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What does the new cosmetic ban mean for under-18s?

I have been turning away under-18s for facial aesthetics for years.

A smiling woman. By Eric McGregor - (CC BY 2.0)
A smiling woman. By Eric McGregor - (CC BY 2.0)

Following Royal Assent of a new piece of legislation for the U.K., from 1st October 2021, clinicians who treat the under-18s with dermal fillers or botulinum toxin face prosecution, including dental professionals. The legislation is the Botulinum Toxin and Cosmetic Fillers (Children) Act 2021.

From it 1st October it will become illegal for certified injectors to administer cosmetic muscle paralyzers or fillers on patients who are under 18.  Age verification will also become a requirement before treatment to ensure patients and injectors are complying with the legal act.

The most common muscle paralyzer is ‘botox’. The toxin is derived from the bacterium Clostridium botulinum (and some related species). The toxin is one of the deadliest on the planet, although the toxicity risks under clinical conditions are low. However, one in six people who have a facial injection go on to suffer complications such as bruising, headache, nausea and “frozen” features.

According to Dr Sharon Kaur, who is a dentist and a Clinical Advisor for NHS England, this move is important to safeguarding the mental and physical health of young people.

Dr Sharon Kaur tells Digital Journal there is a distinction between ‘botox’ and medical fillers: “Botulinum toxin is a prescription-only medicine and therefore must be prescribed by a registered doctor or dentist who has completed a full assessment of the patient. Injectable medical fillers, on the other hand, do not require a prescription.”

Injectable fillers are soft tissue fillers injected into the skin at different depths to help fill in facial wrinkles, provide facial volume, and augment facial features.

This means: “Any dental professional who chooses to provide these treatments to patients must make sure they are trained, competent and indemnified to do so.”

Offering a dentist’s perspective on the new law, Dr Sharon Kaur, looks at the ethics: “I have been turning away under-18s for facial aesthetics for years and increasingly so over the last few, thanks to the rise of influencers and social media.”

She adds that she welcomes the ban, explaining: “Social media is so powerful; if we can create trends in minutes, we should be able to use the same platforms to educate our younger generations to value and appreciate what makes them unique. Having injectables is a decision too many people are making lightly; this cannot be compared to getting your nails done or having lash extensions.”

She adds that she can relate to the current pressures, noting: “Also, being a mother of two means I know one day my children’s generation will have a responsibility to ensure the well-being of future generations. I want other practitioners, like me, to begin to make that change for them.”

As a way of counterbalancing the growing requests for facile treatments, Dr Kaur observes: “For me, facial aesthetics and dentistry have always been about treating the person holistically.  By this, I mean finding their motivation for improved health and aesthetic change and discussing openly why a person may not be managing their own oral health or why they are requesting facial aesthetics so far from their presenting appearance.”

To do this, topics like body dysmorphia need to be discussed and this is the starting point for patients so that dentists can help to make the right decisions for them.

Dr Kaur concludes with: “I have a quote on my wall that states, “Don’t be pretty like her, be pretty like you” and this is the language I use with my patients.”

Written By

Dr. Tim Sandle is Digital Journal's Editor-at-Large for science news. Tim specializes in science, technology, environmental, and health journalism. He is additionally a practising microbiologist; and an author. He is also interested in history, politics and current affairs.

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