Cosmetic practitioners to screen patients for body dysmorphic disorder

A new professional body – the Joint Council for Cosmetic Practitioners – is introducing measures to ensure that health practitioners screen clients for mental health problems before carrying out cosmetic procedures.

Botox and other cosmetic procedures are worryingly easy to accessPop Paul-Catalin | Shutterstock

NHS national medical director, Professor Stephen Powis, welcomes the change, saying that practitioners should be trained to recognize vulnerable individuals who are looking for “quick fixes” and to assess their suitability for the procedures.

Powis says providers should be able to identify people with mental health issues such as body dysmorphic disorder (BDD - where people obsess over their appearance) and refer them to NHS facilities if needed:

We know that appearance is the one of the things that matters most to young people, and the bombardment of idealised images and availability of quick fix procedures is helping fuel a mental health and anxiety epidemic.”

‘A major step forward’

Following a meeting with NHS England, the Joint Council for Cosmetic Practitioners decided to introduce the new measures, which all members of the council will be expected to implement.

However, since the meeting, only 100 out of 1,000 practitioners have registered with the council and those who are not members will not have to follow the new rules.

Cosmetic firms bringing in tighter controls to protect young people’s mental health is a major step forward, but voluntary steps on their own mean mental health too often will still be left in the hands of providers operating as a law unto themselves."

Professor Stephen Powis, National Medical Director of the NHS

He adds that although the long-term plans the NHS has are significantly expanding mental health services, all parts of society need to demonstrate a duty of care and take measures to “prevent avoidable harm.”

Powis wants all practitioners who offer procedures such as Botox injections and dermal fillers to join the new council. Superdrug, which offers such services at its flagship London store, signed the agreement after Powis wrote to the chain expressing his concerns.

Joining the new council would mean practitioners agree to undergo online training for the following:

  • Recognising signs or symptoms of mental health issues or vulnerability
  • Understanding the psychology of appearance
  • Knowing when to refer clients for help if they appear to be vulnerable

Living with Body Dysmorphic Disorder (BDD)

Body Dysmorphic Disorder, or BDD, is an anxiety-related mental-health condition that can occur at any age. The condition is characterized by a persistent obsession with body image, with sufferers becoming extremely distressed about their appearance and often resorting to behaviors such as repeatedly checking how they look in a mirror and constantly seeking reassurance.

Prone to becoming intensely stressed and anxious, individuals with BDD are more likely to turn to “quick-fix” procedures to help them feel better, even though these “fixes” do not actually address or help the underlying psychological problem.

“BDD affects one in 50 people, causing significant distress and has a huge impact on quality of life,”  says Kitty Wallace, from the Body Dysmorphic Disorder foundation. However, “cosmetic procedures like Botox, now widely available on the high street can have a damaging effect on the mental health of young people.”

Powis welcomes the move some practitioners are making to adopt the new training, calling it a "major step forward,” although the numbers are still too low, he says: "We need all parts of society to show a duty of care and take action to prevent avoidable harm."

Powis also warns that clients must screen practitioners properly before undergoing any cosmetic procedures such as botulinum toxin injections, fillers, skin peels, lasers and hair restoration surgery.

Botched cosmetic procedures are becoming increasingly common

The introduction of the new code followed an investigation by ITV News earlier on this year, which uncovered many examples of the procedures going wrong and found that many practitioners who carried them out were often not able to undo the mistakes.

According to Save Face, a company that runs an official national register of accredited practitioners, the number of complaints filed about non-surgical procedures has risen to 600 over the last three years.

A survey conducted on behalf of ITV News found that lip filling errors accounted for almost 70% of all corrective procedures and that almost half of the complaints followed procedures that had been carried out by beauticians.

Since no legal requirements are in place to ensure errors are reported, the actual number of mistakes could be much higher.

In an interview with ITV News, one recipient of a lip augmentation treatment described significant injury after the filler was injected into an artery by a beauty therapist. Ms Knappier described the pain she suffered as unbearable, with a “burning throbbing pulsating” in her lips that made them feel as if they were “just seconds away from bursting.”

Earlier this year, the British Association of Aesthetic Plastic Surgeons (BAAPS) called for regulations to be made much tighter regarding who is legally allowed to administer fillers in the UK.

BAAPS spokesperson and plastic surgeon Nora Nugent believes that for a person to perform an invasive procedure… which any injectable treatment is… they “at the very least should have some medical training.”

It's great to see the NHS and professionals leading the sea change but we now need all parts of society to change their attitudes and take action to protect vulnerable individuals."

Kitty Wallace, Body Dysmorphic Disorder Foundation

Sally Robertson

Written by

Sally Robertson

Sally has a Bachelor's Degree in Biomedical Sciences (B.Sc.). She is a specialist in reviewing and summarising the latest findings across all areas of medicine covered in major, high-impact, world-leading international medical journals, international press conferences and bulletins from governmental agencies and regulatory bodies. At News-Medical, Sally generates daily news features, life science articles and interview coverage.

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