I think smoothes comments on therapists injecting botox and fillers aré totaly contradictory ,especialy the fact that she had been training theese people on one day courses at the accademy of cosmetic training,as i myself was on of theese people,who she ton money of,gave a qualification,and then decided to close the company,not supply to any of them anymore,and deny having any ivolvement in it.then cheekily calls theese companys for training none medics,and she wouldnt have a treatment done bt them.she didnt mond taking out money!
Beauty therapist administering botox/injecting fillers
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essentia
Well-Known Member
I am getting really confused as according to the CTIA website they have a prescription service which I quote is " [FONT=Arial, Helvetica, sans-serif][SIZE=-1] in accordance with the Law and the CTIA prescribing policy which has been accepted by MHRA", so who is right here? 
It sounds credible and supportive, so why should any BT not believe it?[/SIZE][/FONT]
It sounds credible and supportive, so why should any BT not believe it?[/SIZE][/FONT]
BotoxBoy
Well-Known Member
I am getting really confused as according to the CTIA website they have a prescription service which I quote is " [FONT=Arial, Helvetica, sans-serif][SIZE=-1] in accordance with the Law and the CTIA prescribing policy which has been accepted by MHRA", so who is right here?
I would say the Nursing and Midwifery Council (NMC) are right here. Their guidance on their website is unequivocally clear that a person administering botox from a prescription where the prescriber (be that a doctor or and independent nurse prescriber) hasn't seen the patient face to face, then this constitutes a 'remote' prescription.
As is the General Medical Council (GMC). These bodies legally control and monitor nurses and doctors practice and are separate from the MHRA. It is a combination of these bodies and legal guidance that is used.
Botox is a prescription only medicine and can only be administered from a prescription.
The grey area only seems to come from two things (to my knowledge so far).
1. A prescriber can instruct anyone to administer a prescription medication.
2. Potentially (and this is because this hasn't yet been 'tested' in law), botox "could" be administered via a remote prescription for 'medical' reasons such as excessive sweating (hyperhidrosis) or where the treatment could be deemed as medical for example, if someone's appearance and wrinkles were deemed to be causing a significant mental health issue etc.
The NMC recently clarified their stance on botox, HOWEVER one thing people seem to miss is that they have ALWAYS said a remote prescription should only be used in emergencies.
To put it into context, if a nurse was working in a ward on a night shift and a patient became very unwell and needed some urgent medication, but because there was only one doctor and he/she was dealing with another emergency, they could bleep that doctor and they could direct the nurse to administer a drug over the phone. In this situation it is sensible and right not to delay the administration of a drug because there is no immediate written prescription available.
However, the routine use of botox as a cosmetic treatment is so far removed from this situation that any Nurse or BT administering botox in this way leaves themselves wide open to potential criminal prosecution.
Is it really worth it?
I suspect, although this is my opinion, that the companies out there saying 'MHRA approved' are potentially bending the rules a little and claiming the treatment is 'medical'. I don't know but thats the only way i can see they get around it.
But the bottom line is really that this is an area that is complex and difficult enough for registered qualified nurses to work in if they are not prescribers, therefore for beauty therapists to even contemplate this, in my view is unbelievable.
Even though fillers are classed as 'medical devices' not drugs, I still feel BT's do not and will never have the correct training and experience to administer them. After all, you are injecting a substance under the skin on someones face, the most visible part of the body, essential for communication so the stakes are pretty high if things go wrong!
Its not about being elitist, or bullying people into submission or saying'you cant do this you cant do that'. It's about getting the right advice, training, legal protection and overall service to the clients who deserve to be treated by appropriately trained and experienced aesthetic practitioners.
I suspect we will see a raft of legal cases, like with the General Dental Council on teeth whitening, come about in the near future with this. (A man got fined in excess of £5000 for whitening teeth as he falsely believed it was a 'cosmetic' treatment not a dental treatment.)
Who would want that!?
X
BotoxBoy
Well-Known Member
Cosmetic Treatments and Injectables Association (CTIA)
I also wanted to just post this link from the consulting room (a respected industry information source).
