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Unregulated Clinics Exploit Anxieties About Appearance, Say MPs

Vulnerable people worried about their appearance are being exploited by unregulated clinics offering potentially dangerous cosmetic procedures, MPs have warned.

A rise in body image dissatisfaction, driven by social media and unscrupulous advertising, has fuelled the growth of an industry that promises to change how people look using lasers, injections of anti-ageing fillers, chemical peels and other non-surgical procedures.

In a scathing report published on Tuesday, the Commons health and social care committee warned that shame and depression about their appearance is prompting men and woman of all ages – and even children – to change their face or body to conform to society’s ideals of beauty.

It demanded an end to the current situation whereby the lack of oversight means that cosmetic practitioners with little training are allowed to carry out procedures such as injecting substances into people’s faces, despite risks including infections and disfigurement.

“We heard of some distressing experiences – a conveyor belt approach, with procedures carried out with no questions asked, procedures that have gone wrong, [and] the use of filthy premises,” said Jeremy Hunt, the former health secretary, who chairs the cross-party group of MPs.

The committee urged ministers to finally implement their plan to start licensing premises offering cosmetic treatments as an urgent priority by next July, as part of a raft of changes intended to clean up an industry worth an estimated £3.6bn in the UK. It has been delayed because the government has still not launched the public consultation exercise it needs to hold before licensing such establishments.

“It was clear throughout our inquiry that some groups are particularly vulnerable to exploitation in this growing market that has gone largely unregulated,” added Hunt. “We need a timetable now for a licensing regime with patient safety at its centre to reduce those risks.”

People undergoing non-surgical cosmetic procedures should always have to give a full medical and mental health history to the clinic, and have a cooling-off period after the consultation to consider properly whether such treatment is best for them, the MPs said.

The report warns that: “Body image dissatisfaction and its associated health impacts can affect anyone regardless of gender, sexuality, ethnicity or age. Body images can also result in increased health risks for specific groups, from the increased risk of suicide in those suffering from body dysmorphic disorder (BDD) to the total suppression of testosterone and its cardiovascular risks in people taking long-term anabolic steroids.

“The government seems not to appreciate these risks and is providing too [few] services for those needing help.”

As many as 31% of teenagers and 35% of adults feel ashamed or depressed about their appearance, according to a 2019 survey by the Mental Health Foundation thinktank the MPs cited.

“These pressures are directly impacting the health of the population,” said their report into the impact of body image on physical and mental health.

Kim Booker, a BDD sufferer who has had cosmetic treatments, told the committee’s inquiry that: “With my body dysmorphia and having those very strong compulsions to erase or fix certain parts of myself, I got overwhelmed by it.”

Some clinics do not tell clients what they can expect to achieve from treatment or consider their emotional or psychological needs, she added. “Literally, you walk into these places and it is like a conveyor belt. You have 10 to 15 minutes for a procedure that, from start to finish, should take at least an hour, to really survey the person’s face and understand their reasons for wanting the procedures to be done.”

The MPs also want the government to order cosmetic treatment providers to clearly mark images used in promotional activities that have been digitally altered, to reduce the risk of clients having unrealistic expectations of how they can change their appearance or of developing an eating disorder.

Ross Matthewman, head of policy and campaigns at the Chartered Institute of Environmental Health, said that currently local councils can only draw up a list of practitioners in their area who perform tattooing, semi-permanent makeup, piercings, electrolysis and acupuncture.

“Four out of five of these are considered high risk, due to the fact that they penetrate the skin and can carry a risk of blood-borne virus transmission. Some of these also have a well-documented history of outbreaks of infections, which require hospital treatment and can lead to permanent disfigurement and scarring,” he added.

“Many practitioners also perform procedures from their home or at the client’s home. Some of these practitioners are likely to have the least training and can be operating under the radar. The risk to vulnerable people is therefore very real and safeguarding issues can arise as, for instance, there is no legal minimum age limit for those wishing to get piercings.”

Poor hygiene standards, low knowledge of infection control and poorly sterilised equipment are also risks in too many clinics, he added.

A government spokesperson said: “We will be introducing a national licensing scheme… [which] will build on the existing support we have put in place, from expanding mental health services – including for those with body dysmorphic disorder – with an additional £2.3bn a year by 2024, to changing the law preventing under-18s accessing Botox and filler treatments for cosmetic purposes.”

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