News Special Young Patients
@aestheticsgroup
Aesthetics Journal
With the consumer press increasingly reporting a trend in young girls seeking aesthetic treatment, Ruth Donnelly investigates the effect this has on the industry
Too much too young? Ever since 17-year-old American socialite Kylie Jenner admitted to having had lip filler injections in May this year, reports have flooded consumer media that claim more and more young girls are seeking to emulate the heiress. Many of these stories have concentrated on the 20-30 age group, but at the end of September both The Times1 and the Mail Online2 reported that girls as young as 14 were not only requesting, but receiving cosmetic injectable treatments, influenced by celebrities like Jenner and the new ‘selfie’ culture. Many feel that this media uproar reflects badly on the aesthetics industry, but do the statistics support the stories? The inside track While the press may be awash with stories about teenagers having lip filler, many industry professionals tell a different story. Sharon Bennett, chair of the British Association of Cosmetic Nurses (BACN), explains that she posed a question to BACN members about the number of young girls requesting treatment. She says, “The answer came back that very few under 16s asked for treatment.” Dr Paul Cronin, of the Eternal Youth Clinic in Cheshire, has not seen a noticeable increase either, although he comments, “I have performed botulinum toxin treatments on patients aged 23 or 24 on a preventative basis, but I would feel it unethical to do any significant facial work on someone whose face hasn't finished developing.” It is difficult to get a true picture of the numbers, as none of the UK professional associations' annual audits cover the age distribution of patients. In the US, however, both the American Society for Aesthetic Plastic Surgery (ASAPS) and the American Society of Plastic Surgeons (ASPS) produce yearly reports that look at age distribution. The ASAPS reports a 0.3% increase in the 18
number of patients below the age of 18 undergoing non-surgical procedures in 2014,3 but a 0.7% decrease in the 20 to 29 age group,4 certainly not the surge that the mainstream media would have us believe. The ASPS figures do show a more significant increase in the number of teenagers seeking treatment, with a 3% rise overall, and a 7% and 6% increase respectively in teens undergoing botulinum toxin injections and HA fillers.5 But can the American statistics be applied in the UK? The lack of data available makes it impossible to attribute any figures to the concern. Going underground The general feeling amongst the practitioners interviewed on this matter is that if teenagers are receiving cosmetic treatment, then it is not being performed by medically-qualified practitioners. Consultant plastic surgeon Mr Stephen Hamilton says, “This is a potential concern, particularly with the portrayal of cosmetic surgery as an easy choice in some parts of the media, and probably to a great extent in those parts aimed at young women.” Mr Hamilton adds, “There are certainly a lot of column inches devoted to [cosmetic procedures] in the consumer press and the main concern I have is that this coverage can run the risk of trivialising procedures, encouraging young women to take decisions lightly.” The Mail Online story claims that beauticians are responsible for treating many teenage girls,2 which brings the regulation issue clearly to the forefront: while botulinum toxin, as a prescription medicine, is prohibited for use by unqualified practitioners, dermal fillers are not, and there is no legislation to prevent a beauty therapist from injecting a filler into someone's lips, whatever their age. Aesthetics | November 2015
Aesthetics
aestheticsjournal.com
A regulatory issue Regulation – or lack thereof – has long been an issue in the medical aesthetics industry. While Health Education England (HEE) has submitted standards for expected qualifications and education to practise aesthetics, they are still awaiting ministerial approval. Sally Taber, director of Treatments You Can Trust who took part in the HEE consultation, explains, “HEE demands that delivery of injectable cosmetics will be allowed only upon suitable training to Qualification Curriculum Level 7 and we believe this will rule out most beauty therapists currently performing injectable treatments.” In addition to HEE’s work, the General Medical Council began consultation on guidance for all doctors who offer cosmetic interventions in June 2015, including points regarding the specific care of children and young people.6 The final guidance document is due for release early next year, however as beauty therapists are not qualified medical professionals, the guidelines will not apply to them, so this may well have limited impact. While there is no solid evidence that beauty therapists are injecting teenagers, it is clear that there is a significant lack of UK-based data available that can tell us how widespread the concern is. HEE’s standards of education could of course help reduce the risk of beauty therapists offering injectable treatments, however they will not help us discover how many young people are seeking and undergoing treatment here in the UK; whether this be from beauty therapists or medically-qualified practitioners. Perhaps, then, a database that collates the age of each person undergoing treatment is the way forward. Hopefully the media furore over Kylie Jenner and her followers might work in the industry's favour and spur the government into taking action. REFERENCES 1. Danielle Sheridan, ‘Girls risk their lives with cheap lip injections’, The Times, 26 September 2015 <http://www.thetimes.co.uk/tto/ health/news/article4568367.ece> 2. Kate Pickles, ‘The number of teenagers getting risky cosmetic procedures is soaring, with children as young as 14 getting their lips ‘plumped’’, Mail Online, 26 September 2015 http:// www.dailymail.co.uk/news/article-3250112/Ministers-accusedfailing-protect-children-number-teens-getting-risky-cosmeticprocedures-booms.html 3. The American Society for Aesthetic Plastic Surgery, ‘2013 Cosmetic Surgery National Data Bank Statistics’, p.15 <http:// www.surgery.org/sites/default/files/Stats2013_4.pdf> 4. The American Society for Aesthetic Plastic Surgery, ‘2014 Cosmetic Surgery National Data Bank Statistics’, p.19 <http:// www.surgery.org/sites/default/files/2014-Stats.pdf> [accessed 12 October 2015] 5. The American Society of Plastic Surgeons, ‘2014 Plastic Surgery Statistics Report’, <http://www.plasticsurgery.org/Documents/ news-resources/statistics/2014-statistics/cosmetic-proceduresteens.pdf> 6. General Medical Council, Guidance for all doctors who offer cosmetic interventions (UK: gmc-org.uk, 2015) <http://www.gmcuk.org/guidance/news_consultation/27171.asp>