One of the key things that sticks out here is that 'the manufacturers of botox AND fillers don't support their use by non-trained clinicians or beauty therapists'
So, this is another fundamental principle stacked against beauty therapists using these treatments. In normal use of medicines according to manufacturers guidance, if something goes wrong which is an acknowledged side effect then the clinician has some protection as the manufacturer will acknowledge that there is potential for a side effect to occur. However, if the product is not being used 'in accordance with manufacturer instruction' and in the case of BT's this is impossible as their own guidance says they shouldn't use it, then they are completely legally responsible, even IF the side effect is a recognised common one. Therefore, the client would only need a half decent solicitor to investigate and the injector would receive the full force of the law.
An example is this: if a nurse administers an antibiotic injection mixed in saline according to the manufactures instruction, checks for allergies but the patient subsequently died of an allergic reaction, the nurse would not be prosecuted as he/she was acting in accordance with the instructions and the reaction was a known risk.
However, if he/she mixed it with salt water (saline) against instruction, then they would be fully responsible. This is the theory of 'vicarious liability', a concept which BT's will probably never have heard of, but its these principles and theories that all form part of the assessment and consultation process when dealing with botox and fillers for clients.
Adam
I also wanted to just post this link from the consulting room (a respected industry information source).
One of the key things that sticks out here is that 'the manufacturers of botox AND fillers don't support their use by non-trained clinicians or beauty therapists'
So, this is another fundamental principle stacked against beauty therapists using these treatments. In normal use of medicines according to manufacturers guidance, if something goes wrong which is an acknowledged side effect then the clinician has some protection as the manufacturer will acknowledge that there is potential for a side effect to occur. However, if the product is not being used 'in accordance with manufacturer instruction' and in the case of BT's this is impossible as their own guidance says they shouldn't use it, then they are completely legally responsible, even IF the side effect is a recognised common one. Therefore, the client would only need a half decent solicitor to investigate and the injector would receive the full force of the law.
An example is this: if a nurse administers an antibiotic injection mixed in saline according to the manufactures instruction, checks for allergies but the patient subsequently died of an allergic reaction, the nurse would not be prosecuted as he/she was acting in accordance with the instructions and the reaction was a known risk.
However, if he/she mixed it with salt water (saline) against instruction, then they would be fully responsible. This is the theory of 'vicarious liability', a concept which BT's will probably never have heard of, but its these principles and theories that all form part of the assessment and consultation process when dealing with botox and fillers for clients.
Adam
essentia
Well-Known Member
Thanks for the reply. I am sure this debate will rage on but the CTIA website seem credible but I take the points raised. I certainly do not think BT should be doing these treatments as it currently stands but I do empathise that with some of the arguments put forward by this organisation. I believe they are trying to get an accredited course for BT at level 4/5. I guess we will have to see what happens.......
I have seen the consulting room debate before and one thing I must add - just because we are BT does not mean we have no intelligence to understand/learn things. I am educated to degree level myself as are others - these debates often smack of us being no more than bimbos. However I appreciate the law and its protection in keeping practices safe and any decent BT would only practise with good ethics and responsibility. However it is the medical profession that have trained and allowed some BT to do this - otherwise how would they get to do it in the first place. I have often seen posts totally deriding BT for wanting to do these courses but it is nursing/medic providers that are offering these courses - can people really blame BT for wanting to do these courses if offered?
I have seen the consulting room debate before and one thing I must add - just because we are BT does not mean we have no intelligence to understand/learn things. I am educated to degree level myself as are others - these debates often smack of us being no more than bimbos. However I appreciate the law and its protection in keeping practices safe and any decent BT would only practise with good ethics and responsibility. However it is the medical profession that have trained and allowed some BT to do this - otherwise how would they get to do it in the first place. I have often seen posts totally deriding BT for wanting to do these courses but it is nursing/medic providers that are offering these courses - can people really blame BT for wanting to do these courses if offered?
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BotoxBoy
Well-Known Member
I can totally understand your viewpoint and I want to reiterate I'm in no way saying BT's are bimbos or in any way less intelligent. It takes balls to set up a business! Something which I am learning everyday since starting up in August last year and please don't take my comments as derision towards you.
