Under eighteens and the law

5.5.1What the Act does

It creates criminal offences. The central one concerns administering, to a person under eighteen in England, botulinum toxin or an injection of the kind described, for a cosmetic purpose. A second concerns making arrangements or booking such a procedure for someone under eighteen, which reaches the business and the person taking the appointment as well as the person holding the needle.

The Act also provides for circumstances in which the prohibition does not apply, principally where a procedure is carried out by a registered health professional, or under the direction of one, in defined circumstances. That provision exists because there are legitimate clinical uses of these substances in people under eighteen, which are not what the Act is aimed at.

5.5.2The wording, and why it matters here

The formulation used in the Act refers to a subcutaneous, submucous or intradermal injection of a filler or other substance for a cosmetic purpose. The phrase other substance is broad on its face, and a polynucleotide product injected intradermally for a cosmetic purpose would appear to a lay reader to fall naturally within that description.

We are stating what the wording says rather than offering a legal conclusion, because the application of a statutory provision to a particular product in a particular case is not something a general reference should assert. What we will say plainly is that anyone who reads the Act and concludes that it plainly does not cover this category is reading it against its evident purpose, and that a business proceeding on that basis is taking a position that a court has not endorsed.

5.5.3Advertising to under eighteens

Separately from the criminal offences, the CAP Code prohibits advertising for cosmetic interventions being directed at under eighteens. That applies across media, including social platforms where a substantial part of this category's promotion takes place, and it does not depend on the scope of the 2021 Act.

The two provisions work together. One addresses the procedure, the other addresses the promotion, and both reflect a policy position that has been settled for some years: elective cosmetic injectables are not for children.

5.5.4The rest of the United Kingdom

The 2021 Act extends to England. Arrangements in Scotland, Wales and Northern Ireland differ, and a reader outside England should check the position in their own nation rather than assuming it is the same.

5.5.5The question underneath the law

Legislation of this kind exists because the question was not resolved by professional judgement alone. It is worth stating the underlying position directly rather than treating it as a compliance matter.

Elective cosmetic injectable treatment on a person whose face has not finished developing, whose relationship with their own appearance is still forming, and who is subject to intense image pressure from platforms designed to hold their attention, is not a decision a reasonable practitioner should be making regardless of what the statute covers. The legal question of scope is genuinely interesting. The ethical question is not close.

5.5.6If you are a parent

Two practical points. First, the Act reaches arranging and booking, not only administering, which means a parent arranging a procedure for a child under eighteen in England is within the territory the Act addresses. Second, and more usefully, the pressure your child is under is not coming from clinics in the first instance. It is coming from image based platforms and from content that does not present itself as advertising.

Incentivised social content must be identifiable as advertising under the CAP Code, and a great deal of it is not. If you see cosmetic treatment content aimed at young people that is unlabelled, the ASA takes complaints about it, free, from anybody.

5.5.7If you are a practitioner reading this

The safest position is also the simplest one. Verify age. Decline. Record the decline. Do not accept an arrangement made by a parent for a person under eighteen for a cosmetic purpose. And do not rely on an argument that a particular product falls outside the wording, because the reputational and legal exposure of being the test case is entirely disproportionate to the value of the appointment.