Regulators Tighten Rules on Toxin Advertising

By Shannon Kilgariff / 01 Feb 2020

Details of the Enforcement Notice relevant to all aesthetic clinics offering prescription-only medicines

New technology was put in place on January 31 to monitor advertisements on social media relating to the promotion of prescription-only medicines (POMs) such as botulinum toxin.

The Committees of Advertising Practice (CAP) and Medicines and Healthcare products Regulatory Agency (MHRA) issued an Enforcement Notice to the beauty and cosmetic services industry compelling businesses to review ads and make immediate changes. This is the furthest-reaching Enforcement Notice ever issued by CAP, targeting more than 130,000 of the wide-ranging businesses within the cosmetics services industry.

ASA chief executive, Guy Parker said, “We’re taking action to tackle botulinum toxin ads on social media using brand new monitoring technology. This tool helps us to be more efficient and effective in identifying and removing problem ads.” This is the second Enforcement Notice in recent months relating directly to the aesthetic industry. In December 2019, an Enforcement Notice was sent to aesthetic training providers highlighting issues with advertising courses to prospective students.1,2

The CAP code

The Enforcement Notice draws upon existing policies written in both the Human Medicines Regulations 2012 (HMRs) and Rule 12.12 of the CAP Code and includes paid-for ads, non-paid for posts and influencer marketing on social media platforms.3 It is illegal to advertise a POM to the general public in the UK, but recent months have seen an ongoing practice of ads of this kind appearing on social media, according to the CAP and the Joint Council for Cosmetic Practitioners (JCCP). Aesthetic practitioner Dr Tapan Patel, owner of PHI clinic in London, said, “Every day I see people advertising botulinum toxin online, as well as on shop windows, magazines and public advertising boards.”

Actions clinics must take

The CAP Enforcement Notice advises businesses to remove direct references to botulinum toxin or other POMs, which includes hashtags and names such as ‘beautytox’ or ‘beautox’ where it is an obvious a reference to botulinum toxin. It also states not to use a substitute that directly references to POMs with indirect phrases that can only refer to a POM, such as ‘wrinkle relaxing injections’. Practitioners should also be aware that the Advertising Standards Authority (ASA) considers that a reference to ‘anti-wrinkle injections’ alongside a price that relates to a POM will be seen as an ad for that POM. Practitioners should avoid references to treating medical conditions in a way that could indicate the promotion of a POM, for example ‘injections for excessive sweating’.

CAP will also be running a targeted ad campaign across Facebook to raise awareness of the issue. Advertisers not following the rules run the risk of being referred to the MHRA or their professional regulatory body.

Professor David Sines, executive chair of the JCCP commented, “The JCCP supports codes and standards set out by the MHRA and CAP and their endeavours to protect the public from potentially misleading and harmful advertising. We will continue to work alongside the CAP and ASA in identifying unacceptable and misleading promotion within non-surgical cosmetics and encourage the discussion of POMs responsibly within the confines of the codes set out within CAP.”

Industry support

The ASA and MHRA announcement came about following pressure from the JCCP and has been supported by a range of associations and practitioners in the field.

Aesthetic nurse prescriber Sharon Bennett, chair of the British Association of Cosmetic Nurses (BACN), stated, “The notice to enforce existing legislation on the advertising and social media posts of Botox and botulinum toxin injections is a most welcome and significant step forward in the medical aesthetic sector’s bid to protect the public. Myself, the BACN board, and all of our members have supported this campaign and I applaud the persistence and hard work of those who were integral to the notice and ensured it to be realised, particularly the JCCP and Professor Sines.”

Dr Patel added that he supports any positive initiatives in the unregulated field of aesthetics. He said, “I look forward to seeing how the technology works to identify the problem ads. My concerns, at the moment, are that those found to break the rules will be referred to the MHRA or their professional regulatory body, however many toxin injectors are not medical professionals so are not regulated. As always, I welcome more stringent practice, but I do only feel like it could be a small step in the right direction as we do need more legislation and industry regulation.”

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