I also know what you mean about feeling derided etc but there are a few confounding issues really, one is people are passionate, like myself, about the industry and it sometimes comes across in writing on a forum as more negative or even aggressive than it is intended but I', always conscious of this. As in real life, I try to be as approachable and friendly at work as possible and I see it being the same on here. Although new to forums per se, I still think (maybe a little naively) that people should be nice to each other and help people out.
Back to the point in the discussion, I think 'empathise' is probably stretching it a little. Lets step back from the situation a little and look at the facts: BT's attempting to get into botox are looking to perform treatments without adequate training and experience and my be performing illegal acts.
I'm qualifying the point about 'inadequate' training because doctors spend 5 years at medical school and 1 year post qualifying before they would even think about botox. Nurses spend three years doing a degree, but then would need realistically a bare minimum of 2-3 years experience before branching out independently into this field so you're looking at 6 years in total. (Although this is not set in stone, the NMC take a very dim view of nurses performing something which they are not deemed competent to do which is an underpinning nursing principle as well. For example, in my NHS role, I can now undertake procedures such as chest drains, inserting lines into the heart via the arm and request xrays and scans, once only the domain of doctors, but it is the training and experience which enables me to do this legally)
There is not the legal structure, support, training, supervision and clinical governance in place for BT's. Lets also not forget that a BT is pushing the boundaries by getting into botox and fillers against most of the guidance and what is the goal? Ultimately money! Therefore its a pretty murky area to get into and it only takes one prosecution for the floodgates to open with no win no fee solicitors queueing around the block!
So yes, BT's are trained and do fabulous work and are as diverse a group as any others and our common theme should be our entrepreneurship and determination to succeed in our own businesses but there has to be a line between medical and non-medical treatments as its ultimately for the safety of the client.
I think it may be a sore point, but I truly believe its time that beauty therapists forget about botox and injectable cosmetic treatments for good and concentrate on areas that are legal instead. Europe is in line with the UK on this as well and I suspect the Americans would be equally appalled at BT's doing these kinds of treatments.
I've done a little blog on this today as its sparked a personal interest in me and despite my strong views on this, I am avery liberal person and believe nurses etc should be given opportunities to develop their roles like in my NHS work, but it needs to be in a consistent, accountable, legal, professional and overall in the best interests of the client.
Would you let a beauty therapist inject you with Botox?!!
Hope this makes sense...
Adam
essentia
Well-Known Member
The reason I have some empathy with them is that some practitioners have been doing injectables for years and I can understand their angst especially if they have witnessed less than desirable results from so called bona fide practitioners if they have a busy and successful business and feel excluded from the status that other professionals hold .
I personally would not feel comfortable myself with the level of training offered for BT's to do injectables and cannot see myself wishing to do this but I have often wondered why there isn't a route specifically for aesthetic medicine if one so desires. Perhaps this will evolve with time - perhaps not.
Beauty and medicine have made dramatic progress in recent times and formalised training lags behind. Roles have become blurred as to whom does what. I am not talking necessarily about fillers etc but RF, peels, microsclerotherapy etc. We need this clarified but I hope with some scope for advanced units for more aspiring BT who wish to progress further as our profession is becoming more complex and demanding.
I personally would not feel comfortable myself with the level of training offered for BT's to do injectables and cannot see myself wishing to do this but I have often wondered why there isn't a route specifically for aesthetic medicine if one so desires. Perhaps this will evolve with time - perhaps not.
Beauty and medicine have made dramatic progress in recent times and formalised training lags behind. Roles have become blurred as to whom does what. I am not talking necessarily about fillers etc but RF, peels, microsclerotherapy etc. We need this clarified but I hope with some scope for advanced units for more aspiring BT who wish to progress further as our profession is becoming more complex and demanding.
BotoxBoy
Well-Known Member
And essentia, there isn't a specific route for cosmetic medicine etc because cosmetic medicine is not an isolated or discrete area.
For example, a surgeon cannot just train to do breast implants etc. They need the full medical training first then a broad range of surgical procedures before specialising. This is because the body is complex and you need to have a broad foundation of knowledge before focusing on one area. This is to do with limitations of skills, what to do if things go wrong and how body systems interact with each other and with medicines.
