New age restriction legislation for cosmetic injections

While the law prevents under 18s accessing body modifications such a sunbeds, teeth whitening and tattoos it was not until the introduction of The Botulinum Toxin and Cosmetic Fillers (Children) Act 2021 on 1 October 2021 that it became a criminal offence to inject Botulinum toxin or cosmetic filler into a child. Bodies such as the Joint Counsel for Cosmetic Practitioners have lobbied tirelessly to regulate the use of Botox and fillers and this is a welcome step towards regulation in the cosmetic industry. 

The aim of the legislation is to safeguard children from the potential health risks of Botulinum toxin and cosmetic fillers often administered by unqualified practitioners in unregulated premises.  If caught the sanctions for breaking the law range from a summary conviction to an unlimited fine. The police and local Trading Standards bodies have powers to enforce the offence.

From 1 October 2021 it is a criminal offence to:

• Inject Botulinum toxin or a filler for a cosmetic purpose to an under 18 year old in England, even with parental consent.
• Make arrangements for, or book, an appointment for any under 18 year old in England, including by digital or social media. If an appointment is made but does not proceed either because they changed their mind or an enforcement agency intervened, a prosecution can still be brought.
• Inject an under 18 visiting from outside England.

Who does the new law apply to?

• Providers of clinical healthcare services and regulated healthcare professionals.
• Commercial providers of cosmetic procedures, including mobile aesthetic practitioners, regulated healthcare professionals, beauty therapists.
• Individuals performing the procedures on an informal basis.

Can treatment be provided for a clinical need on an under 18?

• Treatment can still be approved and administered to meet a clinical need if prescribed by a registered doctor, who should follow guidance issued by their regulator.
• Registered nurses, dentists and pharmacists may administer the treatments when they are acting under the directions of a doctor.

What steps should practitioners and businesses take from 1 October?

1. Age verification of patients – Practitioners and businesses in England must verify the age of all customers before booking an appointment, or carrying out the treatment.
2. Registered health professionals - Arrangements to treatments and injecting an under 18 can only be made by doctors, dentists, nurses or pharmacists, and the treatment must be under the direction of a doctor.

Demonstrating compliance the law

• age verification checks: use a dual checking process at the time an appointment is made and before the treatment
• online bookings: businesses should consider putting into place age-verification procedures using systems that are compliant with PAS 1296:2018, a code of practice for online age verification service providers.
• signage and CCTV: ensure that there are adequate signs in place to inform consumers of the minimum legal age for the treatments. CCTV can provide useful evidential support in the case of any complaints or allegations.
• maintain a refusals register: keeping a record (date, time, incident, description of potential buyer) where sales of age-restricted procedures have been refused, this will help to demonstrate that there is an effective system in place.

The Act offers a defence if the person administering the injections had taken reasonable steps to establish the person’s age and could reasonably believe that they were aged 18 or over.

If you would like advice or assistance in relation to this new legislation, please get in touch with Julie Charlton.

Useful guidance

• Botulinum Toxin and Cosmetic Fillers (Children) Act – factsheet for healthcare professionals, professional bodies and regulatory bodies.
• Botulinum toxin and cosmetic fillers for under 18s: guidance for businesses
• Botulinum toxin and cosmetic fillers for under 18s: guidance for young people and parents/guardians
• Botulinum toxin and cosmetic fillers for under 18s: guidance for enforcement officers