Healthcare regulator Ahpra is tightening the reins on the booming cosmetic injectables industry, with tough new guidelines now in force that require real-time prescribing checks, more rigorous consent from patients and a crackdown on influencer-style advertising.
“Practitioners have been warned. If we find practitioners prioritising profits over patient care, we will not hesitate to act. Patient safety must come first,” Ahpra chief executive Justin Untersteiner said in a media statement.
Non-surgical procedures covered by the changes include treatments like prescription-only cosmetic injectables such as botulinum toxin and dermal (soft-tissue) fillers, as well as fat-dissolving injections, thread lifts, sclerotherapy and microsclerotherapy. CO₂ laser skin resurfacing, cryolipolysis (fat freezing), laser hair removal, dermabrasion, chemical peels and hair transplants are also included.
Under the new guidelines, many practitioners will need more than just the foundational qualifications included in their initial training before they can safely perform non-surgical procedures like cosmetic injections. Nurses, for example, will be required to complete a set 12-month period of practice before expanding their scope to include non-surgical cosmetic procedures
From 1 September, every prescription for a cosmetic injectable must follow a real-time consultation with the authorised prescriber, either in person or by video. Text or form-based “asynchronous” prescribing is explicitly ruled out, and bulk or batch prescriptions are no longer acceptable, the guideline states [link here].
Among the sweeping changes, practitioners have been told to take a culturally safe, holistic history when assessing for suitability, which must include screening for psychological issues such as body dysmorphic disorder. Screening must explore motivation and expectations; discuss alternatives (including not proceeding); referral for independent review if red flags are identified; and practitioners should decline treatment when the procedure is not appropriate.
A new focus on protecting young people sees the introduction of a mandatory seven-day cooling-off period between informed consent and any non-surgical cosmetic procedure for those under 18, and the Boards consider botulinum toxin and dermal fillers should not be prescribed for cosmetic purposes in this age group. Advertising aimed at under-18s is banned, with clinics told to age-gate social content to limit exposure.
Advertising rules are also sharpened, especially on social media, testimonials and claims that could mislead.
The accompanying guidelines for practitioners advertising for higher risk non-surgical cosmetic procedures [link here] state that the use of testimonials – such as patient stories and experiences, success stories or fake testimonials – in advertising is prohibited by National Law and that advertising for higher-risk non-surgical cosmetic procedures “must not use testimonials due to their potential to create unrealistic expectations of beneficial treatment.”
While clinicians are not responsible for what patients post on third-party review sites, the guidelines states they are expected to “not interact with testimonials” and to reduce risks by disabling reviews, comments or tagging on their own social pages.
Specialist claims banned
Meanwhile, claims that imply specialist registration, qualifications or endorsement where none exists, for example, saying a practitioner “specialises” in an area without holding specialist registration, should not be used. As well, professional membership acronyms should not appear on their own without explanation, as this may mislead prospective patients, the regulator states. And where advertising names the individual clinician performing a higher-risk procedure, it must now also include the practitioner’s registration details, including the registration number.
A crackdown on over inflated language that trivialises higher-risk procedures will see terms like “doll-maker”, “magic hands”, “sculptor”, “artist”, “god”, “king”, “queen”, “master”or “world renowned” banned for promoting practitioner or practice expertise.
Consent has been tightened and made more transparent. Verbal discussion must be paired with plain-language written information that neither glamorises procedures nor overstates results. For injectables, records should spell out the product type and quantity, set realistic expectations about outcomes and maintenance, and explain both common and serious complications, including when hyaluronidase or other follow-up care may be required. Clinics are expected to match facilities to the level of risk, have clear escalation plans for complications and emergencies, and consider accredited settings where skin is pierced or incised.
Professional boundaries have also been clarified. Many practitioners will need further education or experience before expanding into non-surgical cosmetic work, and the onus sits with the individual to ensure they are sufficiently trained.
Enrolled nurses must work under registered-nurse supervision, complete relevant education, and avoid injecting dermal fillers in very high-risk areas such as the glabella, nose and forehead. Injections in other high-risk facial zones are only permitted where the prescriber and/or an RN is immediately on site, and laser skin resurfacing requires direct RN supervision with settings checked in advance.
Medical Board of Australia Chair, Dr Susan O’Dwyer, said the advertising changes would help shrink the gap between patients’ expectations and reality.
‘Unfortunately, exploitative advertising has increased as fast as patient demand. We have tightened the rules to support patients, so they can make safe and informed choices,’ Dr O’Dwyer said.
‘A filler is not a facial. These guidelines aim to educate patients about what is really involved in these procedures.’