Staying in control

Finding the right cosmetic practitioner can be daunting, especially in a market that is largely unregulated. Vicky Eldridge explores how to safeguard yourself against rogue aesthetic practitioners

In any other area of medicine you would expect government regulation to be in place to ensure safety and standards were being met. Yet, when it comes to cosmetic procedures, the regulatory arena has become a minefield, putting consumers at risk from unscrupulous practitioners trying to cash in on the lucrative anti-ageing market.

While the cosmetic surgery sector is regulated by the Care Quality Commission (CQC) and operating facilities are inspected to make sure they meet standards, the public can still fall foul of rogue practitioners labelling themselves as cosmetic surgeons when they are not actually qualified to do so.

Harley Street has become synonymous with cosmetic surgery, but it is important to remember that Harley Street is an address not a qualification, so the only way to safeguard yourself is to always check that your surgeon is on the specialist register with the General Medical Council (GMC).

For people seeking less invasive forms of cosmetic enhancement, however, it is not so cut and dry. The non-surgical sector is one of the biggest growth areas, particularly when it comes to cosmetic injectables, such as botulinum toxin (Botox®) and dermal fillers, but the lack of regulation surrounding it has made it difficult for consumers trying to find a safe and ethical practitioner.

Since the government made the somewhat controversial decision not to impose statutory regulation on this booming market, everyone from vets to beauty therapists and podiatrists have been trying to take a bite of the cosmetic injectable pie. But with demand rising every year, the need for some form of control was hugely apparent.

After six years of discussion between the industry and the Department of Health, it seemed as if there was finally a light appearing at the end of the tunnel when, in September 2010, the Independent Healthcare Advisory Services (IHAS) launched its Register of Injectable Cosmetic Providers, known as Treatments You Can Trust (TYCT). The aim of the scheme is to provide indirect regulation through the Health and Safety at Work Act, Medicines Act and professional fitness-to-practice controls (namely the GDC, GMC and NMC), and to encourage members of the public to choose providers that have been awarded its Quality Assurance Mark.

TV’s Dr Hilary Jones, who is a member of the TYCT Governance Group, which has been set up to establish the independence of the register, says: “Anything we can do to make it easier for consumers to find an appropriate provider in a safe environment is a major step forward.”

Unlike lipstick and mascara, these treatments are serious medical procedures with serious risks attached

The scheme is now growing in strength but with many clinics being slow to sign up for the voluntary register, industry bodies, such as the British Association of Cosmetic Doctors (BACD), have been doing their own part to promote the safe and ethical practice of cosmetic medicine. Chairwoman Dr Samantha Gammell says: “We vet all of our members and also have a star-rating system on our website so patients can see whether the doctor has met our more advanced criteria.”

One area that the IHAS is cracking down on is the issue surrounding the use of cosmetic injectables by beauty therapists.

“Beauty therapists are not allowed to carry out botulinum toxin treatments in the UK full stop,” says Sally Taber, director of the IHAS. “They are not medically trained and therefore cannot prescribe or administer the treatment legally, as it is a prescription only medicine.”

But it is in the area of dermal fillers that a loop hole or grey area exists and it is this that causes the IHAS, and the industry at large, the most concern. Fillers are classified as medical devices rather than medicines and therefore it is not actually illegal for a non-medic to administer them, however fillers can potentially cause lasting damage. “It’s extremely concerning that the law currently allows beauty therapists to carry out injectable cosmetic treatments. TYCT will categorically not accept these individuals on to the register,” adds Ms Taber.

Dr Gammell comments: “Injectable treatments are increasingly becoming part of our daily beauty vocabulary but, unlike lipstick and mascara, these treatments are serious medical procedures with serious risks attached. It may be cosmetic but it is still medicine.”

While people are often fully aware of the risks of cosmetic injectables, many underestimate the danger of lasers. A burn from a laser can be extremely serious, which makes it even more shocking that, in October 2010, the government decided to deregulate cosmetic lasers and intense pulsed lights (IPL) for cosmetic uses.

This means that although the CQC continues to regulate all healthcare professionals using lasers and IPLs to treat “disease, disorders or injury”, the beauty sector now falls outside of its remit, leaving non-medically trained practitioners to treat clients without being accountable.

Dr Philip Dobson, medical director at LCS Healthcare, says: “The regulations have been framed so as to regulate the medical sector to the highest professional standards for carrying out procedures, whereas, identical treatments performed by beauty therapists, including advanced skin ablation, could be done perfectly legally on their kitchen table, without any statutory regulation or even medical supervision.”

With feelings in the industry about de-regulation still running high a year after the changes were imposed, the IHAS has been working alongside industry bodies to set up a similar quality mark for cosmetic lasers and IPLs, which could come into place early in 2012.

But all this is not meant to scaremonger the beauty seeking public. In the right hands, cosmetic procedures are incredibly safe, as long as you remember that the right hands should be medical - and they should be accountable.


  • Look for cosmetic injectable providers with the TYCT Quality Assurance Mark.
  • Make sure your surgeon is on the Specialist Register with the GMC or that your dentist, doctor or nurse is registered with their relevant professional body (GDC , GMC , NMC).
  • Use the “find a surgeon/doctor” locators on the BAAPS or BACD websites.
  • Don’t be afraid to question your practitioner about their experience and qualifications.
  • Make sure you have a thorough consultation.
  • Do not go to a beauty therapist or non-medic for cosmetic injectables.