In Scotland, there is currently no specific regulatory framework for non‑surgical procedures. These are procedures that are carried out for cosmetic purposes or for broader wellbeing and lifestyle reasons. The number of these procedures has risen considerably over the years and continues to do so.
These procedures are currently undertaken by different types of practitioners and in different types of settings. Procedures are carried out by a mix of regulated healthcare professionals and beauty therapists. However, in some cases, individuals with no formal training are carrying out procedures, and sometimes, even unsuitable or unlicensed products are used, knowingly or unknowingly by practitioners. Procedures are sometimes carried out in clinical settings such as independent hospitals and clinics, subject to regular inspection by Healthcare Improvement Scotland. They are also carried out in beauty salons, which are not subject to inspection or external scrutiny, or sometimes in hotels, mobile vehicles or someone’s home.
If things go wrong, harm can range from minor complications to permanent disfigurement. The Scottish Government has reported cases of harm and is seeking to introduce regulation to improve public safety and consumer protection in this expanding sector.
The Scottish Government is introducing two separate measures to regulate non‑surgical procedures:
- the Non‑surgical Procedures and Functions of Medical Reviewers (Scotland) Bill. This SPICe blog gives background to the provisions in the Bill.
- the Civic Government (Scotland) Act 1982 (Licensing of Non‑surgical Procedures) Order 2026. This SPICe blog gives background to the provisions in the Order.
Each has a distinct role. The Bill focuses on higher risk procedures and sets out where and by whom they can be carried out. The Order creates a licensing scheme for certain lower risk procedures that pierce or penetrate the skin but do not require healthcare input. This blog looks at how the Bill and the Order compare and how they intersect.
Scope and definitions
The Bill would apply to non‑surgical procedures that pierce or penetrate the skin that require to be undertaken in settings where an appropriate, regulated healthcare professional is available. These include:
- ablative laser treatments,
- cellulite subcision,
- chemical peels that penetrate deeper than the epidermis,
- dermal microcoring,
- injectable procedures such as dermal fillers and botulinum toxin,
- intravenous procedures,
- thread lifts, and
- microneedling at depths of 1.5 millimetres or more.
It excludes procedures carried out by or for the health service, those performed for medical purposes, and those already requiring a licence under the Civic Government (Scotland) Act 1982.
The Order, on the other hand, would apply to procedures which pierce or penetrate the skin, and do not require the input of a health care professional. These include:
- nonablative laser and light treatments,
- superficial chemical peels that do not penetrate deeper than the epidermis,
- cryolipolysis,
- cryotherapy,
- electrocautery,
- high intensity focused ultrasound (HIFU),
- radio frequency treatments, and
- microneedling at depths of less than 1.5 millimetres.
It excludes procedures involving prescribed anaesthetics, those carried out on intimate areas (except nonablative laser hair removal), and procedures in premises proposed under the Bill.
The Scottish Government’s intention is to create a clear distinction between higher risk and lower risk procedures by imposing different types and degrees of clinical oversight and governance. However, the boundary between the two may require careful interpretation. For example:
- Microneedling falls under the Order if the depth is less than 1.5 mm, but under the Bill if it is 1.5 mm or more.
- Chemical peels that do not penetrate deeper than the epidermis come under the Order, while those that go deeper come under the Bill.
- Non-ablative laser treatments are licensed under the Order, while ablative laser treatments are regulated under the Bill.
These distinctions seem clear in principle, but there may be some questions around how they are enforced. It might be that clear, practical guidance is needed to avoid uncertainty, particularly where devices are capable of being used on multiple settings or within combined treatments.
