As demand for non-surgical cosmetic procedures continues to grow, concerns have been raised about patient safety and whether existing regulatory arrangements remain fit for purpose. Earlier this year, the UK Parliament's Women and Equalities Committee reported that regulation had failed to keep pace with the rapid growth of the market. Scotland has passed legislation establishing a statutory framework for certain non-surgical cosmetic procedures, and a licensing scheme is under development in England. Developments elsewhere in the UK may prompt Wales to consider whether current arrangements are sufficient to address emerging safety concerns.
How are cosmetic procedures regulated?
Cosmetic procedures can be broadly divided into surgical and non-surgical interventions.
Surgical procedures include operations such as breast augmentation, rhinoplasty (nose reshaping), and liposuction. These procedures are generally undertaken privately and are delivered within established healthcare regulatory frameworks. Independent (private) hospitals and clinics in Wales are regulated by Healthcare Inspectorate Wales (HIW), while doctors, nurses, and other healthcare professionals are regulated by UK-wide professional bodies such as the General Medical Council and the Nursing and Midwifery Council.
The picture is more complex for non-surgical cosmetic procedures, which include treatments such as dermal fillers, botulinum toxin injections (Botox), chemical peels, microneedling, and some laser-based procedures. Some treatments are subject to specific controls. For example, botulinum toxin is a prescription-only medicine and must be prescribed by an appropriately qualified healthcare professional. Other procedures, including many dermal filler treatments, are subject to fewer regulatory requirements and may be carried out by individuals who are not regulated healthcare professionals.
A longstanding regulatory issue
Concerns about the sector are not new. The 2013 Keogh review, which examined the regulation of cosmetic interventions, highlighted the rapid growth of the dermal fillers market. It noted that practitioners could carry out treatments without any requirement for training, qualifications, or previous experience. The review described dermal fillers as a ‘crisis waiting to happen’.
More than a decade later, many of the issues identified by the review continue to be raised by professional bodies and patient safety organisations. The Professional Standards Authority (PSA), for example, has cautioned that significant gaps remain and that stronger safeguards are needed.
Growing demand and patient safety concerns
Demand for non-surgical cosmetic procedures has grown significantly in recent years. The UK Parliament's Women and Equalities Committee heard evidence that social media and changing attitudes towards cosmetic treatments have contributed to this trend. Treatments are now also available through a wide range of providers and settings, prompting concerns about patient safety. The Committee described parts of the sector as:
… a ‘wild west’ in which procedures have reportedly taken place in Airbnbs, hotel rooms, garden sheds and public toilets, leading to many individuals experiencing serious harm.
The potential risks associated with cosmetic procedures are well documented and can include infection, allergic reactions, scarring, tissue damage, and disfigurement. Despite these risks, the PSA has highlighted that some high-risk procedures can still legally be carried out by practitioners without any recognised qualifications or training.
Cosmetic tourism
Concerns have also been raised about cosmetic surgery undertaken abroad.
A 2025 rapid review undertaken by the Health and Care Research Wales Evidence Centre found that complications following cosmetic surgery abroad commonly included infections, wound breakdown, and the need for further surgery. Treatment costs associated with these complications were estimated to range from around £1,000 to almost £20,000 per patient.
However, the review found that the scale of cosmetic tourism in Wales, and its impact on health services, remain largely unknown. It called for more systematic data collection to better understand the number of people requiring NHS treatment following complications from procedures undertaken abroad.
Similar evidence gaps exist in relation to the domestic market for non-surgical cosmetic procedures. Data on the number of procedures undertaken, associated complications, and resulting demand on NHS services remain limited.
Regulatory developments across the UK
The UK Parliament's Women and Equalities Committee published a follow-up report on cosmetic procedures in September 2026. The Committee reiterated its recommendation that the UK Government should introduce immediate restrictions on the highest-risk cosmetic procedures and require all practitioners performing invasive surgical cosmetic procedures to have specialist training and appropriate board certification. It also called on the UK Government to set out a timetable for wider reform of the sector.
In England, the UK Government has committed to introducing a licensing regime for certain non-surgical cosmetic procedures, although the details of how the scheme will operate are still being developed.
Meanwhile, Scotland has taken legislative action. In March 2026, the Scottish Parliament passed legislation establishing a statutory framework for the regulation of specified non-surgical cosmetic procedures.
To date, neither Wales nor Northern Ireland has announced equivalent reforms.
The scope of devolved powers
Wales already operates a licensing scheme for some procedures carried out outside healthcare settings. The Public Health (Wales) Act 2017 introduced a licensing scheme for certain 'special procedures', including acupuncture, body piercing, electrolysis, and tattooing (including semi-permanent make-up). Practitioners must be licensed and premises approved by local authorities. The Act also provides powers to bring additional procedures within the scheme in the future where this is considered necessary to protect public health. In its 2026 Wales manifesto, the PSA called for the scheme to be extended to cover non-surgical cosmetic procedures.
However, responsibility for the regulation of cosmetic procedures is shared across devolved and non-devolved areas, meaning the overall regulatory landscape is complex. The Welsh Government does not have powers to regulate medicines, medical devices, or healthcare professions. Responsibility for matters such as the regulation of botulinum toxin as a medicine, the approval of medical devices, and the professional regulation of doctors, nurses, and dentists remains with the UK Government and UK-wide regulatory bodies.
At the same time, some aspects of cosmetic procedures fall within devolved policy areas, including public health, local government, and NHS services. Within these areas, there may be scope to introduce licensing or regulatory requirements relating to premises standards, practitioner competence, and local authority enforcement.
The policy debate also extends beyond regulation. Issues such as NHS data collection, public awareness initiatives, and education relating to body image and social media literacy may likewise fall within devolved areas of responsibility.
As the cosmetic procedures market continues to expand, and as other parts of the UK pursue regulatory reform, discussions in Wales may increasingly focus on what role devolved policy levers can play in strengthening safeguards for people undergoing these procedures.
Article by Philippa Watkins, Senedd Research, Welsh Parliament