Recently, it was published in The Times newspaper about ‘Black Market Botox’, documenting their own undercover investigations with unregulated practitioners – using unlicensed botulinum toxin products obtained from the black market.
This is nothing new, unfortunately – ‘practitioners’ with no medical training, who advertise on social media offering cut-price treatments, ‘sharing’ vials, competitions, enticing younger women and men to be injected. Potentially putting them at risk.
These ‘black market’ toxins have not been approved by the UK’s Medicines and Healthcare products Regulatory Agency (MHRA)
For many years there have been only three MHRA approved botulinum toxins for cosmetic and off-license use – Botox, Azzalure and Boccouture.
When I trained in dermal fillers and consequently botulinum toxin 17 years ago, only dentists, doctors and nurses (healthcare practitioners) were allowed to attend these courses and your GDC, GMC or NMC PIN number was required (registration numbers with your governing body)
Since the Keogh review in 2013, he highlighted the escalating problems in the aesthetics industry and campaigned for stricter regulations from the Government. Alas, these recommendations had not been up—regulated by the Government.
As already regulated nurses, dentists and doctors, we are bound by our codes of conducts and registration to put our patients safety first and protect them. We are also working within strict rules and regulations as prescribing clinicians within our speciality.
Its disheartening to see so many ‘aesthetic practitioners’ popping up, who have been ‘trained’ (in varying standards) in dermal fillers, botulinum toxin, thread lifts, PRP, vitamin injections, offering treatments that I cannot offer. I have to be registered with the CQC (Care Quality Commission) for example to be able to perform thread lifts and take bloods for PRP (platelet reduced plasma).
But the unregulated, non-medically qualified practitioners are ‘under the radar’ and able to offer possibly life threatening procedures, without the authorised access or probably training to administer prescription medicines if a complications occurs.
Botulinum toxin is a prescription-only medicine that should be prescribed by a healthcare professional after a face-to-face consultation with the patient. However this is being administered by people with no medical training, buying online, unregulated botulinum toxins or obtaining them from prescribers.
Its a relief to know that there is a new License slowly in progress through Parliament, as part of the Health and Care Bill, which is mandatory for certain procedures. This license scheme will start to regulate thousands of practitioners, and it will be an offence to work without it.
Botulinum Toxin has been around for decades, more time than people realise. Its been over 30 years since the medicine ‘Botox’ was approved as a medical option for blepharospasm and strabismus. (excessive blinking/eye twitching). Also over-active bladder, cerebral palsy muscle spasms, migraines, dystonia.
The other side affect noticed from the treatment for blepharospasm and strabismus – the wrinkles to the treated areas had softened markedly, or gone.
The husband and wife physicians, Jean and Alistair Carruthers published their first study on botulinum toxin type A for the treatment of glabellar frown lines in 1992.
Following on from then, botulinum toxin type A began to be utilised for cosmetic improvement of frown lines, forehead lines and wrinkles at the sides of the eyes (‘crows feet’).
Moving forward to current day and new botulinum toxins are being launched, for the first time in 14 years.
Croma-Pharma has launched Letybo. Galderma has launched the first liquid (pre-mixed) toxin, Alluzience.
Within aesthetic medicine, botulinum toxin is used off-label for various indications, including the lower face and neck.
While it is preferable to use a licensed product for specific indications, it can still be used after patient assessment if the prescribing practitioner feels that a good result could be achieved to improve the patients quality of life and psychological benefit.
These areas should be treated by an experienced medical practitioner with advanced training
Popular areas. –
- Gummy smile
- Platysmal bands (neck muscle)
- Teeth grinding/large masseter muscles
- Jawline slimming
- Dimpled chin
- Eyebrow lift
- Downturned mouth
