Expert calls for regulation of cosmetic procedures in NZ after ban on Botox, dermal fillers for under-18s in UK

In the wake of the United Kingdom passing legislation to ban teenagers under the age of 18 from having Botox or dermal fillers for cosmetic reasons, there are calls for New Zealand to regulate the non-surgical appearance medicine industry.

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Dr Catherine Stone has 20 years of experience in non-surgical cosmedicine. Source: 1 NEWS

The legislation was approved by the Queen on April 29, banning those under 18-years of age from accessing Botox and dermal fillers in the UK.

It comes after a lack of regulation in the industry and data sources and analysis by the UK’s Health Department in 2020, estimated there may have been as many as 41,000 botulinum toxin procedures carried out for under 18s in 2020, and over 29,300 dermal filler procedures for under 18s may have been undertaken in 2017.

The Bill, entitled the Botulinum Toxin and Cosmetic Fillers (Children) Act 2021 was initiated by UK MP Laura Trott, who also apportioned some blame to social media for the increase in teens having cosmetic procedures.

“No child needs cosmetic Botox or fillers, and I am delighted my Bill is now in law for children across England. The Act will ban cosmetic Botox and fillers being administered on under 18s and stop the dangerous and unnecessary procedures which damage people's lives. I know consultations are underway in Scotland and Wales to ensure we have a united approach here in the UK, and I hope other countries will follow suit so that children across the world can be protected,” she told 1 NEWS.

“Social media exerts a huge pressure on young people to conform to aesthetic ideals, which are simply not attainable without cosmetic surgery or interventions, and this, combined with their increasing availability on the high street and in people’s homes, means that we have an increasing normalisation of cosmetic interventions among the young,” she said at the Bill's Second Reading in the House of Commons last year.

“These procedures risk ruining young people’s lives,” she said.

Trott cited an example of an under 18-year-old female who “nearly lost her lips” after being injected with filler by an improperly trained injector.

She did stress that the Bill stops cosmetic procedures for those under 18, not medical procedures. Those who need Botox for conditions such as migraines will still be able to receive them.

The Ministry of Health told 1 NEWS there is “currently a limited level of regulation in New Zealand regarding dermal fillers” nor age restriction for the receiving of fillers.

Similarly, Botox does not have an age limit either.

“Botox is classified as a prescription medicine. It can be prescribed and administered by medical practitioners, dentists, nurse practitioners and certain other health care professionals with a relevant scope of practice,” a ministry spokesperson said.

The Botox data sheet says, “Safety and effectiveness in children below the age of 12 years have not been established for the indications of upper facial lines (forehead, crow’s feet and glabellar lines)”.

The Care of Children Act 2004 does however set a standard by stating that the age at which a person can generally give legal consent to medical procedures is 16 years old.

Dr Catherine Stone has 20 years of experience in non-surgical cosmedicine and is a leading injector and trainer with clinics in Auckland and the UK.

She applauds Trott’s Bill and says the industry in New Zealand needs better standards.

“Traditionally the UK has been seen as one of the least regulated countries in our industry, so I applaud this move,” she says.

“I have worked at some of the top clinics in London, and am part of a global ‘hive’ of trainers for Botox and Juvederm (dermal filler), so I have several friends who have been pushing for better regulation of cosmetic injectables in the UK.

“I truly hope that we can start to implement similar changes, as unfortunately New Zealand has deteriorated to becoming more like the UK. Even in South Africa, only doctors can inject cosmetic injectables. We need to do more to ensure that New Zealand is better regulated and licenced,” Stone says.

While dermal fillers are classified as a medical device and must be notified to Medsafe by manufacturers or importers, the Ministry of Health says under the Medicines Act, fillers can be legally imported, sold and used in New Zealand if notified on Medsafe's Web Assisted Notification of Devices (WAND) database.

Stone sees this as problematic as “essentially anyone can inject them”.

“The lack of pre-approval by MedSafe of products means that anyone can inject any ‘filler’ into someone’s face,” she says.

“If someone injects a non-approved, non-dissolvable filler, the person receiving the treatment may be permanently disfigured, with the permanent fillers having a much higher risk of both severe infection, causing scarring, and permanent lumps called granuloma.”

“I believe there are currently no regulations protecting our teens from less ethical practitioners in New Zealand, and that this would be a great place to start providing more regulation of our industry,” Stone told 1 NEWS.

She agrees social media has become part of the problem for teenagers.

“It’s tough, as I understand there is a lot of social pressure at that age, especially with modern impact of social media. I actually feel there is a societal responsibility by social media, ‘influencers’ and our own industry to stop glamourising the distorted perspective on beauty.”

Stone says her clinic screens clients for body dysmorphic disorder, a mental health condition characterised by an obsession with one's appearance or physical flaws and a subsequent preoccupation with fixing those. 

Stone says the condition is “quite rare, less than one per cent" of the population but says treating those people often makes their condition worse.

“So if we pick up that there could be an indication, then it’s a gentle but honest discussion – kind of moving them into areas which are going to be more appropriate for them like counselling, cognitive behavioural therapy and anti-depressants which we know helps them and makes a big difference,” she says.

Stone says the percentage of body distortion (a distorted perception of beauty or one's appearance) however is the highest in the cosmedicine industry. She says the industry has a responsibility to model best-practice and “to make sure we look natural and normal so we can model that to our patients."

While there is no sign of any new regulation into the cosmetic medicine industry yet, the Ministry of Health says it is continuing work on the draft Therapeutic Products Bill that will replace the Medicines Act 1981.

“Following consultation on a draft Therapeutic Products Bill in early 2019, the Ministry received 442 submissions. These are informing ongoing work on the Bill, which is still in development,” a spokesperson said.

“The date for the Therapeutic Products Bill entering Parliament has yet to be determined and will be decided by the Government.

“There will be further opportunities to make a submission on the Bill once it is introduced to Parliament at the Select Committee stage, and during the development of Regulations.”

In the UK the Queen must approve all Bills before they become legislation.