Boots the chemists opened the way yesterday to a new world of apparent perpetual youth in which we will age without a wrinkle, deprived of our ability to frown by injections of a toxin related to botulism. Botox treatment has been launched in four Boots stores - two in London, one in Manchester, and the fourth in Milton Keynes, Buckinghamshire. The injections paralyse the muscles of the face which we use every day to laugh, smile, frown and cry.

The Dorian Gray exchange is the end of crow's feet and wrinkles at the cost of much facial expression. Among those said to have had the treatment are Cher, Madonna, Kylie Minogue, Liz Hurley, and Sir Cliff Richard.

The doctors administering the injections will be qualified GPs, said Steve Boothroyd of Boots yesterday. "They have all had at least one year's experience dealing with Botox," he said.

But because Botox is a prescription medicine, licensed for a variety of conditions including spasticity in cerebral palsy patients but not in the UK for cosmetic use, any doctor who gives the injections for the purely lifestyle complaints of lines and wrinkles will have to do so on his or her own responsibility. If anything goes wrong, the manufacturer is not to blame.

Botox was licensed by the US food and drug administration for cosmetic use last month. The medicines control agency, which licences drugs in the UK, would not say whether there had been an application here. There have been 85 suspected adverse reactions reported to the committee on the safety of medicines, which advises the MCA, but only two were related to cosmetic use. One doctor reported a patient's eyelid drooping after treatment, and another told of a facial rash and swelling.

For all its links with botulism, the fatal form of food poisoning, doctors who use Botox for cosmetic treatment say it is safe, as long as it is in the right hands.

Supervision

Patrick Bowler set up the British Association of Cosmetic Doctors 18 months ago, for those who carrry out the non-surgical beauty techniques such as skin peels and injections in private clinics. The aim, he said, was "to make sure the doctors were educated, trained and up to scratch with the techniques". The association has over 70 members but he said another 100 to 150 doctors carried out non-surgical techniques in the UK.

Dr Bowler is not certain the drug is always injected by medical personnel with the right training or supervision: nurses can give the injections if a doctor is supervising. "It is already available in high street beauty salons and private parties, and I even heard of a van touring around offering Botox injections. If a nurse is doing it in a van, what is happening is that doctors are prescribing the Botox and it then depends on your definition of supervision. The doctor might say I'm supervising from a distance because the nurse can phone me at any moment."

Botox parties were common, he said. A doctor or nurse is invited from a private clinic, and as the champagne and canapes circulate, she administers the injections into the face muscles of those who want to lose the lived-in look. "There are doctors who do it regularly, say once a month," said Dr Bowler. But mixing Botox and alcohol did not go, because the increased blood flow resulting from drinking can wash the toxin away from the muscle that causes crow's feet or a frown. At his Harley Street clinic or in Boots, £200 will buy enough injections to prevent muscles around the eyes from deepening the crow's feet or stop the creasing across the forehead. The injections do not eliminate existing lines, but soften them.

Some of Dr Bowler's clients are in their 20s, wanting to preserve their looks; others are in their 60s, hoping to roll back the years. The first injections last for three or four months, but the more often they are carried out, the more the muscles atrophy.

Dr Bowler said he could spot celebrities who have had the treatment by their lack of expression. "My theory has always been to underdo patients and not give them a mask like appearance. If you get someone in their 40s or 50s who cannot move their forehead, it doesn't look in keeping with the lower part of the face. I always underdo it so they have a bit of movement."

The enormous popularity of Botox and its move to high street accessibility has potential social implications, increasing the pressure on women and men (15%of Dr Bowler's London clients are now male) to make themselves look younger.

Clive Orton, president of the British Association of Aesthetic Plastic Surgeons, said he thought people might rush to get the injections without thinking the matter through properly.

"The hype and the marketing will draw in a lot of self-conscious individuals. The point is that when somebody begins to worry about their appearance, they really do need to see somebody who can take an overview on whether treatment really is going to help them. Botox is a pharmacological agent, not a beauty product." He believed it was part of a bigger problem. His association has been pressing the government to tighten the rules, and ensure cosmetic surgeons have appropriate surgical qualifications. But new regulations from the Department of Health, although they demand a two week cooling-off period and state the surgeon must see the client before the operation, say only that the surgeon must be medically qualified and have attended a postgraduate course.

"In the face of increased public demand, glossy advertising and inadequate regulation, only the most sanguine optimist can believe the situation has been controlled adequately," wrote Mr Orton in the British Medical Journal yesterday.

Nerve poison to smooth wrinkles

· Botox is the brand name of botulinum toxin A, which is a neurotoxin - literally a nerve poison.

· There are several forms of botulinum toxin, the main ones are labelled from A to F. They are produced by the bacterium Clostridium botulinum.

· The potentially fatal form of food poisoning known as botulism, which has been contaminated by one of the botulinum toxins, causes vomiting and muscle paralysis. A small dose can be fatal, because of heart and lung failure.

· Botox paralyses the muscles which enable the face to frown. It reaches the neurotransmitter called acetylcholine and stops it taking the message from the brain to facial muscles.

· Three parts of the upper face can be treated - crow's feet, the crease across the brow and the furrow between the eyes. The Boots injections cost £200 for one area, £265 for two and £320 for three.