Should beauticians be allowed to inject Botox and dermal fillers? Rosie Taylor looks at the ongoing debate on who you should trust with your face.

You would only trust a dentist to give you a filling, so should you only trust a doctor to inject fillers into your face?That is the question which is currently dividing the cosmetic industry in the UK. Experts are torn over whether non-medical practitioners like beauty therapists should be allowed to inject botulinum toxin (commonly referred to as Botox) and dermal fillers.

At the moment there is no law in Britain requiring therapists who carry out these procedures to have any medical education – meaning some are setting up shop using products bought online after basic one or two-day training courses. According to Save Face, an organisation which recommends trusted medical practitioners, the non-surgical treatment industry makes up to £2.1 billion a year from like botulinum toxin, dermal fillers and facial peels but is largely non-regulated.

A question of qualifications

To combat the hordes of unregulated therapists providing non-surgical treatments, the Government has recommended certain qualifications which could be required for anyone carrying out the procedures. These were announced by Health Education England (HEE) in November 2015 and led to the creation of the Joint Council for Cosmetic Practitioners (JCCP) in early 2016. The JCCP aims to create a register of approved practitioners – including therapists who have met the standards.

But this has proved a divisive issue: on one side of the debate stands the JCCP which believes beauty therapists without medical backgrounds should be allowed to perform the procedures as long as they reach a certain standard of training – equivalent to the first year of a foundation course (usually requiring 5 GCSEs and 1 A Level or equivalent before training starts).

Will it weed out rogue traders?

The JCCP argues giving reputable therapists official status on the proposed register of approved practitioners will encourage them to train to a higher level, weed out rogue traders and raise public awareness of the danger of using backstreet beauticians. It has said: “We would certainly like to give [beauty therapists] every opportunity to join the register at the level of competence that they can demonstrate based on the HEE framework.”

It announced this week that any register would be divided into two parts, those registered with a professional statutory body (such as doctors, nurses, dentists and pharmacists) and those who were not but had reached the required standards and agreed to work under clinical supervision where necessary.

Yet many doctors and nurse practitioners, as well as many beauty therapists, are appalled by the idea. They say recognising therapists in the same register as specialists who have years of medical training will undermine their expertise. They also warn there is a danger when any non-medical professional carries out these procedures as they do not have the training to deal with any complications.

Undermining professionals

An online petition launched by doctors titled “Stop beauty therapists giving botox and fillers” (https://www.change.org/p/government-stop-beauty-therapists-injecting-botox-and-fillers ) has gained more than 2,600 signatures. It states: “Botox is a potent neuromuscular toxin which can cause unwanted side effects which need to be clinically managed. Dermal fillers can cause again a whole host of medical problems such as vessel occlusions and infections.

“Medical interventions are required when both of these treatments go wrong, requiring immediate access to prescription medication such as steroids and adrenaline.

“An unregulated practitioner has no medical training and does not have access to this and this leaves the patient in a vulnerable and dangerous situation – which could potentially cause irreparable damage leading to disfigurements or even worse – an anaphylaxis.”

Risks and botched jobs

It is not just doctors who have signed the petition. The respondents include people working across the industry – as well as patients – who are unhappy with the situation. Therapist Chantal Power from Aberdeen wrote in her submission: “I am a beauty therapist and tired of our industry having 1 or 2 day courses and inexperienced people then charging cheap prices to get customers. There is more to know about the treatments and there are some treatments you just don’t do as a therapist! Sick of hearing or seeing the results of inexperienced people’s work and the public is pulled in by cheap, instead of quality, treatments!” Another beautician, Claire Lewis, from Pontyclun, said: “I wouldn’t dream of providing this service. Definitely best left to professionals like doctors, nurses, dentists.”

Lip enhancement gone wrong

Mary Irving, a nurse aesthetic injector from Essex, said she performed an average of 14 corrections a month on girls who had received “botched treatments”, while Paula Bagshaw, from Lytham St Annes, wrote: “I am a qualified practitioner and see so many people with horrendous results that need sorting out.”

Patient Kelly Irving, from Bradford, added: “I’ve had a bad reaction to lip filler because the practitioner wasn’t medically qualified. It was horrifying and I had to seek medical attention and thankfully I had the filler removed before it did lasting damage but others won’t be as lucky and it needs to stop! Only see a medically qualified profession for these kind of procedures. You wouldn’t go to them to fix a broken leg or stitch up an open wound so why trust them with your face!”

Process continues

The JCCP announced this week it is on target to be fully operational by 2017. Interim chair Professor David Sines said: “It has been a huge task to get so many stakeholders in the non-surgical aesthetics sector together and to reach a consensus on the role of the JCCP and how it can achieve its primary aim of delivering safer treatments for the public.

“For the first time working with its sister body the Cosmetic Practice Standards Authority (CPSA) it will be able to identify to the public practitioners and education/training providers who will work to the newly agreed set of educational, clinical and practice standards and within the JCCP Code of Practice.”

While the body looks all set to start work on the register, there are still decisions to be made about how exactly it will work. No doubt the debate over whether only medically trained staff should inject clients is one that will rumble on for many months to come.