Thriller: A pretty problem

Welsh Government regulations introduced in 2025 require anyone carrying out special procedures – including tattooing and body piercing – to hold a valid Special Procedures Licence, a scheme which CIEH was engaged in the development of.

This week, a Merthyr Tydfil tattooist was fined after continuing to carry out tattooing despite being served with a Stop Notice and receiving repeated advice from Environmental Health Officers at Merthyr Tydfil County Borough Council.

Work is ongoing to review CIEH’s guidance on tattooing, amid growing recognition that existing legislation and regulation must evolve to keep pace with modern practices and emerging risks.

In this blog, Ian Andrews, CIEH Head of Environmental Health, and Martha Prudence, a University of Derby student, examine the key challenges facing the sector, explore where improvements may be needed, and invite perspectives from professionals working across the field.

Across many areas of Environmental Health, consistency is an inherent assumption within the aims of the advice, guidance, and legislation which impact upon duty holders.

Inconsistent enforcement not only creates an uneven playing field for those who seek to comply with different pieces of legislation but it also creates reputational risks for professionals and employers.

Knowing what you need to do to comply with the law, and being told what the consequences might be of not doing so, are built into the work that many professionals within the environmental health workforce undertake.

The phrase ”postcode lottery” has been used to describe variations in health care provision across different regions, but it also applies to a few pieces of legislation that EHPs work with.

Across England and Wales, there are three different legislative regimes that apply to tattoo artists:

• Within most of England, local authorities work with legislation that was passed when Michael Jackson released the song 'Thriller' (1982);
• Within London, the legislation goes back to when the singer Chesney Hawkes released the song 'The One and Only' (1991);
• A licensing scheme was launched in Wales in 2024 (ironically, when the song 'Ordinary' was in the charts).

One important aspect of these different schemes is the cost which businesses are required to pay to a local authority and there is a perception that things are not consistent. This inconsistency creates risks and challenges which could be addressed during the current Parliament.

Tattoo artists and those that work within this creative industry want to do what is right.

As Trey Burnside, a Sheffield-based artist comments:

“Tattooing is a creative profession, but it is also an invasive procedure with real public health implications. A modern, consistent competency standard is urgently needed, and collaboration between practitioners and Environmental Health professionals is essential if we want to protect both the public and the integrity of the industry.”

Julie Russell is a former microbiologist who has written on skin infection risks and who now runs Old Marine Arts, a tattoo studio based in North London:

She said: “The fact that requirements for licensing tattoo studios vary between local authorities creates confusion for tattoo practitioners and uneven standards for both studio owners and the general public. I commend and support the CIEH's objective of improving consistency in licensing tattoo and permanent make-up studios across England.

“However, I suspect that guidance alone is unlikely to be enough. I believe there’s a strong case for revisiting how tattoo equipment is sold, particularly online, and for ongoing, consistent enforcement of licensing requirements across the wider community.

“Public education is really important. People need to understand that tattooing isn’t just an art form - it’s also a procedure with potentially serious health implications. The aim isn’t to restrict tattooing, but to ensure that safe access to the profession and public safety are fully aligned.”

The postcode lottery in practice

The regulation of tattooing, electrolysis, body piercing, acupuncture, and semi‑permanent makeup is primarily governed by The Local Government (Miscellaneous Provisions) Act 1982, which enables - but does not require - local authorities to adopt provisions relating to the registration of practitioners and premises.

The act permits authorities to impose byelaws concerning cleanliness of the premises, instruments, equipment, and practitioners, however because the adoption of registration requirements is optional, regulatory standards and enforcement can vary significantly across the UK. The consumer implications of this system are that in each region local authorities may approach regulation differently.

In the treatment sector, the concept of a postcode lottery stems from the adaptability of the legislation(s) behind regulation. In 2025, as part of ongoing student research, one of us gathered data on the number of complaints received by the unitary authorities in England about these treatments.

The average number of complaints ranges widely — from an average of 108 in the southwest to just nine in the northwest. In some regions registration may be a requirement for the practitioners in that area, and equally some local authorities will have their own standard of hygiene control under local bye-laws.

The inconsistency in these approaches across England are creating risks and challenges for practitioners and regulators.

Another important aspect of regulation and registration, under the 1982 Act, to be aware of is that local authorities cannot refuse an application unless specific criteria are met.

Since the release of 'Thriller' and the 1982 Act the techniques and tools used by the tattoo industry have moved on. The traditional coil machines, requiring the use of autoclaves and ultrasonic machines for sterilisation, are being phased out by tattoo artists in favour of single-use pre-sterilised needles.

Critically, the types of non-surgical cosmetic procedures performed in aesthetic premises has also advanced since 1982; irrespective of this, the legislation has not changed.

Increasing reports indicate that unregistered tattooists are working undetected at home; and the appropriate authorities are only being alerted when poor standards lead to an incident, such as an infection.

The increase of complaints about unregistered home tattooists is indicative of a larger problem whereby tattooists are operating from home, without the necessary resources and regulatory education, increasing their potential to cause harm.

A typical misconception is that independent businesses cause the most issues of non-compliance, however, High Street brands are as likely to be practicing in a way that might cause a pretty problem.

For example, jewellery brands across the UK have been providing piercing services for a number of years, and yet they can still face challenges when equipping their stores with the adequate facilities required to comply with the legislation.

The regulators, and businesses working in these industries are facing increasing challenges in achieving compliance because treatment advancements are swifter than the development of the law.

The Women & Equalities Committee called for “regulatory alignment across all UK nations on legislation governing non-surgical cosmetic procedures” in February this year.

From a business perspective, there is a need to fundamentally review what could be described as a “pretty problem”.

We’re waiting to see what happens next. In the meantime, CIEH is working with a group of committed members and stakeholders to review its existing guidance. If you’d like to know more, do get in touch (email - [email protected]). 

*Further resources - https://www.cieh.org/media/4409/r1-regulation-of-cosmetic-treatments-in-the-uk.pdf