideration; and
• If feeling unwell after injection, seek medical attention immediately.

Notes to editors:

The Hong Kong Medical Association, founded in 1920, aims to bring together Hong Kong's government, institutional, university and private medical practitioners for an effective exchange of views and co-ordination of efforts.  The foremost objective of the Association is to safeguard and promote public health.  The Association speaks collectively for its members and aims to keep its members abreast of medical ethics, issues and advances around the world.  In fulfilling these goals, the association hopes to better serve the people of Hong Kong.