As hay fever symptoms peak during the summer months, demand for a quick solution can be strong. For some patients, the idea of a single injection that could provide relief from seasonal symptoms may sound particularly appealing.
But the British College of Aesthetic Medicine (BCAM) has issued a safety warning over the continued demand for so-called ‘hay fever injections’ or ‘hay fever jabs’, highlighting concerns around patient safety, informed consent and whether people fully understand the risks involved.
For practitioners and clinics, the issue also raises wider questions. What does it mean when a medicine is used off-label? Who is appropriately qualified to prescribe and administer it? And, importantly, does your medical malpractice insurance cover the treatment you are providing?
Long-acting steroid injections used for hay fever typically contain triamcinolone acetonide, a corticosteroid associated with the brand name Kenalog.
Kenalog is a prescription-only medicine (POM) licensed for certain conditions in the UK, but it is not licensed specifically for the treatment of hay fever. The Medicines and Healthcare products Regulatory Agency (MHRA) has previously warned clinics about promoting it for this purpose and, in 2022, took joint action with the Committees of Advertising Practice (CAP) over illegal online advertising.
The issue remains current. In May 2026, the MHRA published details of further action following complaints about websites offering medicinal treatment services for hay fever. The regulator reiterated that advertising rules prohibit public advertising likely to lead to the use of a POM and that Kenalog is not licensed as a hay fever treatment.
BCAM’s warning forms part of its ‘Vet It Before You Get It’ campaign, which encourages patients to research injectable treatments and understand who is providing them, what is being administered and the potential risks involved.
Dr Rebecca Norman, Vice President of BCAM, said, “We completely understand why patients suffering with severe hay fever are attracted to the idea of a single injection that appears to solve the problem for months. However, many people are unaware that this is a powerful steroid medication that circulates throughout the entire body, not just the nose or eyes where symptoms occur.
“For the vast majority of patients, evidence-based treatments such as steroid nasal sprays, modern antihistamines and, where appropriate, specialist allergy services provide safer and more targeted options. Patients should be fully informed of both the benefits and the risks before agreeing to any injectable treatment.”
The hay fever injection debate highlights an important distinction between a medicine being ‘unlicensed’ and being used ‘off-label’.
Off-label use generally means that a licensed medicine is prescribed or used outside the terms of its marketing authorisation. This might relate to the condition being treated, the dose, route of administration or patient group.
Off-label prescribing is not automatically inappropriate or unlawful. It is an established part of healthcare and may be clinically justified in some circumstances. But the decision carries additional professional responsibility. The prescriber must be satisfied that the treatment is appropriate for the individual patient, work within the standards set by their professional regulator, and provide enough information for the patient to make an informed decision.
That means the fact that a treatment is available, requested by a patient or widely discussed online does not, on its own, make it appropriate to provide.
For aesthetic practitioners, one of the most important questions is whether a treatment sits within their individual scope of practice.
Scope of practice is not defined simply by whether someone can physically administer an injection. Practitioners need to consider their professional background, qualifications, training, competence and ability to assess the patient, recognise contraindications, manage complications and provide appropriate follow-up.
This becomes particularly important when a clinic expands beyond cosmetic procedures into services that treat medical conditions. Hay fever is a medical condition, and a long-acting systemic corticosteroid carries a different risk profile from many of the treatments more commonly associated with aesthetic practice.
Practitioners should be able to demonstrate why they are competent to provide the treatment and that they are acting within the requirements of their professional regulator. Where prescribing is involved, the prescriber must also meet the standards that apply to their own profession.
As Hamilton Fraser has explored in its wider content on practitioner training and continuing professional development, completing a course does not automatically mean that every treatment falls within a practitioner’s appropriate scope of practice.
There is another question that should be considered before offering any treatment: are you actually insured to provide it?
Medical malpractice insurance protects practitioners against allegations of negligence arising from the advice they give or the treatment or procedure they carry out, subject to the terms, conditions and exclusions of the policy.
But cover should never be assumed.
A practitioner may be qualified to prescribe a medicine, but that does not automatically mean every use of that medicine is covered by their insurance policy. Equally, a treatment being widely offered by other clinics does not mean it falls within an individual practitioner’s cover.
Before adding a new treatment or service, practitioners should check whether
Hamilton Fraser’s approach to cover depends on factors including the practitioner’s professional background, training and the specific treatments declared and insured. Your policy schedule is an important document because it sets out the treatments and procedures covered under your policy.
If a treatment is not listed, or you are unsure whether a particular use falls within your cover, speak to your insurer before providing it.
The issue is not limited to clinical practice. Clinics also need to think carefully about how prescription-only medicines are marketed.
Prescription-only medicines cannot be advertised to the general public in the UK. In its 2022 enforcement action, the MHRA made clear that this restriction extended beyond simply using the brand name Kenalog. It also addressed indirect descriptions such as ‘hay fever injection’ and ‘hay fever jab’ where these promoted the use of the POM.
This is particularly relevant in an industry where services are often promoted through social media, seasonal campaigns and online booking pages.
Clinics should review their websites, social media posts, paid advertising and other marketing materials with these rules in mind. A treatment should not be presented as a simple seasonal add-on without careful consideration of the medicines advertising rules and the clinical responsibilities involved.
For more, read our guide to social media marketing.
BCAM has also highlighted the importance of balanced information.
Unlike more localised treatments for hay fever, a long-acting steroid injection can have effects throughout the body. BCAM warns of potential side effects including raised blood sugar levels, increased blood pressure, sleep disturbance, mood changes, fluid retention, weight gain, immune suppression, skin thinning and hormonal disruption. Particular caution may be needed for people with certain medical conditions or risk factors.
For practitioners, informed consent should reflect the individual patient, the proposed treatment and its material risks. Where a medicine is being used off-label, the patient should receive clear information that allows them to understand the nature of that use and any reasonable alternatives.
Good documentation matters too. Consultation notes should record the clinical reasoning behind the decision, relevant medical history, contraindications considered, alternatives discussed, information given to the patient and the consent process.
This is important for patient safety and can also be critical if a complaint or claim arises later.
The debate around hay fever injections reflects a broader issue for clinics as treatment menus continue to expand.
Aesthetic practitioners are increasingly working across areas that overlap with wider healthcare, including weight management, menopause-related services, regenerative treatments and other interventions involving prescription-only medicines. As services develop, the boundaries between cosmetic treatment and medical care can become more complex.
The key questions remain consistent: Are you appropriately qualified? Are you working within your scope of practice? Is there a clear clinical rationale? Have you met your prescribing and consent responsibilities? And does your insurance cover what you are doing?
Patient demand should never be the only factor driving a new service.
Before introducing any treatment, particularly one involving off-label use or a prescription-only medicine, check your professional responsibilities and speak to your insurer if there is any doubt about cover.
Hamilton Fraser provides specialist medical malpractice insurance for aesthetic practitioners and clinics, with cover based on factors such as professional background, training, and the treatments provided. If you are adding a new treatment or changing the scope of your services, contact our team to check your cover before you start treating patients.
To find out how Hamilton Fraser can support you, call us on 0800 63 43 881 or get an online quote today.
