A new law in England has banned under-18s from receiving Botox and fillers in a move that signals tightening regulation within the cosmetic industry. This trend was discussed in our blog Beauty and the Regulatory Beast? where we considered the All-Party Parliamentary Group (APPG) report into Beauty, Aesthetics and Wellbeing and its conclusions that the lack of a legal framework around training and standards in the industry left consumers at risk and undermined competent providers.

An estimated 41,000 under-18s in England underwent Botox-style procedures last year and up to 29,300 under-18s received dermal fillers. However as of 1 October, a new law is in force that restricts under 18's from receiving the popular cosmetic injectable. The Botulinum Toxin and Cosmetic Fillers (Children) Act 2021 makes it an offence for persons or businesses to administer, or to arrange to administer, Botox or filler for a cosmetic purpose to under-18s.

The Act

The new law aims to protect young people from harm, by placing a positive obligation on practitioners to ensure their client is over 18 years old. However, if charged with an offence, it is a defence to show that the practitioner had taken reasonable steps to establish the client's age, and reasonably believed that the client was aged 18 or over. It will therefore be important for practitioners in England to ensure that steps are taken to verify age and a paper trail is kept of this.

The Act does not create a blanket ban on Botox or filler injections for under-18s. Procedures can still be carried out either by a registered medical practitioner or a regulated health professional (such as a dentist, pharmacist, or nurse), acting under the direction of a registered medical practitioner for clinical purpose.

The penalties for breaching the Act include criminal prosecution and an unlimited fine. The Act is the realisation of one of the 17 recommendations from the APPG report and further step on the regulatory journey of the UK cometic industry.

Growth in the Industry

The cosmetic industry within the UK continues to grow at an exponential rate, with the filler market alone valued at £1billion/year. As the popularity of non-surgical cosmetic treatments has risen, so to have the treatment options and treatment providers. However, the legal framework has lagged, and currently there is no requirement for practitioners to have formal qualifications or training for injectable treatments.

This has, unsurprisingly, resulted in a rise in injuries and claims following Botox and fillers. Save Face, a national, government-approved register of accredited non-surgical treatment practitioners, has seen a significant increase in complaints, from 378 in 2017 to 2,083 in 2020. They have also seen a 328% rise in reports of bad practice and procedures gone wrong from 2017 – 2019.

It is estimated that 86% of treatments complained about were carried out by non-medically qualified practitioners. Professional providers and insurers will no doubt welcome the change in law, as it provides more certainty around the legal framework for these procedures and adds to industry best practice.

What Next?

Looking forward, further regulation in the industry is expected. Industry activists have so far commented that procedures such as "fox-eye" thread lifts, which are growing in popularity with young people, are not covered by the Act. Additionally, although the restrictions are not yet replicated in Scotland or Wales, similar bans are anticipated.

As discussed previously, other proposed recommendations, such as licensing, the introduction of national minimum standards for training and requirements for practitioners to hold adequate and robust insurance cover, could be introduced. The likely increased public confidence and provision of more certainty to insurers, will undoubtably have a positive effect on a growing industry.


Lynn Livesey

Legal Director