Following the BBC’s undercover investigation, which exposed UK aesthetic practitioners using unlicensed botulinum toxin, the British College of Aesthetic Medicine (BCAM) released its Annual Clinical Review 2025. The report highlights the risks of the unregulated aesthetics industry. In response, BCAM has launched “Vet it Before You Get it”, a new campaign featuring a questionnaire patients can send to clinics before booking a consultation.
The aesthetics industry is growing fast. BCAM’s review found that in 2023, 7.7 million people had undergone an aesthetic treatment, and a further 13.9 million were considering getting a treatment.
BCAM reports that in 2024, the UK aesthetic industry grew by 8.4% and by 2026, the injectables market is forecasted to reach £11.7 billion.
The report highlights that the surge in demand is now matched by a surge in complications, with aesthetic medicine increasingly treated as “high street beauty rather than a medical intervention.”
The result is increased pressure on the NHS.
According to the report 67% of BCAM doctors treated problems caused by other practitioners, and BCAM members reported treating more than 3,000 complications in the past year from procedures performed elsewhere, with almost 2,000 cases linked directly to beauticians.
“These figures confirm what we see daily in clinics: patients suffering at the hands of underqualified practitioners. Doctors are left to pick up the pieces, sometimes in life-threatening circumstances. Regulation is no longer optional; it is urgent,” said Sadie Van Sanden Cook, BCAM chief operating officer.
The concern surrounding unregulated practice, specifically counterfeit botulinum toxin, has grown over the recent months, following reports of 41 cases of botulism. The annual report confirms that unregulated practice is fuelling an increase in botched outcomes, medical emergencies, and under-18s still seeking illegal treatments.
Botulinum toxin and fillers
The data found that around 900,000 toxin injections are given annually in the UK.
Botulinum toxin can only be administered by registered medical prescribers, and the toxin must be purchased from accredited pharmacies, prescribed for individual patients.
The data found that there were 668 botulinum toxin complications from beauticians, which resulted in drooping eyelids, distorted smiles, and severe distress. In August, the government confirmed that it would introduce a new licensing scheme to regulate aesthetic procedures, requiring practitioners to meet strict standards in education, training, infection control, patient safety, and insurance before they can operate legally.
There are also growing concerns about the safety of filler treatments. Currently, there is no legal requirement for practitioners who administer fillers to be medically qualified. However, the report found that fillers account for 87% of all reported complications, ranging from infection and lumps to vascular occlusion and tissue necrosis, and 1,239 reported cases have been directly linked to beauticians.
Other Risks Emerging
It is not just botulinum toxin and fillers which are posing risks to the public; the report found that non-medics are using other medical devices without proper qualifications. Laser treatments were associated with 264 adverse effects such as burns and pigmentation damage. Thread lift procedures resulted in 85 cases involving skin puckering, scarring, and infection, BCAM reports.
The risk surrounding under-18s
Under the Botulinum Toxin and Cosmetic Fillers (Children) Act 2021, it is illegal in England to give botulinum toxin or filler injections for cosmetic purposes to anyone under 18.
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Despite this, 21% of BCAM members were approached by under-18s seeking treatments.
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Eight minors required corrections after illegal filler or toxin work carried out by non-BCAM practitioners.
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Some under-16s were treated for non-medical laser hair removal, despite legal protections.
BCAM “Vet It Before You Get It” campaign
The Vet It Before You Get It campaign gives patients the opportunity to ask any difficult questions before they book a consultation, aiming to improve patient confidence and safety.
“The results of BCAM's annual review make it very clear that we need tougher regulations in the UK to help stop needless complications arising from non-medics administering aesthetics to the public. Whilst we still don’t have the necessary rules in place, it is very important that the public do all they can to safeguard themselves from individuals who are carrying out these procedures. BCAM members and the majority of the aesthetic industry believe that aesthetic treatments should only be administered by qualified doctors, dentists, or nurse prescribers,” shares Dr Sophie Shotter, president of BCAM.
“BCAM is launching a new campaign to help the public stay safe. The ‘vet it before you get it campaign’ is a questionnaire patients can send to clinics ahead of booking for a consultation. This means any awkward questions can be answered before a face-to-face meeting, and they can feel comfortable that they have booked with an ethical practice before any money leaves their account. BCAM members and I support this campaign and hope members of the public will take this action to support their safety,” Dr Sophie Shotter adds.
The questionnaire will answer vital questions such as:
1. Is the clinic CQC-registered, and is the practitioner a BCAM member?
2. What are the practitioner’s qualifications and registration number (GMC, GDC, or NMC)?
3. Roughly how many of these procedures has the practitioner performed before?
4. Which product will be used in my treatment— and is it CE-marked or FDA-approved?
5. What are the risks, contraindications, and expected results?
6. What aftercare and emergency support will be provided?
The ‘vet it before you get it campaign’ kicks off on the 21st October with a questionnaire available via BCAM’s website available for people to download and send to clinics ahead of booking for a consultation.
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