After years of stagnation, a long-awaited shift towards stricter regulations and professional standards is taking shape, driven in part by a landmark decision to protect the title ‘nurse’ and a new ban on remote prescribing in cosmetic medicine.
For years, the UK’s non-surgical aesthetics sector has struggled with lax oversight, leaving patients vulnerable and the industry subject to criticism. Described as the ‘Wild West’ by experts and media alike, the field has been marked by high-profile botched treatments and unregulated practitioners.
As Aesthetic Medical Practitioner previously reported in its feature ‘Unregulated UK Cosmetic Surgery is Like the Wild West’, thousands of patients have been left exposed to poor outcomes and limited avenues for recourse after treatment involving non-healthcare providers operating without oversight.
The 2013 Keogh Review highlighted the need for reform, recommending the establishment of a compulsory register for all cosmetic practitioners to better protect patients. Despite the Keogh Review’s stark warning and a string of government consultations, structural change remained elusive.
Progress since then has been incremental. In October 2021, the UK introduced a ban on cosmetic injectables for individuals under 18. In September 2023, the Government launched its first-ever public consultation into non-surgical cosmetic procedures, inviting patients and businesses to share their views on how to improve safety across treatments like neurotoxin injections, dermal fillers and laser procedures.
The consultation proposed the introduction of a new national licensing scheme – potentially including restrictions on who can perform high-risk procedures – and was pitched as a major step forward in reforming the fragmented regulatory environment. As the government noted at the time, any licensing scheme would aim to ‘protect patients from potential harm’ and ensure consistent standards across the sector.
However, nearly two years on, formal action is still pending, fuelling criticism from within the industry. Many stakeholders say the consultation raised expectations but delivered little structural change.
The recent move to protect the title ‘nurse’ in law is therefore being seen as a long-overdue, but nonetheless welcome, step towards a more standardised and enforceable regulatory framework. It also suggests that change is underfoot.
Protecting the title ‘nurse’
In a milestone move, the UK government has agreed to legally protect the title ‘nurse’, ensuring that only registered professionals can use it in clinical and aesthetic settings. This decision, following the introduction of the Nurse (Use of Title) Bill by Labour MP Dawn Butler, aims to curb the misuse of the title by unqualified individuals in the booming aesthetics sector.
Previously, only the title ‘registered nurse’ was legally protected, creating a loophole that allowed unqualified individuals to describe themselves as nurses in aesthetic settings.
The new legislation seeks to close that gap. Under the bill, only those who are fully qualified and registered may use the title in any clinical or aesthetic context. The move has been widely welcomed as a baseline measure to help curb misinformation and rebuild public trust.
Still, it’s just one part of a broader recalibration now taking place – one that also includes a major shift in prescribing practices for cosmetic procedures.
NMC bans remote prescribing in cosmetic practice
In a landmark update to its regulatory position, the UK’s Nursing and Midwifery Council (NMC) has ruled that from 1 June 2025 nurses may no longer remotely prescribe medicines for non-surgical cosmetic procedures. This marks a sharp break from years of leniency, where video or phone consultations were often used to approve prescriptions for botulinum toxin and dermal fillers.
According to the NMC’s updated position, prescribing nurses must now conduct face- to-face consultations with patients before issuing any prescription for aesthetic treatments. Furthermore, prescriptions must be issued from regulated premises – such as an NHS facility or a Health Improvement Scotland-approved site – and only by qualified prescribers including doctors, dentists, prescribing nurses or pharmacists.
In a statement, the NMC said: ‘The NMC is updating its position on the remote prescribing of non-surgical cosmetic medicines, including certain anti-wrinkle injections and aesthetic emergency kit items. From 1 June 2025, nursing and midwifery prescribers will be required to consult with people face- to-face before issuing prescriptions for these procedures. We expect all nurse and midwife prescribers to deliver safe and effective prescribing practice every day, but inconsistent regulation of non-surgical cosmetic practice can present risks to people who use these services and the public. Face-to-face consultations support the mitigation of these risks, and adopting this position will better align the NMC with other health and care regulators.’
The NMC clarified that this move aligns with its existing Code of Conduct, which requires all registrants to prioritise safety, obtain valid consent and work within their competence. Aesthetic practitioners who breach these rules risk fitness- to-practise investigations, regardless of whether their practice is within the NHS or in the private sector.
While the NMC’s updated approach addresses some long- standing concerns, it stops short of resolving the broader issue of the UK’s largely unregulated aesthetics sector, particularly for procedures that don’t involve prescription medicines. Still, many medical practitioners are likely to view this as a welcome and long-overdue first step.
UK, Australia: shared challenges, different approaches
Both the UK and Australia face common challenges: the rapid growth of the aesthetics industry, the rise of social media-driven beauty standards and the influx of dodgy ‘practitioners’.
Australia has undertaken a more aggressive approach to reforming its aesthetics industry. Following a series of scandals and patient complaints, the Medical Board of Australia and the Australian Health Practitioner Regulation Agency (Ahpra) implemented sweeping reforms effective 1 July 2023.
These include mandatory GP referrals for cosmetic surgery, stricter advertising guidelines and enhanced patient consent protocols.
Ahpra also established a Cosmetic Surgery Enforcement Unit, leading to disciplinary actions against over 200 practitioners for unsafe practices in just 18 months.
While Australia’s sweeping reforms have been applauded by regulators and some patient advocacy groups, the mood among many aesthetic practitioners is far less optimistic. The TGA’s tightening grip on advertising – including bans on terms like ‘anti-wrinkle’ and ‘dermal filler’ – has left clinics scrambling to find compliant, yet meaningful ways to communicate with patients.
Adding to the tension is a marked increase in Ahpra notifications and enforcement actions, which many practitioners see as a sign of a system that has shifted from reform to reprimand. ‘We’ve moved from a system lacking regulation to one that’s almost hostile to practice,’ one doctor told AMP.
What’s clear is that the global aesthetics industry is moving towards greater accountability. The challenge ahead will be finding the right balance – one that ensures safety, maintains trust and allows skilled professionals to thrive. AMP
