Botulinum toxin and cosmetic fillers for under 18s

Botulinum toxin and cosmetic fillers for under 18s: guidance for enforcement officers

This guidance is for young people under 18 and their parents or guardians on the Botulinum Toxin and Cosmetic Fillers (Children) Act, which came into force on 1 October 2021.


Key message

From 1 October 2021 it is a criminal offence to administer botulinum toxin (commonly known as ‘Botox’) or a filler by way of injection for a cosmetic purpose to a person under 18 in England, even if they have the permission of someone over 18.

It is also an offence to make arrangements or book an appointment to provide these treatments to anyone under the age of 18 in England.

The new law will safeguard children from the potential health risks of botulinum toxins and cosmetic fillers.

There is separate:

What the law says

From 1 October 2021, it is against the law for anyone to inject botulinum toxin (commonly known as ‘Botox’) or fillers for ‘cosmetic purposes’ to a person who is under the age of 18 in England.

The definition of ‘cosmetic purposes’ set out in the Act includes any substances that are inserted into the body with the intention of producing a filling effect to change appearance.

It is also against the law to ‘make arrangements’ (such as book an appointment) for the treatments to be given to anyone under the age of 18 in England.

A parent or guardian cannot give permission for a person under the age of 18 to have the treatments. An offence would still be committed by the person or business providing or making arrangements for the treatment.

Registered doctors, nurses, dentists and pharmacists can still provide the treatments to under 18s, but only in cases where the treatment has been approved by a doctor.

The power for enforcing the legislation lies with the police and local weights and measures authorities (usually Trading Standards).

Who the law applies to

The new law affects everybody in England, not just businesses. If a business or person provides or arranges for one of the treatments to be given to someone under 18, they can be prosecuted and fined.

It does not matter if the person under 18 does not live in England, or is just visiting. They will still not be able to have anyone perform either procedure on them while they are in England.

The law applies whether or not the procedure is undertaken in the course of a trade or business or as a private individual.

Procedures the law covers

The new law only affects treatments planned or given after 1 October 2021.

Botulinum toxins

These are medicines injected into the skin to smooth lines and wrinkles. There are several trade names used for cosmetic treatments made with botulinum toxin, the most common of which is Botox.

Cosmetic fillers

These are gel-like substances commonly injected into the lips or face to add volume and plump the injected area. They may also be used in hands, feet, or for ‘non-surgical nose jobs’.

If you’re under 18

If you’re under 18, it is illegal for anyone to inject you with botulinum toxin, or fillers for cosmetic purposes, or make plans or book an appointment to do so.

It does not matter if you or your parents or guardians give their permission for the procedures to take place. The new law means that no one is allowed to perform these procedures on someone under 18 in England.

A registered medical practitioner (doctor) can still give permission for the treatments to be carried out on under 18s, but only when the injections are given by either a registered doctor, nurse, pharmacist or dentist.

If you’re 18 or over

If you’re 18 or over and from 1 October 2021 you want a botulinum toxin or filler treatment for a cosmetic purpose, you can expect to be asked to provide proof of age by the practitioner or business:

  • before an appointment is made with you
  • again before the procedure is done

Practitioners or businesses could ask to see:

  • a passport
  • a photo card driving licence
  • a photographic identity card or digital ID bearing the national Proof of Age Standards Scheme (PASS) hologram or digital mark
  • any other officially recognised document that can prove the person is 18 or over

It is not enough for the practitioner or business to decide that the young person looks to be over 18 – they must take careful steps and check documents to make sure they are certain the person is 18 or over to avoid breaking the law.

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