In brief
Non-surgical aesthetic treatments are a booming but largely unregulated market, creating potential safety risks for consumers, and giving rise to an increasing number of "botched" or unsafe procedures.
Whilst some legislative foundations exist, the licensing regime for England is not yet fully implemented, with significant gaps still to fill.
Introduction
The term "non-surgical aesthetic treatments" encompasses a wide range of treatments, from commonplace procedures such as laser hair removal, skin boosters, and body contouring (ice sculpting anyone?) to more "intrusive" ones like dermal fillers, BBLs, botulinum toxin (aka Botox), thread lifting procedures, and fat dissolving injections. However, it does not cover "surgical" treatments such as facelifts, breast augmentations, implants etc., which are regulated under a different regime.
There are three key aspects to consider when providing non-surgical aesthetic treatments: (i) the issues arising from these treatments; (ii) the current regulations; and (iii) the changing regulatory landscape.
Unsafe procedures
A British College of Aesthetic Medicine study found that 7.7 million people underwent an aesthetic treatment in the UK in 2023, amounting to 11% of the UK population. The estimated market value at the time was around £3.2 billion, and is still growing.
However, the reason this is such a hot topic is not simply the cascade of Instagram posts from influencers boasting lusciously plump lips and flawlessly smooth skin, but also (and importantly), the potential dangers of these practices. The historic lack of caution in this area came to a head following shocking deaths of people, who, after undergoing a BBL, have died from symptoms linked to the procedure.
The rare fatalities are not the only issues resulting from unsafe procedures. A study in the Netherlands included participants sharing the day-to-day impact on them of undergoing an improperly administered procedure with long-term impacts, with one participant stating that, "due to one small syringe of silicone, my whole life has been ruined". The study records stories of faces suddenly puffing up, stabbing pains, puzzled doctors, and regret. Sadly, these cases are far from isolated, with England alone recording 38 cases of botulism poisoning in July 2025.
The prevalence of unsafe procedure cases is likely attributable to the lack of regulatory scrutiny in this area. Indeed, despite the 6,117 regulated providers in the UK, it has been estimated that for every one regulated provider, there are up to three unregulated providers. Anyone can pop "aesthetic treatment provider" on their LinkedIn profile or Instagram handle, with no prior experience or training needed. What passes for training in this sector is equally concerning; the undercover BBC documentary "Under the Skin: The Botched Beauty Business" exposed how online courses offering to qualify practitioners are often just an hour and a half long, with no practical training.
Self-administration is also growing. Facilitated by the internet, buying lip filler kits online can seem as easy as buying a new lipstick, with Trading Standards identifying that unsafe and unregulated filler products are readily available to buy online for as little as £20. Unregulated providers are therefore also key to this problem and how to resolve it, as they sell treatments without complying with adequate health and safety standards, which, apart from being potentially dangerous, is against the law.
Lastly, the unsanitary conditions that some of these procedures are being carried out in do nothing to reduce the risk, with providers operating out of "pop up" shops on high streets, cubicles in public toilets and hotel rooms, increasing the risk of infection.
The above demonstrates a real need for more regulation in England, and importantly, for ways to enforce any such regulations.
The current regulatory framework
There are some voluntary industry associations e.g., the British Association of Beauty Therapy and Cosmetology and the UK Spa Association. Both of these have professional codes of conduct, and any member is removed if they breach them. However, the key aspect is that participation is voluntary, not obligatory.
The Health and Care Act 2022 gave the Secretary of State for Health and Social Care the power to introduce a licensing regime for non-surgical cosmetic procedures in England. The objective was to ensure that consumers who choose to undergo procedures are confident that treatment is safe and will be performed to a high standard. This implies adequate training, a qualifications regime, appropriate indemnity cover, and operating from premises with a higher hygiene rating than zero. However, as explained below, this has yet to be implemented.
Outcomes of a Government consultation in relation to the licensing of non-surgical cosmetic procedures in England were published in August 2025 but there are no concrete dates yet published for implementing the proposed changes detailed below. However, on 17 October 2025, the Government confirmed it was committed to addressing longstanding concerns around the safety of the cosmetics sector and legislating to introduce a licensing scheme, as detailed below, as well as being committed to mandating age restrictions for cosmetics procedures.
Proposals for future regulation
England is already in the process of implementing change by proposing licensing of non-surgical cosmetic procedures and sorting them into a three-tier traffic light system:
- Green: practitioners are eligible to perform licensed procedures where they meet the agreed standards. The procedures proposed to be allowed include micro needling, intense pulsed lights, etc.
- Amber: practitioners need a licence and oversight by a named healthcare regulated professional. This would include Botox, weight loss injections, etc.
- Red: restricted to qualified and regulated healthcare professionals only. This would include thread lifting procedures BBLs, hair restorations, chemical peels, etc.
The above classifications are proposed to be adopted in combination with the following key proposals put forward in the UK consultation:
- The scheme regulating these procedures would be operated by local authorities;
- Practitioners would need to be licensed by their local authority, in order to perform specific non-surgical cosmetics procedures;
- Premises would have to be licensed for specific activities; and
- It would be an offence to carry out non-surgical cosmetic procedures without a licence.
Similarly, Scotland has also launched a consultation on the regulation of non-surgical procedures and the responses show a "broad support for action to make the sector safer", with the Government proposing to introduce a bill focused on non-surgical cosmetic procedures in its legislative programme.
There is still much to be done before England's licensing regime is underway, including moving it through the necessary legislative stages, and local authorities using the powers delegated by the Secretary of State, to start issuing licences and imposing restrictions.
Another angle of attack is the supply chain. Following the wave of botulism outbreaks last year, the MHRA warned of a crackdown on the illicit trade in unlicensed botulinum toxin products, which would impact the initial manufacturers, but also the end sellers.
Whilst some online retailers have paywalls, mandatory membership requirements, and clear wording indicating they sell only to licensed professionals, many do not, and the purchase of products such as lip injectors has become far too easy.
Public awareness is also insufficient. The BBC documentary referred to above was a useful starting point, but broader, Government-backed campaigns are needed to warn consumers of the risks and how to obtain these treatments safely.
Lastly, the UK needs an adequate framework for enforcing the licensing regime. The Government consultation encourages public reporting, compliance checks and inspections, but for procedures performed by people operating out of their lounge, enforcement becomes difficult. The Government must, alongside the licensing regime, set aside funding for police investigations, and considering using AI tools to monitor the internet and social media for any mentions of at home services (similar to the AI tools used by the ASA to monitor advertising).
How Mishcon de Reya can help
Whether you are a business concerned with how best to adequately safeguard itself and manage risk appropriately or need advice in connection with regulatory investigations and/or enforcement action our Health and Safety team can assist. They advise on regulatory developments and horizon-scanning; identify exposure to investigations, enforcement action, or prosecution by local authorities, the Health and Safety Executive or the MHRA; pursue or defend consumer protection claims arising from unsafe procedures; and advise on, and act in, potential class actions.