Change in law on botulinum toxin and cosmetic fillers for under 18s

Fillers and Botox cannot be administered to under 18s for cosmetic reasons in England.

A change in the law means that it is a criminal offence to administer botulinum toxin or a subcutaneous, submucous or intradermal injection or filler for cosmetic reasons to a person under the age of 18 in England. However, such treatments can be administered by a dentist after approval by a registered medical practitioner where there is a clinical need.

Regulation and indemnity

Non-surgical, aesthetic treatments have become increasingly popular over the last few years and are easily accessible. There is no regulatory framework in the UK as to who can administer the injections and no requirement for the provider to have insurance.

Dental practitioners need to comply with the guidance set out by their own professional regulators. Standard 1.7 of the GDC's Standards for the Dental Team states, you have an obligation to put patients' interests "before your own or those of any colleague, business or organisation," and "before any financial, personal or other gain."

In FAQs, the GDC states that those carrying out non-surgical cosmetic procedures such as Botox should 'ensure that you only work within your knowledge and professional competence, adhere to the Council's standards at all times, and be prepared to back up the decisions you make.' You also need to ensure you have appropriate indemnity in place.

Click here for more on how the DDU can offer indemnity to dentists who are suitably trained.

Safeguarding children

The Botulinum Toxin and Cosmetic Fillers (Children) Act came into force on 1 October 2021. It aims to safeguard children from the potential health risks associated with botulinum toxin (commonly known as Botox) and cosmetic fillers. The law applies not only to businesses but also to providers of clinical healthcare services and regulated practitioners.

It is a criminal offence to administer fillers for cosmetic purposes to those under the age of 18 and permission to go ahead with treatment cannot be provided by someone with parental responsibility for the child. It is also an offence to book appointments or make arrangements to provide treatment to anyone under the age of 18 in England.

Definitions and exceptions

The definitions of cosmetic purposes are set out in the Act and include any substances that are inserted into the body with the intention of producing a filling effect to change appearance. An exception to the law is where treatment is provided to those who are under 18 to meet a named clinical need when administered by a registered doctor, nurse, dentist or pharmacist, having been approved by a registered medical practitioner.

The only other exception providing a defence is where the provider takes reasonable steps to establish the patient’s age, and reasonably believed they were 18 or over.

DDU advice

When providing cosmetic interventions, make sure you comply with the GDC's Standards and guidance on advertising and are competent to carry out the treatment. You must be convinced the proposed treatment is reasonable, in line with current accepted practice and in the patient's best interest.

You must also comply with other relevant guidance such as those from the Advertising Standards Agency and rules on advertising prescription only medicines. See our further advice on cosmetic treatments and dentistry.

This page was correct at publication on 18/10/2021. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.