AHPRA broadens crackdown on cosmetic procedures

New training and education requirements will be put in place for health professionals carrying out cosmetic procedures under new guidelines designed to protect patients from harmful side effects.
 
An advance copy of guidelines for non-surgical cosmetic procedures, such as botox injections and fillers, were published by the Australian Health Practitioner Regulation Agency (AHPRA) on Tuesday, aimed at health professionals apart from medical practitioners.
 
The new document means cosmetic procedure guidelines will cover all regulated health professions once it comes into effect on 2 September.
 
Rules for medical practitioners performing cosmetic surgery and procedures are already in place after their introduction by the Medical Board of Australia (MBA) in 2023.

AHPRA has also released guidance on advertising higher risk non-surgical cosmetic procedures, which sets out details of a complete ban on targeting ads at under-18s.
 
Associate Professor Caroline Johnson, a GP and academic specialist at the University of Melbourne’s Department of General Practice and Primary Care, welcomed the clearer boundaries for cosmetics procedures.
 
‘This is an industry that should be very carefully regulated because there are risks for consumers,’ she told newsGP.  
 
‘Having widely available access without thinking about some of the health implications, both for physical and mental health, is a problem – and I’m really glad to see this extra regulation.’
 
AHPRA’s CEO Justin Untersteiner called the publication of the advertising and professional guidelines ‘a big step towards improving the regulation of cosmetic procedures’.

‘They’re all about putting patients before profit, ensuring practitioners are well trained, and not downplaying the risks associated with having these procedures,’ he said.
 
The new guidelines stipulate that newly qualified enrolled nurses (ENs) will need to practice for a year ‘to consolidate foundational skills’, then spend a further 12 months in a related field of practice before providing non-surgical cosmetic procedures.
 
ENs will also not be able to administer dermal filler injectables to very high-risk areas, including ‘the glabella, nose and forehead’.
 
According to the guidelines, the procedure for high-risk areas, such as ‘temples, nasolabial folds, peri-orbital and medial cheek’, should only happen in a clinical setting with ‘immediate onsite access to the prescriber of the cosmetic injectable and/or a registered nurse (RN)’.
 
ENs will also need to be supervised by a registered nurse (RN), with the guidelines stating that supervision by a GP or another medical practitioner does not meet the Nursing and Midwifery Board of Australia’s requirements.
 
Procedures covered by the guidelines include prescription-only injectables such as botulinum toxin, dermal fillers, fat dissolving injections, thread lifts, sclerotherapy and microsclerotherapy, CO2 laser skin resurfacing, cryolipolysis (fat freezing), laser hair removal, dermabrasion, chemical peels and hair transplants.
 
On its website, AHPRA says it is ‘not possible to provide an exhaustive list of higher risk cosmetic procedures’.
 
‘The cosmetic procedures industry is constantly evolving,’ it states.
 
‘As this innovation continues to transform the cosmetic procedures space new higher risk cosmetic procedures may also be developed and performed by registered health practitioners.’
 
Mr Untersteiner, meanwhile, said advertising guidelines are aimed at protecting those under the age of 18, who will also now have a mandatory seven-day cooling off period between an initial consultation and any procedures.
 
‘This industry relies heavily on having a social media presence, so practitioners have been put on notice that their advertising must comply with the new guidelines when they come into effect later this year,’ he said.
 
He told the ABC that the regulator had heard of cases of permanent irreversible facial nerve damage as well as potentially life-threatening strokes from cosmetic injectables – and that the rules make expectations regarding the appropriate skills for health practitioners ‘crystal clear’.
 
‘That will likely require specific training around facial anatomy or physiology. And I can tell you that is not a weekend course; this is proper training that will be required,’ Mr Untersteiner said.
 
AHPRA has faced pressure to tighten regulation on the cosmetics procedures since the Four Corners ‘Cosmetic Cowboys’ program highlighting industry malpractice aired in 2021.
 
Earlier reforms focused on surgical procedures, but the regulator announced it would expand its focus to include new guidelines for non-surgical interventions in 2023.
 
The RACGP had previously raised concerns about the then largely unregulated cosmetics industry back in 2015 in a letter to the MBA.

Between September 2022 and March 2025, AHPRA said it looked into about 360 notifications related to non-surgical cosmetic procedures.
 
These included complaints about medical practitioners, nurses, midwives, dentists, psychologists and Chinese medicine practitioners. 
 
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