I still don't feel you're grasping the concept of knowledge and experience fully. No matter how 'advanced' the training is for a BT, they will never have the underpinning knowledge and experience of a registered nurse or doctor.
Even the pharmacology of the drug itself for example is really important, how it works, how it's made, the potential side effects, the dangers, the contraindications.
Because of the complexity of the human body it is impossible and unrealistic to learn about one drug and one body system in isolation and think this is adequate.
It's like saying I can drive a car because I know how to put water in the screen wash, but don't know how to put petrol in but that won't matter as I'll get around it somehow... You can't!
Adam
For example, a surgeon cannot just train to do breast implants etc. They need the full medical training first then a broad range of surgical procedures before specialising. This is because the body is complex and you need to have a broad foundation of knowledge before focusing on one area. This is to do with limitations of skills, what to do if things go wrong and how body systems interact with each other and with medicines.
I still don't feel you're grasping the concept of knowledge and experience fully. No matter how 'advanced' the training is for a BT, they will never have the underpinning knowledge and experience of a registered nurse or doctor.
Even the pharmacology of the drug itself for example is really important, how it works, how it's made, the potential side effects, the dangers, the contraindications.
Because of the complexity of the human body it is impossible and unrealistic to learn about one drug and one body system in isolation and think this is adequate.
It's like saying I can drive a car because I know how to put water in the screen wash, but don't know how to put petrol in but that won't matter as I'll get around it somehow... You can't!
Adam
angelina221
Master Lash Tech
BotoxBoy
Well-Known Member
It is, but we're allowed to do it legally and professionally! My point is that pushing the boundary or bending the rules when BT's try to do botox to make profit would surely be seen in a very bad light?
angelina221
Master Lash Tech
I was just saying that you made it sound like beauty therapists would do it purely for financial gain. This may well be true but that's why you do it too. Doctors and nurses go into the profession to see sick people and find a way to help them. A lot of doctor's now do private work and cosmetic procedures purely to make easy money. They don't want beauty therapists doing botox because they don't want to lose some of that money. I'm not saying it's right for beauty therapists to do injectables, I'm just saying that you shouldn't say that beauty therapists would only do it for the money when that's what you and hundreds of nurses and doctor's do it for.
I think Angelina has a good point there. It's a bit 'pot calling kettle black' isn't it.
Anyway, all I have to add to this is a little thought I've just had;
You know when you see someone that's just had TOO MUCH work done on their face? Have you ever wondered why that is?
Could it be that although the person that did it was a MEDICAL professional, they have zero eye for aesthetics?! Unlike many of us who can make someone look 10 years younger with an eyebrow tint and wax?!
So surely the best person to go to for this, would be someone that's actually qualified in both areas.
Anyway, all I have to add to this is a little thought I've just had;
You know when you see someone that's just had TOO MUCH work done on their face? Have you ever wondered why that is?
Could it be that although the person that did it was a MEDICAL professional, they have zero eye for aesthetics?! Unlike many of us who can make someone look 10 years younger with an eyebrow tint and wax?!
So surely the best person to go to for this, would be someone that's actually qualified in both areas.
BotoxBoy
Well-Known Member
I agree in part Katelisa, in that there is the element of the 'art of beauty' to all this.
One of my principles is to not allow my clients to go too far and I have turned clients away (3 in the last two months) who were trying to push me to do more work than they needed so yes it's about beauty and medicine x
One of my principles is to not allow my clients to go too far and I have turned clients away (3 in the last two months) who were trying to push me to do more work than they needed so yes it's about beauty and medicine x
essentia
Well-Known Member
When I replied on this thread it was about the CTIA and not really getting into my personal opinions.
Of course I realise that surgeons do not just train to do breast implants!! but I am talking about the BT role and how it has and is evolving and covers more really than the filler/Botox debate. The role has changed due to medical and technological advancement. Just like nurses never used to prescribe and do other tasks like putting in chest drains etc the demands have increased in our field as well. Exam boards are now introducing level 4/5 courses now - which is long overdue.
I do not think that BT should necessarily be able to inject Botox but I do understand those who wish to train in fillers providing they have sufficient training and a suitable environment to do this. Training does provide the underpining knowledge. It is where everyone starts.
