The future for therapists in AESTHETICS | Pocketmags.com

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The future for therapists in AESTHETICS

News Analysis

The beauty and medical aesthetic industries have been at loggerheads for some time, mainly because of the debate surrounding who should and shouldn’t be administering injectable treatments. A key development in the complex issue came in August when the Joint Council for Cosmetic Practitioners (JCCP) reversed its decision to allow beauty therapists on its registers for injectables for a three-year assessment period, and as the beauty industry continues to fight for aesthetic qualification pathways, concern is growing about therapists’ future in a market many feel unwelcome in.

“The beauty sector as a whole had been very supportive of the JCCP and what it was trying to do”, says Caroline Larissey, who is quality and standards manager at the National Hairdressers’ Federation (NHF) and the new National Beauty Federation (NBF), as well as a JCCP trustee representing the beauty sector. “We thought this was going to allow our therapists to progress, but unfortunately when it came to the decision about the three-year exclusion from the registers, I was outvoted. I argued our case because I totally understand how much training and expertise a therapist has at levels 3 and 4, but others really don’t understand the requirements and what a therapist has to do. They have to have all that knowledge but then also show their competence too”, she says.

Fighting to be heard

But it isn’t just therapists that are feeling unheard. Dr Selena Langdon, founder and medical director of clinic Berkshire Aesthetics believes that doctors, nurses and dentists are also feeling pushed out of a market in which they shouldn’t have to compete with those who are non-medically trained. “There’s a reason people spend five years at medical school; there’s all that practice that I think people are taking for granted and feel isn’t required”, she says.

However, Larissey argues, “If someone is a Level 4-qualified therapist they’ve already had at least four years of training.” She likens this to the length of time a doctor or dentist spends studying, and adds: “I don’t think some people understand the technicalities and the amount of anatomy and physiology required to do a therapist’s job. Even at Level 3 it’s absolutely mammoth. It’s not an easy thing to do.”

Langdon thinks that “invasive procedures should be in the hands of medical practitioners because you’ve got to be able to deal with the consequences of what you’re doing. If you can’t deal with the complications you shouldn’t be doing that procedure.”

While this standpoint is more clear cut when thinking about injectables, it becomes complex when applied to treatments such as microneedling – the latest procedure to come under scrutiny for potential safety risks.

Microneedling in the spotlight

In June, the Food and Drug Administration (FDA) in the US declared that microneedling tools in every form are medical devices, sparking questions over whether this means the treatment itself should only be carried out by medics. At present, Skin Pen from manufacturer Bellus Medical is the only FDA–approved microneedling device, and the machine Langdon uses in her clinic.

“I have three therapists who work for me and they are allowed to needle to a certain depth that I feel is safe for them to do, but I see those more complicated patients who present with conditions like acne scarring, and I needle to a deeper level that I feel is appropriate.”

However, if the FDA regulation were to be implemented this side of the pond, the potential ramifications to beauty businesses offering skin-needling treatments in the UK could be huge. Martine Jarman, owner of SkinGenius Clinic in Cheshire, remains confident. “It is a little bit daunting and frustrating but actually I think we need to get on board to an extent and squeeze out the people who come into the industry to take shortcuts and make quick money”, she says. Even as a therapist herself, this is something Jarman, and many reputable, skilled and experienced advanced therapists, agree with the aesthetic medical community on.

“I think the stigmatism we face as therapists in this debate boils down to the training providers offering courses to unqualified people”, she explains. “They bring ‘therapists’ into the industry who have not practised on skin; they don’t have the skin health and physiology knowledge.”

Larissey is also unfazed by the suggestion that advanced treatments such as microneedling could be ruled medical in the UK. “Microneedling and rollering have always been under beauty therapy, so I can’t see that changing. It’s the same with skin peeling, there have always been occupational standards. A lot of this is money-oriented”, she says.

Education options

At present, no education route exists in the UK that allows therapists to gain a recognised UK qualification above Level 6 that would allow them entry onto the JCCP’s voluntary registers. Larissey thinks this lack of available education options is where the problem lies. “In the future, how are we going to make sure that the beauty sector can have this progression and can actually get on the registers?”, she asks. “Our ideal scenario would simply be to have that academic progression route so that advanced therapists would be able to join the register.”

Jarman hopes for a similar future, in which therapists entering the industry can aspire to an eventual career as a recognised advanced aesthetic therapist. “I’d like there to be a qualification where someone can get medically trained just on the aesthetics side as a cosmetic aesthetic practitioner, so it’s a career path someone can embark on”, she says.

With client demand rising for treatments like injectables, skin needling and peels, there is also the consideration that demand could outweigh supply if only medics are able to provide them, says Larissey: “There aren’t enough doctors or nurses to do those treatments and I think that’s what people forget”, she says, adding, “Some medics in this debate seem to have latched on to beauty therapists as the enemy and I don’t know why, because there’s a whole raft of other non-medical professionals doing these treatments, like podiatrists.”

Safety first

Langdon, however, is also strongly opposed to allied medical professionals providing advanced aesthetic treatments: “A physiotherapist or pharmacist doesn’t have the same skill or clinical acumen as a doctor or nurse that specialised in dermatology”, she says. “Anyone providing a treatment should be able to confidentially say to their client, ‘should anything go wrong I’ll be able to handle it and I won’t have to refer you to anybody else’.”

Those without specialist knowledge and experience working with the skin are able to perform such procedures because they can get insurance seemingly easily. “As long as [insurance companies] insure anyone for just about anything, of course you’re going to get bad practice”, says Jarman. Langdon is in agreement that this is a big part of the problem. “We have a difficult situation with insurance companies providing insurance for every treatment under the sun for basically anybody”, she says.

This is why Langdon believes tighter regulation over microneedling could benefit the UK industry. “Now, in the States, any accidents that happen or any treatment that takes place without an FDA-approved device mean that person delivering the procedure isn’t covered by insurance”, she explains. This isn’t just limited to therapists – Langdon says there are a “huge number” of doctors using devices that aren’t CE-marked or don’t have medical literature behind them as evidence of safety in practice.

“Often, the purchase decision is just based on how cheap the consumables are. You’d be shocked at how little attention even some in the medical community pay to the safety of their devices”, she says.

Moving forward

Jarman isn’t sure that the type of regulation now being implemented in the US would necessarily solve any problems in the UK: “Because we can’t work with medical-grade devices, which are often the safest and most rigorously tested ones, people can end up working with dangerous, untested devices from overseas”, she says.

“If someone really wants to provide that treatment, they will find a route to obtain a device that lets them do it. That’s where you get the standard of treatment that’s advertised on social media at cut prices.” Jarman, Langdon and Larissey are all in agreement that until mandatory regulation comes into play, the future of the aesthetics industry on both the medical and nonmedical sides is uncertain.

Until then, it’s more important than ever that therapists weigh in with their opinions to avoid being squeezed out of a market that many have already been operating in safely, professionally and expertly for years. PB

This article appears in PB November 2018

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PB November 2018
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