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Crackdown on the 'botox cowboys'

By Channel 4 News

Updated on 13 September 2010

As a new online register is set up of safe botox practitioners, its founders tell Channel 4 News the importance of clamping down on the so-called "botox cowboys", who can inject the cosmetic treatment with little or no training.

Botox injections are unregulated - but there's a new register to crackdown on the cowboys.

A government-backed online register of medically certified practitioners and sites has been set up to combat the risks of receiving treatment from rogue practitioners.

The register - Treatments You Can Trust - has been set up to help people "shop responsibly" for injectable cosmetic treatments including botox and other dermal fillers.  

It will include a directory of the regulated doctors, dentists and registered nurses who can administer the treatments safely.

Sally Taber, director of the Independent Healthcare Advisory Services (IHAS), is responsible for the management of the standards and training element of Treatments You Can Trust.

Ms Taber, a nurse by background, told Channel 4 News: "Given that the general public wants to look younger, we need to make sure there are controls about that and we want to make sure that the quality mark is known by everybody looking at cosmetic injectables."

According to a Mintel survey, around one million injectable cosmetic treatments are carried out every year.

Practitioners will have to self-regulate on the scheme - which excludes beauty therapists. If they meet the standards required by IHAS, they will receive a quality assurance mark and be listed on the register.

"The model we chose was the CORGI gas model – it's a self regulating scheme," Ms Taber said.

"So if people are looking for a plumber, they know the CORGI regulated plumber will be safe. In the beginning we wanted to call it a Cosmetic CORGI – but actually Treatments You Can Trust is exactly what it is."

The risks of cosmetic injectables
"We know that the problem is significant. Just anyone shouldn't be able to use cosmetic injectables because they are under the Medication Act, but there are people on the internet," Treatments You Can Trust's Sally Taber told Channel 4 News.

"People can get infection if they are injected in the wrong environment – shops, hair salons, or at botox parties.

"You need a knowledge of facial anatomy as well – in particular around the eye, knowledge is so important so that it does not go wrong, and lead to swelling, which can be permanent.

"We all know the high profile person who had filler injected into their lips, which was done by someone who was not appropriately trained.

"The other big thing is the inappropriate waste disposal of needles – in domestic waste for example. And the storage of botox – there has been knowledge of people storing botox in domestic fridges, which is not acceptable – next to the cheese or something.

"The cosmetic industry has grown without controls – it used to be something that was kept secret and frankly I think people did go to inappropriate providers. Given that the general public wants to look younger, we need to make sure there are controls about that and we want to make sure that the quality mark is known by everybody looking at cosmetic injectables."

Criteria to be included on the register include providing face-to-face consultations before treatment; providing a clean and safe clinical setting for the injections, and ensuring that practitioners have appropriate training.

The site went live today, with 156 clinical sites listed across the UK. A further 113 are working towards registration.

However, some have warned that the scheme is just a "marketing tool" rather than a mark of safety.

The British Association of Aesthetic Plastic Surgeons (BAAPS) said that - despite not being the main purveyors of cosmetic injectables - it was often their role to "pick up the pieces" when the treatments go wrong.

It urged that the quality assurance mark and register be put on hold pending guidance from the British and EU standards agencies - partly because the scheme makes no distinction between practitioners who have trained for years and those who have taken a weekend course.

A poll amongst its members found that less than 4 per cent of surgeons would sign up for the register.

BAAPS said the IHAS is part-funded by clinics, which meant it was a conflict of interest for them to have a regulatory role.

Consultant plastic surgeon and BAAPS president Nigel Mercer said: "It is evident from the information circulated by the IHAS to the profession that the scheme is being used as a marketing tool, its regulation appears rudimentary and their 'quality mark' is not recognised by the British Standards Institute or any other regulatory body.

"No regulation scheme should be set up in the interest of bringing in business. For example, clinics already have to register with the Care Quality Commission because it is the law and it is the job of this agency to regulate the facilities where these treatments are performed. The IHAS scheme is not enforceable and has no teeth to stop poor practice. It seems to be sold to the profession on the basis of marketing rather than patient safety.

"The unenforceable IHAS register seems to amount to state-sponsored marketing of cosmetic procedures, and that is not appropriate for any regulation scheme."

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