Legal, decent, honest and truthful—do all your adverts meet this standard? Are they candid and honest? Are you sure? Unfortunately, scrutiny of many social media posts and advertisements provides evidence that this is not always the case. Rather, some advertisements have been found to include exaggerated and misleading information that occasionally demonstrates carelessness in regard to pressure being placed on members of the public to procure unsafe and uninformed treatments. Such behaviours are irresponsible and result in members of the public experiencing confused messaging on social media, some of which are supported by false claims of procedure outcomes and underrepresentation or explanation of the risks associated with certain procedures. Many advertisements are close to crossing the ‘lawful line’. Remember: what is written on social media is also a form of advertising.
All practitioners are required to exercise honesty, candour and commitment to upholding the best interests and safety of their patients.
What is new
While many were taking a break this summer, the Advertising Standards Authority (ASA) and Committee on Advertising Practice (CAP) were working hard. They published many new rulings that will affect both registered healthcare practitioners working in aesthetic practice and lay practitioners. All practitioners need to be aware of the rulings relating to the publication and advertising of medicines and devices, such as botulinum toxin and dermal fillers. Additionally, the ASA and the Medicines and Healthcare products Regulatory Agency (MHRA) recently issued a joint enforcement notice on the advertising of Kenalog after a summer of widespread offers of this hayfever injection on social media (ASA and MHRA, 2022).
The escalation of white noise
Although the UK aesthetics sector was given warning from the ASA in 2019 concerning its advertising and social media promotions, it would appear, that instead of the sector cleaning its act up, things have become much worse which is very concerning.
Much of the flood of adverts spreading across social media—in particular, Facebook and Instagram—are, without doubt, coercive and not in the public's interest. The Botulinum Toxin and Cosmetic Fillers (Children) Act 2021 also came into force in October of last year (Department of Health and Social Care, 2021). Additionally, in May 2022, there was a pronouncement that advertising targeted at those aged under 18 years was illegal; however, even that did not restrict many advertisers (CAP, 2021).
The Joint Council for Cosmetic Practitioners (JCCP) has worked tirelessly to raise awareness of the impact that persuasively dishonest and illegal advertisements have on members of the public. Many of its complaints to the ASA and CAP have resulted in a series of rulings that were issued this summer. These rulings demonstrate the reasons for concern and set out what can and cannot be directly advertised to members of the public.
During summer 2022, the ASA published the third in a series of bitesize videos designed directly for the non-surgical aesthetics sector (CAP, 2022). These videos include an introduction, pre- and post-production segments, examples of misleading advertising, social responsibility and botulinum toxin dos and don'ts. The JCCP recommends that these should be regarded as compulsory viewing.
Other rulings produced by the ASA and CAP this year relate to prescription-only medicines (POMs), including Biotin injections and B12. They have published guides to the language that may be used when advertising, including that which appears on social media. One specific advertisement that we bring to readers' attention refers to the use of ‘Aqualyx’, where the strapline was ‘Make me a skinny bitch’. I am sure I need not say more to you regarding this statement, as all will recognise the inappropriateness of this statement and acknowledge that practitioners' duty of care is to safeguard members of the public and practice, at all times, in accordance with the tenet to ‘first, do no harm’.
An additional interesting notice was also published by the ASA on the use of the term ‘doctor’. The ASA advised that, if one is not a registered medical doctor and cannot prove they are a medical doctor, then the ASA regards them be deliberately misleading members of the public. By extension, the same applies to registered nurses, particularly in regard to prescribing rights.
What can be done
Practitioners should be truthful and frank in what they tell potential patients/members of the public. This includes making it easy for a member of the public/patient to check up on a practitioner's qualifications by knowing their full name and PIN number. Being in the commercial sector does not entitle registered nurses (or other registered healthcare professionals) to obfuscate their credentials. For instance, one clinic advertised a claim to be nurse-led and perform many invasive procedures requiring requisite knowledge and higher-level skills. Yet, the advertisement only provides the forenames of the two people performing these procedures, making it impossible to check with the Nursing and Midwifery Council (NMC).
As the sector moves towards the design and implementation of a licence to practise aesthetics in England, all practitioners need to step up regarding their credibility, accountability and visibility.
If you see an unacceptable and potentially illegal advertisement, you need to ask yourselves whether you report them or scroll on. The following link provides advice on how to make a complaint to the ASA/CAP: www.asa.org.uk/make-a-complaint.html.
If you do not report, are you part of the problem?
As I listened to the findings of the recent coroner's report into the tragic case of Molly Russell, the 14-year-old girl who died from an act of self-harm in 2017, I thought of the devastating pain her family must be experiencing. They also showed admirable courage and bravery in seeking the truth, as well as hearing the disturbing findings of the coroner, which laid the blame for the content that Molly viewed firmly at the door of the social media giants. This is a sobering reminder to all about our responsibilities to promote responsible and truthful advertising in the non-surgical aesthetic sector. Social media platforms carry a huge responsibility, but so do those that post the content. We must all push for the Online Safety Bill to be restarted immediately (Milmo, 2022).