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Sale and Altrincham Messenger 13 June 2013

Anti-wrinkle procedures – who can perform them?

Q – I have seen a number of newspaper reports over the last few months about the regulation of the “˜cosmetic procedures’ industry, but what exactly is the present position in terms of who can and who can’t perform anti-wrinkle injections? Anon
A – This subject has had a lot of coverage recently, prompted by the scandal over PIP breast implants (thousands of women were given implants made from industrial silicone, which carried a far greater risk of rupture). However, the resulting review (led by Sir Bruce Keogh, Medical Director of the NHS) was extended to include non-surgical procedures, and many of the concerns raised centred on the provision of anti-wrinkle injections.
Botulinum toxins, which act as a muscle-relaxant, are prescription medications, and therefore a prescription is required before a person is treated. The prescription can be from a doctor, or a nurse with special authority to prescribe, or a dentist. The injections themselves can be administered by anyone, which is why you hear of treatments given by non-prescribing nurses and beauticians. However, unless a face to face consultation has occurred with the prescriber, prior to treatment, then treatment would be unlawful.

Turning to dermal fillers, this area came in for heavy criticism in the review for being “almost entirely unregulated”. Fillers are not classed as a medicine, and therefore at present can actually be given to anyone by anyone, at any place, at any time (a situation rightly described as “˜bizarre’). Treatments administered at “˜salons and beauty parties’ were highlighted as being particularly indicative of poor practice in the industry. Even the products themselves are not properly regulated (there are said to be 190 fillers available across Europe, but only 14 in the US).

Most reputable practitioners fully support the review’s recommendations for regulation, and I personally hope that changes to the law occur sooner rather than later. In the meantime patients are vulnerable, so I would encourage anyone thinking of seeking treatment to do their research into potential practitioners and their products before proceeding.