Jenny ReesWales Health Correspondent
For Lizzie Day, getting Botox was as much a part of her routine as her morning coffee.
It wasn't until a doctor friend expressed concern about a treatment she was using to “dissolve fat” that the 30-year-old took stock and began to question what was going on in her body.
Until this point, the recruitment consultant admitted that she would simply “jump on the bandwagon” of the latest aesthetic procedures that would be discussed on social media.
Regulator of Wales Health Inspectorate Wales (HIW) believes that a comprehensive review of the type of services available, as well as who provides them and where, is needed.
Its chief Alan Jones said the regulation was inadequate, creating “loopholes and anomalies”, while one doctor likened the current situation to “freedom for all”.
The Welsh Government has said brands of botulinum toxin such as Botox and weight loss drugs can only be supplied on prescription and a study will be carried out early next year to see if further regulation is needed.
Botulinum toxin, commonly known under the brand name Botox, is also sold under several other licensed brands in the UK, including Azzalure, Bocouture and Dysport.
“I had no idea what they were injecting me with,” Lizzie said.
“It's just hype, it's a trend, a bit like fashion: if everyone buys the same handbag, it becomes popular, and I would say the same goes for aesthetics.”
In England, anyone prescribed anti-wrinkle or weight loss injections. Muñaro and Ozempic must be registered in Care Quality Commission (KKK).
However, in Wales only doctors are required to register with the Welsh equivalent of the HIW.
This means that other healthcare professionals are not legally required to meet the same standards or undergo regular testing.
Despite this, many don't question who does the work, as Lizzie adds: “It's like going for coffee in the morning – going for Botox.”
Lizzie has lived in Manchester for the past ten years, where she says procedures such as fillers, jawline enhancements and laser treatments are the norm for many.
It was only when a doctor friend back home in South Wales expressed concern about the treatment she was using to “dissolve the fat” that she took stock.
She is now receiving Botox treatment from a GP at a private clinic in the Vale of Glamorgan, where she will also be refused treatment unless they deem it necessary – something she is not used to elsewhere.
“I begged him for Mujaro,” she laughed.
“But he said, 'Sorry, you don't fit.'
“But I know some people that one person will say no to and they will go anywhere to get it.”
HIW's Alan Jones said a comprehensive review was needed.
“Unless you're a clinical person doing Botox injections, it's hard to understand where that oversight comes from,” he added.
“The legislation that gives us the power to act is very outdated.”
Certain procedures require HIW registration, but only if done from a fixed physical location, he said.
“This way you can provide certain services on a mobile basis and you will no longer need to register with us,” Mr Jones added.
He said monitoring and inspections would raise standards or identify poor practice, which in turn would keep the community safe.
“What the public may not know is that the person giving them the injection has had minimal training and may not be prepared to handle a medical emergency if they have a reaction to that injection,” he said.
Hannah Jones, from Cardiff, started using what she thought was Botox when she turned 30 last year.
But she continued to come for refills every two weeks because it did not give the desired “freezing” effect.
It was only when she came across conflicting advice from another doctor online that she began to wonder what was being injected into her face, since dosages were never discussed.
She also learned that she had to wait 12 weeks between these injections and Botox prescribers had to see patients in person, whereas she only ever received injections from a third party and not from the named prescriber.
“It was a major red flag,” she said.
“I think it's really important that people do research before they commit to treatment.”
These are the problems of the aesthetic industry itself. has long been campaigning for changeacross the UK, with a new bill drawn up earlier this year in Scotland.
Dr Tom Kamal works as a GP registrar in Barry, but also runs his own private clinic in the Vale of Glamorgan, where he provides aesthetic treatments such as Botox, as well as weight loss injections, which can have serious side effects if not used correctly.
He said that he had treated many clients who had previously undergone Munjaro treatment very quickly unnecessarily.
“Everyone seems to think that the higher the dose, the faster the weight loss, but that's actually not the case – it's no wonder they experience side effects.”
He said that with proper monitoring, the drug “can make a huge difference” but side effects can range from nausea, constipation and diarrhea to more sinister effects such as pancreatitis and gallstones.
Dr Kamal described the situation in Wales as a “free for all”.
With the non-surgical aesthetics industry valued at £3 billion, Dr Kamal said regulators were being challenged to keep up with the pace of change in the sector driven by social media trends.
“Saying no is one of the most important things we do here at the clinic,” he said, adding that it would be easy to capitalize on trends and provide unnecessary services to clients willing to pay.
It's the kind of advice Lydia Cheetham, from Penarth, wishes she had received eight years ago, when the fashion was “big lips, big bum, big cheeks – everything was bigger”, she said.
Lydia first had lip fillers at age 18, but they painfully dissolved a few years later.
“I wouldn't want to go so crazy at all because I think I'm still living with the lingering effects around my mouth and I don't know if it will ever go away completely,” she said.
“I wish someone would just say, 'Look, you don't need all this.'
“There needs to be a lot more regulation so that people can't do something just because it's trendy this year or your friends did it.”
The Welsh Government said the drugs “can only be supplied on prescription from a suitably qualified healthcare professional who must act in accordance with the standards set by the relevant professional regulatory bodies.”
“Failure to meet these standards may result in regulators restricting or suspending the practice of healthcare professionals,” the spokesperson added.
“We recently introduced a compulsory licensing scheme for acupuncture, dry needling, body piercing, electrolysis, tattooing and semi-permanent make-up.
“Early next year we will undertake a scoping study specific to Wales to determine whether further regulation is needed and will continue to engage with other UK governments on this issue.”