Of course I realise that surgeons do not just train to do breast implants!! but I am talking about the BT role and how it has and is evolving and covers more really than the filler/Botox debate. The role has changed due to medical and technological advancement. Just like nurses never used to prescribe and do other tasks like putting in chest drains etc the demands have increased in our field as well. Exam boards are now introducing level 4/5 courses now - which is long overdue.
I do not think that BT should necessarily be able to inject Botox but I do understand those who wish to train in fillers providing they have sufficient training and a suitable environment to do this. Training does provide the underpining knowledge. It is where everyone starts.
BotoxBoy
Well-Known Member
Ok... I do respect your opinions and hope you don't think I'm attacking you personally which I'm not. I'm just passionate about patient safety and I've been in charge of many cohorts of student nurses in the past and have designed teaching courses for pre registration and lecture at bolton Uni for qualified nurses.
Therefore, I feel qualified to back up my comments about training requirements and what is really required.
As for the fillers, did you know that if a filler goes horribly wrong you need to use a drug to dissolve it? This drug is an enzyme called hyalase BUT it is prescription only. Who would you send the client to if they were unhappy with the result?
And secondly, dud you know that fillers have a slightly higher risk of allergic reaction compared to Botox? Some also have lignocaine in them which can also cause a reaction.
The severest form of a reaction is called anaphylaxis where the patients throat may swell up so severely they stop breathing. As qualified practitioners we carry prescription only drugs with us to give immediately such as adrenaline, an antihistamine and even an intravenous steroid.
What would you do if this happened after you injected a client with filler? 8 mins plus waiting fir an ambulance is a VERY long time in this situation when a qualified practitioner can give the emergency drug and potentially save a life.
I think it's areas like this which are probably overlooked as well.
Therefore, I feel qualified to back up my comments about training requirements and what is really required.
As for the fillers, did you know that if a filler goes horribly wrong you need to use a drug to dissolve it? This drug is an enzyme called hyalase BUT it is prescription only. Who would you send the client to if they were unhappy with the result?
And secondly, dud you know that fillers have a slightly higher risk of allergic reaction compared to Botox? Some also have lignocaine in them which can also cause a reaction.
The severest form of a reaction is called anaphylaxis where the patients throat may swell up so severely they stop breathing. As qualified practitioners we carry prescription only drugs with us to give immediately such as adrenaline, an antihistamine and even an intravenous steroid.
What would you do if this happened after you injected a client with filler? 8 mins plus waiting fir an ambulance is a VERY long time in this situation when a qualified practitioner can give the emergency drug and potentially save a life.
I think it's areas like this which are probably overlooked as well.
essentia
Well-Known Member
I did say sufficient training in a suitable environment....... if it should come to pass this is acceptable then the powers that be are the ones to decide this. I also should have been clearer and meant hyalauraonic acid. I know this is not without complications as well.
I did not imply that you did not take my opinions seriously only to say that it has not been my intention to get caught in the who does this scenario.
Like I said before I have sympathies with the CTIA who have potential members with many satisfied clients who are not deemed safe because they are not a nurse or doctor.
I did not imply that you did not take my opinions seriously only to say that it has not been my intention to get caught in the who does this scenario.
Like I said before I have sympathies with the CTIA who have potential members with many satisfied clients who are not deemed safe because they are not a nurse or doctor.
BotoxBoy
Well-Known Member
I was referring to HA fillers as well x
pazzy
Well-Known Member
Do you not do a patch test before these fillers are injected? Sounds potentially life threatening then I won't be having them or recommending them either.
If a client had a reaction to a wasp sting in a salon ending up in anaphylaxis - I would't be able to do anything medically about that either. (just saying)
If a client had a reaction to a wasp sting in a salon ending up in anaphylaxis - I would't be able to do anything medically about that either. (just saying)
BotoxBoy
Well-Known Member
Anaphylaxis is very rare so a patch test is not recommended by the manufacturer. A wasp sting is a passive process, a BT injecting a filler is an active process, non random so there is no comparison!
pazzy
Well-Known Member
I know that - I was just saying!!!
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