Ban on adverts targeting under 18s following injectables ban

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Following the introduction in 2021 of the ban on injectables for under 18s, a ban on adverts for cosmetic procedures targeting under 18s came into effect on 25 May 2022.

The ban means that it will be illegal to advertise procedures designed to change a person’s physical appearance – including breast augmentation or reduction, ‘tummy tucks’, eyelid surgery, nose reshaping and facelifts. The ban also includes dermal fillers, teeth whitening products and chemical peels.

The change aims to tackle body image issues in young people after concerns have been raised regarding young people’s mental health in relation to body image pressures.

The Committee of Advertising Practice (CAP), which works closely with the advertising regulator, said:

“Children and young people’s body image perceptions and their susceptibility to pressures to change their appearance, including considering cosmetic interventions as a potential means to address those concerns, are influenced by a number of social and cultural factors. Nevertheless, the evidence shows there is potential that exposure to different forms of media including advertising, particularly those that focus on body image ‘improvements’ such as cosmetic intervention procedures, is likely to exacerbate body image dissatisfaction and negativity during vulnerable stages of their lives.”

The new targeting restrictions require that:

  • Ads for cosmetic interventions must not appear in non-broadcast media directed at under 18s
  • Ads for cosmetic interventions must not appear in other non-broadcast media where under 18s make up over 25 per cent of the audience
  • Broadcast ads for cosmetic interventions must not appear during or adjacent to programmes commissioned for, principally directed at or likely to appeal particularly to under 18s.

CAP and the Broadcast Committee for Advertising Practice (BCAP) will conduct a 12 month post-implementation review to make that the new rules are functioning as intended.

It’s important for practitioners to be aware that the ban covers all forms of advertising, including on websites and online media, as well as social media and influencer marketing.

The guidance also covers misleading issues including the use of before and after images and the use of terms such as ‘qualified’, ‘specialist’ and ‘skilled’.

For more information on how to comply with the new restrictions, the Advertising Guidance on Cosmetic Interventions has been updated to reflect the new rules and clarify the types of treatments and procedures that will be affected by the new restrictions.

The advertising ban follows what was seen as a long overdue step forward for the aesthetics industry, when the Botulinum Toxin and Cosmetic Fillers (Children) Act 2021 came into effect from 1 October 2021.  Effectively, the law means that no invasive nonsurgical cosmetic treatment involving the insertion of dermal fillers, or the injection of toxins, is permissible to any person under the age of 18 unless there is an explicit medically determined reason.

Demand for injectables for under 18s has been on the rise – a survey in 2018 cited by MP Laura Trott, who sponsored the Bill, showed that 100,000 under 16s had undergone cosmetic enhancements, with the most common being fillers. Alarmingly, this has been an unregulated area, with children able to access botulinum toxin and cosmetic filler procedures on the commercial market in the same way as adults, with no medical or psychological assessment required.

The law makes it a criminal offence for a person to give botulinum toxin or filler injections for cosmetic purposes to a person under the age of 18. These procedures will still be available to minors if there is an assessed medical need, from a limited range of registered health professionals. The legislation is intended to safeguard children from the potential health risks associated with botulinum toxin and dermal fillers.

The injectables industry in the UK has been highly unregulated, so this regulation was a momentous moment for the aesthetic sector. Speaking to Aesthetics Journal in support of the Bill after it passed through the House of Lords on 28 April 2021, Sharon Bennett, Chair of the British Association of Cosmetic Nurses (BACN) and Aesthetics Clinical Advisory Board member, commented:

“Legislation in cosmetic medial practice is long overdue. We have legislation in place to prevent under 18s from having a tattoo or sunbed session so it is astonishing that legislation has not been in place for this age group from the botulinum toxin and fillers. Children should be prevented access to these treatments to protect them from themselves and social pressures, unscrupulous practitioners and from those without a medical qualification. The Bill is therefore a welcome step and, as Chair of BACN I fully support it.”

Sharon Bennett, Char of British Association of Cosmetic Nurses (BACN)

Momentum to prohibit the use of injectable procedures for aesthetic purposes on children in England has been building for some time. A 2017 report by Nuffield Council on Bioethics on Cosmetic Procedures and Ethical Issues noted that there are statutory minimum age limits of 18 for other appearance-related procedures such as tattoos and sunbed use. And the 2013 Keogh Review of the Regulation of Cosmetic Interventions called for “greater protection for vulnerable people”, noting that young people and girls in particular, were becoming more concerned with their appearance.

The Joint Council for Cosmetic Practitioners (JCCP) was actively engaged in providing advice to government departments as part of the formulation of this legislation and campaigned for its legal enforcement. Commenting at the time it came into force on what the Bill meant for the industry, Professor David Sines CBE, Chair of the JCCP said,

“Whilst welcoming the new Bill, the JCCP is mindful that much more needs to be done to ensure that the Advertising Standards Authority (ASA) and the Committee for Advertising Practice (CAP) promote best practice that requires all workers in this industry to be committed to the responsible advertising of aesthetic products and services, which do not mislead customers with regard to risk, benefits and outcomes.”

– Professor David Sines CBE, Chair of the JCCP

The JCCP is particularly concerned about the irresponsible use of social media, and the targeting of medically related aesthetic procedures to children, which promote a ‘false picture of perfection’. Read more about ethical marketing and social media here.

The key points of the legislation:

  • Make it an offence to administer botulinum toxin or a ‘subcutaneous, submucous or intradermal injection of a filler for a cosmetic purpose’ to those under 18
  • ­Make business owners liable if a ‘person other than an approved person’ administers botulinum toxin or a ‘subcutaneous, submucous or intradermal injection of a filler for a cosmetic purpose’ to those under 18
  • Make corporate bodies liable if the offence is proved to have been committed with consent of ‘any director, manager or secretary of the body corporate or any person who was purporting to act in any such capacity’

Medical professionals will not be liable if they can demonstrate an identifiable medical need for treatment, or that they took reasonable steps to establish the patient’s age and reasonably believed they were aged 18 or over.

However, the JCCP emphasise that only designated registered healthcare professionals can determine whether a procedure is ‘medical’ in nature, and that any assessment must be within the limitations of the designated registered healthcare professional’s specific competence and scope of practice, and should follow an informed pre-treatment consultation, as defined within the meaning of the new legislation. Since non-medical professionals will not be able to make a medical diagnosis, they will not be able to use this as a defence for treating under 18s.

All aesthetic practitioners need to make sure that they comply fully with the requirements set down within the context of this new legislation.

“Hamilton Fraser Cosmetic Insurance welcomes the news that these treatments will finally be outlawed for under 18s. This regulation is long overdue and we hope that it will be a significant step towards wider regulation around injectables in the future. 2021 marked the 25th anniversary of the Hamilton Fraser family – since 1996 we have innovated, educated and led the sector. We remain committed to raising standards and will continue campaigning for regulation in the cosmetic sector, collaborating with the JCCP, government and other stakeholders to educate and influence the law.”

Eddie Hooker, CEO of the Hamilton Fraser Group

Find out more about Hamilton Fraser’s involvement in shaping the cosmetic industry and its evolution in The journey – a 25 year history of the UK cosmetic industry.