Botox is an increasingly popular non-surgical cosmetic anti-wrinkle treatment, and has earned the nickname “the lunchtime facelift” for the ease of access to the treatment and its fast-acting effects on lines and wrinkles. Anti-wrinkle injections are now treated as a lifestyle product as harmless as lipgloss. However, Botox is derived from a form of botulinum (a bacterial toxin that causes botulism) and must be administered with care by qualified practitioners.



Despite this, many unlicensed clinics offer anti-wrinkle injections and even some teenagers are now demanding the treatment to prevent facial lines from forming. Anti-wrinkle injections carry risks if administered incorrectly, and healthcare bodies and ethical practitioners are now calling for greater regulation on the Botox industry in the UK – estimated to top £1bn this year.

Botox is used to treat wrinkles that form in the skin from repeated muscular activity, for example frown lines, crows' feet and forehead lines. It works by blocking the release of the chemical from the nerve ending that stops the muscle from contracting, the skin over the muscle does not fold, and therefore no folding or wrinkling of the skin occurs.

Aesthetic procedures to enhance an individual's appearance are increasingly accessible and more affordable than in previous years, and if anti-wrinkle injections are properly administered at the right dose, they have an excellent safety record. However, as with any medical procedure there are risks associated with Botox, including bruising, thinning of muscle fibres (if used repeatedly over time), and weakness of the muscles in the treated area, which can lead to drooping of the eyelids or eyebrows. Botox should also not be used on patients affected by certain skin conditions, broken skin or rashes in the area to be treated.

Demand for Botox treatment is steadily growing, and last year a report by Which? found a worrying lack of regulation of non-invasive treatments (i.e. injections, laser treatments, chemical peels etc). There were 472,000 non-invasive treatments carried out last year, and more than 55,000 of these treatments were anti-wrinkle injections. Many of the people having the injections were unlikely to check if the product was appropriately licensed and if the person administering it was qualified to do so.

The Which? report's independent panel of experts visited 19 clinics, and only five rated as “good”. Recently, DIY Botox kits were withdrawn from sale on the auction site EBay amid safety fears – nurses had been selling the kits for people to use at home.

There is no single body that regulates the clinics that give anti-wrinkle injections and other minimally invasive treatments, and often clinics go unchecked. In 2005, a Government working group recommended that Botox anti–wrinkle injections should be regulated by the independent government regulatory body, the Healthcare Commission, but the industry is still only beholden to itself and the situation will not be reviewed until next year. Cosmetic doctors and reputable clinics hope that there will soon be a regulatory body that will rid the Botox industry of the cowboy practitioners who pose a risk to people who seek Botox treatment.

Botox is a prescription drug which can only be issued by a doctor. New General Medical Council rules mean doctors must vet everyone who wants the anti-ageing treatment” Daily Mail, 10th December 2008.