A crackdown on beauty parlours and clinics providing botox treatments and "filler" injections to plump up lips was announced by the Government yesterday amid fears for patient safety.

Two years after Sir Liam Donaldson, the Government's chief medical officer, warned of a risk of permanent injury caused by the treatments, including transmission of hepatitis and vCJD, ministers have asked the cosmetic surgery industry to set up a system of self-regulation to "further improve standards".

The announcement was attacked by critics who said it did not go far enough. Which?, the consumer magazine, said it was "disappointing" that the Government had decided to "bottle out" and "leave it to the cosmetic treatments industry to make itself safe". It has campaigned for statutory regulation.

Demand for cosmetic treatment is soaring with nearly 700,000 procedures performed in Britain in 2005 at a cost of £360m. There are an estimated 20,000 high street clinics offering cosmetic treatments such as botox injections, which paralyse muscles, but which can leave patients with frozen features if too much is used.

While major cosmetic surgery is regulated, non-surgical treatments such as botox and filler injections to smooth sagging skin can be offered by any high street business.

The dangers were highlighted by the actress Leslie Ash, star of the sitcom Men Behaving Badly, who had collagen implants in her lips in 2003 which went wrong leaving her with a "trout pout".

Jenny Driscoll, health campaigner at Which?, said: "There is an increasingly casual approach to non-surgical treatments - just look at Botox parties where people are encouraged to drink champagne before going under the needle. This is a boom sector and our concern is that the rush to make money may result in some businesses cutting corners."

Two government reports published in 2005 drew attention to the risk of the procedures. At the launch of the reports, Sir Liam Donaldson said aesthetic fillers injected under the skin to counter sagging features, popular with celebrities, used material from animals, birds, and human corpses which could be infected with hepatitis and other viruses. Collagen, the most heavily used material, could have bovine material which carried a risk of transmitting vCJD, he said.

Yesterday, Andrew Vallance-Owen, chairman of the working group on cosmetic surgery established by the Independent Healthcare Advisory Service to implement self regulation of the clinics, said he regretted the Government's refusal to bring in a statutory control but had accepted the task because " some regulation is better than none".

He said: "There is no question that better control of these facilities is needed. We are talking about invasive procedures. Botox is a prescription-only medicine and patient safety should be paramount. If things go wrong, some patients could be left scarred physically or psychologically for life.

"As it stands now, almost anyone can set up shop in the local high street, don a white coat and start offering dermal fillers or arrange Botox parties. If we - the industry - don't step in, these procedures will be less regulated than ear piercing."

A code of practice would be drawn up, he said. "It is very hard to work out how many people are being treated or how many suffer adverse incidents, because the clinics are unregulated and there is no data. Occasionally you read of a celebrity who has been injured because there is no escape from publicity for them. But there may be a lot of people who are embarrassed by what has happened or don't want to make a fuss and we don't hear about them." He said Botox came in large bottles for single use, with any remaining being thrown away. But it was likely that less scrupulous clinics were keeping the opened bottles and reusing the contents.

Temporary fillers that went wrong would only be likely to have temporary effects. But semi-permanent fillers designed to plump up or smooth out sagging skin could do lasting damage and there had been suggestions that these should only be given by qualified doctors, he said.

Lord Hunt, the Health minister, said self regulation would be reviewed in three years and replaced with statutory controls if it failed. "While I have every confidence that self-regulation is the best way forward for non-surgical cosmetic treatments at this moment in time, we do not completely rule out the introduction of statutory regulation."

'I tried to move, but nothing happened'

Sarah Manners, actor, 31

Sarah Manners, star of the BBC hospital drama Casualty had Botox treatment four years ago. She had feared that her looks were not perfect enough - but the result nearly ruined her career. Her face froze while she was filming an airline drama in which she played a glamorous air hostess and an entire scene was lost. She said: "The director wanted to do a close up of me looking upset but the movements had to be minimal. As the cameras began rolling, the tears welled up and I made what I thought was a slight movement my eyes with my eyebrows. Nothing happened. The director shouted 'cut' and we did it again - but nothing happened." Manners panicked - she had had two doses of the muscle paralysing injections and she did not dare tell anyone on set. She knew the scene had to be reshot. She spent the next fortnight doing facial exercises to get her face working again.

"It taught me a lesson. You can't afford to have Botox when you're an actor. It could lose you work."

Cost and risks of treatment

BOTOX
HOW IT WORKS: Paralyses muscles to remove wrinkles.
COST: £100 to £300 a session.
RISKS: Hard to predict how it will affect your muscles. Can cause droopy eyelids or eyebrows and, in rare cases, double or blurred vision.

* LIP IMPLANTS (COLLAGEN)
HOW IT WORKS: Plumps up lips.
COST: £250 to £1,000.
RISKS: Allergic reactions such as rashes, joint and muscle pain, headaches, blistering, soreness and restricted breathing. Other less common risks include infection, abscesses, skin peeling, scarring, lumpiness and open sores near the treated area.

* CHEMICAL PEELS
HOW IT WORKS: Acid solution applied to the skin removes blemishes and wrinkles.
COST: £100 for superficial peel to £2,000 for deep peel.
RISKS: Side effects can include: a stinging sensation; redness; blistering; itching and increased sensitivity to sunlight. Other risks include infections, scars and pigmentation changes.

* LASER HAIR REMOVAL
HOW IT WORKS: targets hair follicles to prevent new growth.
COST: £40 to £400.
RISKS: Skin may be red and sensitive. Light-based treatments can cause blisters and burns, leading to mild scarring and changes in skin colour.

SOURCE: WHICH?

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