Government proposes tighter rules for high-risk cosmetic treatments in England

High-risk cosmetic treatments including liquid Brazilian butt lifts, deep chemical peels and so-called vampire facials would be restricted to specified healthcare professionals under government proposals announced on 21 October.

The Department of Health and Social Care has opened a consultation on the draft regulations, which apply to England. The plans would also restrict access for under-18s and create criminal offences for providers who breach the rules.

Fillers injected into parts of the body other than the face, including those used in liquid Brazilian butt lifts, would be legally classified as cosmetic surgical procedures. This would mean only doctors could perform them.

Other high-risk non-surgical treatments would be restricted to doctors, dentists, and nurses, midwives and pharmacists who are qualified as independent prescribers. This would exclude practitioners in those last three professions who do not hold the required prescribing qualification.

The proposed treatment list includes deep chemical peels, dermal microcoring, which removes small cores of skin tissue, and intravenous treatments provided for cosmetic or wellbeing purposes. Permanent facial fillers, subcision and treatments using products derived from blood or plasma, including platelet-rich plasma facials, are also covered.

Restrictions would extend to cosmetic procedures involving a separately injected anaesthetic and specified laser and intense pulsed light treatments. These include lasers used to remove skin layers or introduced through a puncture or incision, and laser or intense pulsed light treatments on the eyelid or within the rim of the eye socket.

Providers offering the procedures would need to register with the Care Quality Commission (CQC), which would oversee enforcement. The proposals aim to close a gap in the current system, under which providers employing healthcare professionals to perform cosmetic surgery must register with the regulator, while those using people outside those professions can fall outside its remit.

Victoria Brownlie, chief policy and sustainability officer at the British Beauty Council, said: “Over a number of years, the line between a beauty treatment and a medical procedure has blurred. A lack of regulation in what has become a booming market has led to an exploitation of these gaps, placing members of the public at serious risk.”

The treatments would generally be restricted to adults aged 18 and over. Exceptions would apply to NHS provision or where a healthcare professional is treating a medical condition. The proposals for England cover cosmetic surgery, including body fillers, plus eight categories of high-risk non-surgical treatment. The full list is as follows:

1. Cosmetic surgery and body fillers

Surgery performed for cosmetic purposes, including liposuction, thread lifts, facelifts, breast surgery, nose surgery, eyelid/brow surgery, tummy tucks, buttock/thigh lifts and cosmetic implants. Fillers injected outside the face, including liquid BBLs, would also be classified as cosmetic surgery.

2. Deep chemical peels

Peels penetrating beyond the junction between the epidermis and dermis.

3. Dermal microcoring

Procedures where needles remove small cores of skin tissue.

4. Intravenous treatments

Any substance injected or infused into a vein for cosmetic or wellbeing purposes, including vitamin and mineral drips.

5. Specified laser and IPL treatments

Three groups: lasers that remove skin layers; lasers introduced through a skin puncture or incision; and laser or intense pulsed light treatments on the eyelid or within the rim of the eye socket.

6. Non-resorbable facial fillers

Permanent fillers injected into facial tissues.

7. Procedures involving a separate anaesthetic injection

Cosmetic procedures where an anaesthetic is administered as a separate injection.

8. Blood- or plasma-derived treatments

Procedures introducing therapeutic products derived from human blood or plasma into the body, including cosmetic PRP treatments commonly called vampire facials.

9. Subcision

Procedures using a needle to cut fibrous bands connecting the skin to underlying tissue, including cellulite subcision.

Providers and registered managers who allowed an unauthorised practitioner to perform a covered procedure, or breached the proposed age restrictions, could face unlimited fines following prosecution. Fixed penalties of £4,000 for service providers and £2,000 for registered managers would be available as an alternative.

Health minister Karin Smyth said the changes were intended to improve patient safety, protect young people and help the public identify qualified providers. The announcement follows reports of invasive procedures being carried out by unqualified practitioners, with serious consequences for patients.

Ashton Collins, director of Save Face, said: “We welcome this vital step towards protecting the public from the harm we have seen in recent years.”

The government remains committed to a separate licensing scheme for clinics offering botulinum toxin treatments, lip fillers and other lower-risk procedures. That work sits alongside the consultation on high-risk treatments.

Brownlie added: “I believe this is a vital step toward the required regulation and commend the Government for tackling this issue head-on. Their assurance that a licensing scheme for ‘lower risk’ treatments will follow is also much welcomed as a vital turning point to ensure the highest standards of competence and care across the beauty and aesthetics sector.”

Practitioners, businesses and members of the public have until 11.59pm on 13 January 2027 to respond. The consultation asks which procedures and professional groups should be included, and how the changes would affect businesses and consumers and can be accessed here.

The parliamentary process is currently planned for spring 2027. A transition period would then allow providers to apply for CQC registration before the restrictions take effect. The implementation timetable will be finalised after the regulations complete the parliamentary process.