Adjournment debate: Licensing for tattoo artists, body piercers and cosmetic clinics

Licensing requirements in England

Section 180 of the Health and Care Act 2022 enables the UK Government to establish a licensing scheme for non-surgical cosmetic procedures for England and Wales. The Act defines a cosmetic procedure as any procedure (other than a surgical or dental procedure) that is carried out for cosmetic purposes that also includes a reference to:

1. the injection of a substance;
2. the application of a substance that is capable of penetrating into or through the epidermis;
3. the insertion of needles into the skin;
4. the placing of threads under the skin;
5. the application of light, electricity, cold or heat;

The government is yet to introduce a national licensing scheme, but it has consulted on its future design (see below).

Local authorities in England already have some powers to license cosmetic procedures under existing legislation:

• The Local Government (Miscellaneous Provisions) Act 1982 (as amended) enables local authorities to regulate acupuncture, tattooing, semi-permanent skin-colouring, cosmetic piercing and electrolysis providers. Local authorities can set requirements as to the cleanliness of premises, persons and equipment.

• The London Local Authorities Act 1991 requires premises used for specified treatments in London (including acupuncture, and tattooing, cosmetic piercing) to be licensed by the council. Councils may set requirements as to the qualifications of the practitioner, safety requirements for the premises and the cleanliness and hygiene of the premises and equipment.

Practitioners are also subject to general requirements set out by health and safety legislation intended to ensure that members of the public are not harmed by the practitioner’s work activity.

Consultation on a licensing scheme for England

The government has not yet introduced a licensing scheme. However, between September and October 2023, the Department of Health and Social Care held a public consultation seeking views on the remit of a future licensing scheme.

The consultation document sets out background on licensing within England, and the government’s views on the need for a licensing scheme. The proposed scheme would be operated by local authorities in England and would require practitioners to be licensed to perform specified non-surgical cosmetic procedures. The premises from which they operate would also need to be licensed.

The government said that a licensing scheme “must strike a balance between protecting the public and building confidence in the safety of the aesthetic industry, while respecting consumer choice and encouraging innovation”.

The licensing scheme would ensure that those who offer specified procedures:

• are suitably knowledgeable, trained and qualified
• hold appropriate indemnity cover
• operate from premises which meet the necessary standards of hygiene, infection control and cleanliness

The consultation website advises that government is currently analysing responses to the feedback.

Wider concern about a lack of regulation in the non-surgical cosmetic procedure industry

There has been concern about a lack of regulation in the non-surgical cosmetic procedure industry in recent years. This has centred on a lack of mandatory education, training and regulatory requirements for those providing the services, and the related risk of harm to members of the public undertaking these procedures.

Background on these concerns and proposals to improve regulation are discussed in sections 1 and 2 of the Library’s briefing, Botulinum Toxin and Cosmetic Fillers (Children) Bill 2019-21 (March 2021).

The range of practitioners offering cosmetic procedures includes regulated healthcare professionals (for example doctors, dentists and nurses), and non-healthcare professionals such as beauty therapists. Healthcare professionals that offer cosmetic procedures are subject to general requirements set out by their professional regulator (for example, the General Medical Council regulates doctors in the UK). These include requirements to practice only within the scope of their knowledge and training, and to take appropriate safeguards to ensure the safety of patients.

The Botulinum Toxin and Cosmetic Fillers (Children) Act 2021 took effect in April 2021. The Act makes it an offence to administer botulinum toxin (‘Botox’) other products used as dermal fillers, to a person under the age of 18 in England.

Voluntary standards for cosmetic practitioners

Cosmetic practitioners can register with professional registration bodies on a voluntary basis. These bodies prescribe education and training standards for practitioners, as well as best practice requirements for the delivery of cosmetic procedures.

The Joint Council for Cosmetic Practitioners (JCCP) maintains a register of cosmetic practitioners and is accredited by the Professional Standards Authority. To join the register, practitioners must meet standards set by the Cosmetic Practice Standards Authority (CPSA).

CPSA produces standards for non-cosmetic procedures which set out recommended ways of working, including on risk management, premises requirements, education and training, professional supervision, and continuous professional development for practitioners.

Save Face is another register of cosmetic providers and is also accredited by the Professional Standards Authority.

Licensing requirements in the devolved nations

Practitioners in Scotland must register with the relevant local council to obtain a licence for tattooing, semi-permanent skin colouring, cosmetic piercing, electrolysis and acupuncture. A similar requirement is in place in Northern Ireland.

In Wales, Part 4 of the Public Health (Wales) Act 2017 requires those providing acupuncture, body piercing, electrolysis and tattooing procedures to be licenced. This provision has not, however, come into force yet.

License conditions in Wales would relate to the competence of practitioners, the premises where practitioners work, the equipment and practices used, advice given before and after the special procedure and the records kept by practitioners. Local authorities would be responsible for enforcing the licensing requirements.

Between January and April 2023, the Welsh Government held a public consultation on the mandatory licensing of special procedures in Wales. The consultation website advises that responses to the consultation are being reviewed. The Welsh Government has set out an intention to introduce the licensing scheme in summer 2024.

Further reading

Section 2 of the Library’s briefing, Botulinum Toxin and Cosmetic Fillers (Children) Bill 2019-21, provides discussion on the regulation of non-surgical cosmetic procedures. The following reports also provide background on regulatory requirements, wider concern about a lack of regulation and proposals for improved regulation:

• The Chartered Institute of Environmental Health and the Institute of Licensing, A fragmented picture: regulation of cosmetic treatments in the UK (PDF), September 2020
• The Chartered Institute of Environmental Health and the Institute of Licensing, The ugly side of beauty: improving the safety of cosmetic treatments in England (PDF), September 2020
• Department of Health, Review of the Regulation of Cosmetic Interventions, April 2013
• Higher Education England, PART ONE: Qualification requirements for delivery of cosmetic procedures: Non-surgical cosmetic interventions and hair restoration surgery (PDF), November 2015
• Higher Education England, PART TWO: Report on implementation of qualification requirements for cosmetic procedures: Non-surgical cosmetic interventions and hair restoration surgery (PDF), November 2015
• Higher Education England, Review of qualifications required for delivery of non-surgical cosmetic interventions (PDF), September 2014