Should beauty therapists be injecting dermal fillers & botulinum toxins?

Posted on the 10 February 2017 at 12:45

This is not a new debate, not by a long shot, but it is one which never seems to go very far away. As the aesthetic industry has grown exponentially in the last decade, so has the number, and variety, of practitioners now offering cosmetic interventions in the form of injectable facial fillers and botulinum toxins to the public at large. Non-medical professionals, such as beauty therapists, and allied healthcare practitioners offering these services are now more commonplace than ever before. But, why?

Well, since the qualification and training recommendations, published by Health Education England (HEE), in response to the Keogh Review, promoted a landscape of 'inclusivity', so the floodgates were opened to justify inclusion of all types of practitioners, medical and non-medical, many of whom were already operating within the non-surgical cosmetic interventions sector as regulation was, and is, not in place to stop it. This in turn encouraged many more to train in providing such treatments, overnight more training centres became established targeted at teaching beauty therapists, and business models incorporating product supply, prescribers and insurance became more easily available, and an attractive option for many already running a beauty salon.

During all this time, Consulting Room has maintained that we only permit medically-led clinics to be listed within our UK directory so do not promote beauty therapists offering cosmetic injectable treatments to the public.

We have raised the debate before about why cosmetic injectables, such as dermal fillers (e.g. lip injections) and botulinum toxins (e.g. Botox) should only be performed by doctors, nurses, dentists and some types of pharmacists. There are many risks and dangers from non-medically qualified individuals performing such treatments. Essentially it comes down to training and competence to do the procedure itself, which is complex enough, but there also needs to be an ability to deal with any complications, allergic reactions, or other adverse effects such as infections which can arise from the treatment, and this is severely lacking in those who are not medically trained.

Only this week a story hit the tabloids about a young girl who suffered from horrific complications following a lip filler treatment performed in her home by a beauty therapist. Social media posts also highlight others with similar tales to tell and photographs to share.

So why I am talking about this again? Well, because everyone else is talking about it again. You see it does not really matter what the HEE have said, or how the Joint Council for Cosmetic Practitioners (JCCP) plans to carry this forward in practice to form a register, or the insistence that beauty therapists will all need to achieve a Level 7 (Masters degree equivalent) qualification in cosmetic injectables, as well as have clinical oversight from a prescriber, in order to practice; because we all know that there is no statutory or mandatory regulation to enforce this as the government prefers an industry lead voluntary approach, so there will simply be no policing of these individuals. Doctors, nurses and dentists are all accountable to their own regulatory bodies, namely the GMC, NMC and GDC, yet those operating as beauty therapists have no regulator to oversee their fitness to practice.

Social media posts and private forum groups are littered with conversations amongst aesthetic medical practitioners with story after story of the corrections that they have performed, and the tales their patients provide about local beauty therapists and their injectable experiences. More worrying are live stories from nurses and doctors who have been contacted within the hour by therapists desperate for help for their client. They come looking for an immediate 'fixer', often asking for a source of hyaluronidase (used to remove hyaluronic acid based dermal fillers); in many cases seeking this from their usual prescriber will take too long for the product to arrive via prescription. You have to feel and pray for the client and their safety in these situations.

Aesthetic nurses raised a 100% in favour vote at the recent Journal of Aesthetic Nursing (JAN) Annual Conference to support the motion that they have no confidence in non-healthcare professionals providing cosmetic injectables. This positive stance was picked up by some media outlets and praised by the industry.

To that end, many are now also signing a petition asking for beauty therapists to be stopped from injecting fillers and toxins. One comment in support of the petition summed up the sentiment displayed - "The general public deserves protection from unqualified people who have no idea of the risks they are encouraging unsuspecting clients to take."

As a provider of quality information about cosmetic interventions available in the UK, and holder of a directory of clinics in the UK and Ireland, Consulting Room take steps to vet the regulatory compliance of all who subscribe for inclusion. It gives you some peace of mind that basic checks about medical oversight have been done for all the clinics listed. This doesn't take away from doing your own research about a clinic or practitioner that you are thinking about visiting for treatment. Ask about qualifications and training, how long someone has been performing a treatment, which product brands they use and all the benefits and risks from treatment. If you feel satisfied with the information provided, then go ahead. If any alarms bells ring, or you feel uncomfortable, then move on and contact another clinic.

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