Premises and practitioner requirements
The Bill would restrict higher risk procedures to ‘permitted premises’. These include independent hospitals and independent clinics registered with Healthcare Improvement Scotland (HIS), certain NHS related premises such as dental surgeries and GP practices under specific sections of the NHS (Scotland) Act 1978, and registered pharmacies. Independent clinics must have services provided or managed by specified healthcare professionals, such as doctors, dentists, nurses or midwives with prescribing rights, or pharmacists who are independent prescribers. This is intended to create a framework of clinical oversight and accountability. The Order would introduce a dual licensing system for both practitioner and premises. The licence must specify the name and address of the practitioner, the name of any business, and the address of the premises.
Proposals in both the Bill and the Order include measures to maintain certain standards, to varying degrees.
The Bill would give Scottish Ministers powers to make regulations on qualifications, hygiene, and enforcement, subject to parliamentary approval. These regulations could set different rules based on risk level, define who can perform or supervise procedures, and create offences such as carrying out procedures without proper qualifications. However, the Order does not require licence applicants to have specific training or qualifications. Instead, it focuses on detailed conditions for premises, such as what procedure rooms must contain, and hygiene and operational standards, including cleanliness, ventilation, and waste disposal.
While this approach reflects the lower risk nature of the procedures covered by the Order, it raises questions about consistency in competency requirements across the two regimes. It also raises questions around consistency when compared with other regimes, such as the Civic Government (Scotland) Act 1982 (Licensing of Skin Piercing and Tattooing) Order 2006. That Order asks local authorities to decide if an applicant is “fit and proper” based on their own knowledge, skill, training, and experience, or those of the people carrying out the work. The new Order makes no such provision.
The Bill does not currently set out the types of information that should be provided to consumers. The Order requires that consumers receive information in an easy-to-understand format about the process, risks, and aftercare for each procedure. There have been suggestions that this could be strengthened by including information on complaints processes and redress options, which would help consumers make informed choices and understand how to raise concerns.
Age restrictions
Both the Bill and the Order prohibit nonsurgical procedures for individuals under the age of 18. The Order requires notices in premises stating that procedures will not be carried out on anyone under 18 or under the influence of alcohol or drugs. Both allow a defence where the practitioner took reasonable steps to verify age and genuinely believed the client was 18 or over.
Enforcement and penalties
Enforcement mechanisms and penalties differ between the Bill and the Order.
Under the Bill, offences would include providing procedures to under 18s, operating outside ‘permitted premises’, and obstructing investigations. Penalties could be imposed up to £5,000, and HIS would have powers to issue improvement notices and revoke registrations. Professional regulators may also become involved where fitness to practise questions arise.
Under the Order, offences include unlicensed activity and breaches of licence conditions. Fines range from £200 for breaches of licence conditions to £2,500 for performing a procedure without a licence, and local authorities can revoke licences or impose bans for up to five years. The Order relies on the enforcement powers in the Civic Government (Scotland) Act 1982, which include inspection and entry rights.
Coordination between HIS and local authorities will be important where businesses offer procedures covered by both the Bill and the Order.
How will the Order and the Bill work together in practice?
It’s clear that the effectiveness of this two-pronged regulatory system could depend on guidance, collaboration, resource and consistent enforcement. Both represent a move towards improving safety and transparency in the non‑surgical cosmetic treatment sector.
The Health, Social Care and Sport Committee has considered the above issues in relation to the Bill during its Stage 1 scrutiny, but it’s clear that there are areas that will require further attention across the two systems, including:
- Practical guidance for verifying treatment boundaries such as microneedling depth or laser setting.
- Competency, training and qualification requirements for practitioners.
- Information for consumers, including complaints and redress.
- Coordination between HIS and local authorities to avoid gaps or duplication in oversight.
- Adequate resourcing for both HIS and local authorities in order to carry out inspections and assess applications
There’s also an element of future-proofing. The success of both the Bill and the Order will rely on how well they are implemented and how effectively they can be adapted to developments in procedure techniques and consumer expectations.
Susan Brown, Health and Social Care Researcher, SPICe
Blog image: “Morpheus- Skin Rejuvenation by Dr.Marwah” by Drsiddharthsen is marked with CC0 1.0.