This week, the BBC released a scathing exposé into Britain's "Botox Wild West", revealing the dark underbelly of the sector where cash comes first and patient safety is disregarded. The documentary comes after a worrying spike in botulism cases across the UK.
Experts and friends of Aesthetic Medicine, including nurse prescriber Cheryl Barton, lent their expertise explaining the dangers of unlicensed, fake or improper use of botulinum toxin. “People have died from Botox,” she stressed. “It is that serious a drug.”
The prescription-only medicine is booming in popularity with around 900,000 toxin injections given annually in the UK according to the British College of Aesthetic Medicine’s annual report. The rise in interest in these treatments is also causing a rise in complications and bad actors wanting to profit - BCAM members reported treating more than 3,000 complications in the past year from procedures performed elsewhere, with nearly 2,000 cases linked directly to beauticians.
In the documentary, undercover BBC journalists, posing as beauticians, converse with seemingly trusted medical professionals who have gone rogue, breaking rules for financial gain.
The segment shows scenes of a nurse selling prescriptions via WhatsApp, a pharmacist advising a journalist how to falsify records and supplying additional vials of medicine based on fraudulent prescriptions, and a fake doctor - Prakash Gurnani- boasting about ‘Botox parties.’ Gurnani admitted to injecting thousands of 'young women' with an illegal Korean toxin, which he also sells from his car boot, along with prescription-only weight loss drugs.
Sector responds
These practices are in direct violation of professional standards set out by the Nursing and Midwifery Council (NMC) and the General Pharmaceutical Council (GPhC).
The NMC announced a significant update to its position on remote prescribing in June 2025, to reaffirm that prescribers must see patients in person before issuing prescriptions for cosmetic procedures.
Similarly, the GPhC has underscored that prescriptions for Botulinum toxin must always follow a physical, face-to-face examination. Both regulators have provided commentary to inform the evidence presented by the BBC investigation and 'will take enforcement action where appropriate.'
The British Association of Medical Aesthetic Nurses (BAMAN) has expressed ‘deep concern’ following the BBC investigation exposing the nurse prescriber Sally Jackson, who was filmed offering to sell Botox prescriptions over WhatsApp without ever seeing patients.
In a meeting filmed undercover, the nurse not only acknowledged that she was required to conduct face-to-face consultations, but openly dismissed this duty, stating:
“I'm supposed to do a face-to-face consultation. But we can do it the other way, WhatsApp me.”
“I should talk to them, but I won't.”
“BAMAN is unequivocal in its response: this behaviour is unethical, unsafe, and in breach of the NMC’s standards,” the association said in a statement. “It compromises patient safety, undermines trust in the profession, and damages the reputation of all nurses working with integrity in medical aesthetics.”
"This is not a grey area. It is a breach of professional duty. Patients deserve competent, ethical, and accountable care."
"The findings are deeply concerning and highlight the risks to patient safety when professional and legal safeguards are ignored. These checks are in place to prevent complications such as swelling, drooping, and other adverse reactions, and to ensure patients receive safe, appropriate care. When standards are bypassed, patients are left vulnerable and exposed to harm. Urgent action is needed to restore confidence and ensure the public can access safe, regulated care," said Professor David Sines CBE, Chair of the JCCP.
"It is unacceptable that members of the public continue to be exposed to such risks. Mandatory regulation and licensing, stronger enforcement against malpractice, and better education are essential if we are to protect patients and uphold professional standards in this rapidly growing industry."
BCAM ‘Vet it Before You Get it’ campaign
To help the public stay safe during these unregulated times, BCAM is launching the “vet it before you get it” campaign, which kicks off on 21st October with a questionnaire available for people to download and send to clinics ahead of booking for a consultation. It aims to help clients avoid any awkward conversations about a professional’s training, credentials and suppliers so they can ensure they are in safe hands.
“BCAM members and the majority of the aesthetic industry believe that aesthetic treatments should only be administered by qualified doctors, dentists or nurse prescribers,” said Dr Sophie Shotter Dr President of BCAM.
“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. "Myself, and BCAM members support this campaign and hope members of the public will take this action to support their safety.”
