In Spring 2013 the Government commissioned an independent review of cosmetic surgery recommending better regulation, better training and proper redress if things go wrong. Initial recommendations have been made as a result of the review and a full statement from the Government is due out tomorrow.

Below is the British Association of Dermatologts response to the review.

The British Association of Dermatologists welcomes the Government’s response to the Keogh Review of Regulation of Cosmetic Interventions.  We are concerned however, that whilst the response makes the right noises in terms of endorsing key recommendations there is little to demonstrate how these recommendations might be thoroughly implemented or robustly enforced, particularly in respect to non-surgical cosmetic interventions.

chemical_peel_cropThis is not a trivial matter.  In a recent audit of our members, the Dermatologists responding judged that 63% of the complications (arising from non-surgical cosmetic interventions) they had seen were irreversible or permanent.

Like many of those involved in the Keogh review process, both medical and non-medical, the British Association of Dermatologists is concerned that without statutory enforcement of training, accreditation and registration, a two tier system will arise.  In a letter in December to Health Minister, Dan Poulter, the Presidents of the British Association of Dermatologists, British Association of Aesthetic Plastic Surgeons and The British Association of Plastic, Reconstructive and Aesthetic Surgeons warned:

“Without a compulsory specialist register, that includes all practitioners in this field – both medical and non-medical – the public will be prey to a two tier system; good practice by well qualified professionals on one level, a level that will almost certainly cost the consumer more, and a cut-price, budget approach provided by untrained practitioners with little consideration of risk and redress for complications on the other, lower, level.

Such a system is unlikely to address the concerns raised in the original Review around unregulated cosmetic interventions.”

This warning has not been heeded.   Whilst the British Association of Dermatologists (along with colleagues in other specialities) continues to work to improve safety in this area through a number of initiatives, the Government has stood back from the vital action: legislation – which we all believe is necessary for public safety.

Tamara Griffiths, Consultant Dermatologist says

“We had hoped to see a great step forward today, in terms of making non-invasive cosmetic procedures safer for the public.  We have instead seen a very small step forward.  We will now work to do our best to make sure that, where we can, these procedures are made safer across the sector.”

The British Association of Dermatologists will put out a full response to the Government response over the next few days.


The Sir Bruce Keogh Review of the Regulation of Cosmetic Industries published its findings in April 2013 – the full report can be found here. The letter written to Health Minister Dan Poulter by the Presidents of the British Association of Dermatologists, British Association of Aesthetic Plastic Surgeons and The British Association of Plastic, Reconstructive and Aesthetic Surgeons is available here.

Consumers (and practitioners) often underestimate the risks of non-surgical procedures simply because there is little data on these risks – however a survey recently undertaken by the BAD showed the following results:

  • 58% of the Dermatologists answering the survey had seen patients with complications from non-surgical cosmetic procedures.
  • 54% of these complications were due to dermal filler injections.  Of these 33% had granuloma formation and 10% had allergic reactions. (Granuloma formation is a chronic, debilitating foreign body reaction, where chronic nodules develop which may require treatment with systemic immunosuppressive agents (e.g. Prednisolone) and recurrent surgical removal)
  • 63% of respondents stated the duration of the adverse events were irreversible or chronic.
  • 59% of respondents stated the adverse event had either a very negative or extremely negative impact on the patient’s quality of life.
  • 49% of respondents felt there was either a missed diagnosis of skin disease, or inappropriate treatment of skin disease associated with the non-surgical cosmetic procedure. This is a particularly worrying area of concern.
  • The two main areas where complications arose were laser/light (67%) and dermal fillers (54%).
  • The types of adverse reactions that might be seen from laser/light treatments are burns, infections and permanent pigmentation changes and scarring.  In the case of lasers there are also rare instances of blindness and visual disturbance.


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