Almost 70% of cosmetic injections not administered by doctors

CIEH says industry “urgently needs regulation” to ensure that only trained and registered practitioners can deliver treatments

Two in three cosmetic surgery injections are not administered by qualified medical doctors according to a University College London (UCL) study, the first to determine who is providing services such as Botulinum Toxin (Botox) and dermal fillers in the UK.

Evaluation of 3,000 websites enabled researchers to identify 1,224 independent clinics and 3,667 practitioners; of these, 68% were not doctors.

“There are well-documented, yet to-date unaddressed challenges in the UK cosmetic injectables market. Without knowledge of the professional backgrounds of practitioners, we cannot adequately regulate the industry,” explained Dr David Zargaran, UCL Plastic Surgery.

“Our research highlights that the majority of practitioners are not doctors and include other healthcare professionals, as well as non-healthcare professionals such as beauticians. The range of backgrounds opens a broader question relating to competence and consent.”

A key challenge facing the government’s licensing scheme, Zargaran says, is to ensure licensed practitioners have the skills and experience to safely administer treatment to minimise risks to patients.

A second study focusing on complications and their impact on patients found 69% of respondents had experienced long-lasting adverse effects, like pain, anxiety and headaches.

“The UK cosmetic injectables industry has expanded rapidly in recent years. This has happened largely without scrutiny or oversight,” said Professor Julie Davies, UCL School Global Business School for Health.  

“Our findings should be a wake-up call for legislators to implement effective regulation and professional standards to safeguard patients from complications,” Davies added. “Although the risks associated with injections are often mild and temporary, the physical complications can be permanent and debilitating.”

“It can be very difficult to be sure who is injecting you, thanks to an array of marketing which often makes it difficult to decipher whether an injector has any medical training.”

A British College of Aesthetic Medicine's (BCAM) survey revealed 82% of its members treated patients with complications caused by another provider last year. Nearly 2,000 reported complications resulting from treatments performed by beauticians, with dermal fillers topping the list.

“The field of aesthetic medicine in the UK is notoriously unregulated, and so these statistics don’t come as a surprise,” said Dr Sophie Shotter, BCAM Trustee. “When patients seek out aesthetic treatments, for many they are looking for a medical doctor as they feel confident in their qualifications and skills… However, it can be very difficult to be sure who is injecting you, thanks to an array of marketing which often makes it difficult to decipher whether an injector has any medical training.”

Julie Barratt, CIEH President said: “We have seen too many examples of the damage, both physical and mental, that wrongly administered treatment of this sort can inflict. This is an industry that urgently needs regulation, such that only trained and registered practitioners can deliver the treatments. We urge the government to move swiftly to extend the current legislation to bring these practices within its scope in order to better protect public health.”

The UK government is preparing to update policy around injectables, with a public consultation due to begin in August 2023. Recommendations are expected to inform amendments to the Medical Act in 2024. The Welsh government is also considering licensing for tattooing, body piercing, acupuncture and electrolysis, as detailed in the Public Health (Wales) Act 2017. Once introduced, more cosmetic procedures may be added to the scheme.

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