Botox Under 18 in England: A Crime, With a Doctor's Exemption

Since October 2021, injecting Botox or a cosmetic filler into someone under 18 in England has been a criminal offence. A business that arranges the appointment can be prosecuted too. The law is often summed up as a ban.

It is narrower than that. The Act exempts doctors, and nurses, dentists and pharmacists working under a doctor's directions. It applies only in England. Scotland passed a wider ban in March 2026, which takes effect in 2027. Australia, meanwhile, regulates the practitioner rather than setting an age bar. This article sets out what each rule actually covers.

Four rules side by side

What England's law says

The Act makes it an offence to give a person under 18 an injection of botulinum toxin or a filler "for a cosmetic purpose" in England.¹ It defines a filler broadly, as any substance used for skin or lip filling.¹

It also catches business owners. A business commits an offence if someone other than an approved person gives the injection, or if "arrangements are made, in England" for them to do so.⁶ Directors and managers can be prosecuted personally if the offence happened with their consent or through their neglect.⁷ The penalty on conviction is a fine.¹

The exemptions are written into the same section. It is a defence to be a registered doctor, or a registered nurse, dentist or pharmacist acting under a doctor's directions.¹ It is also a defence to have taken reasonable steps to check age and to have believed the person was 18 or over.¹

Where England's law stops

The offence is territorial. The injection must be given in England, and the arrangements must be made in England.¹⁶ The Act does not cover a treatment booked online with a foreign clinic and given abroad.

Advertising rules add a layer. Since November 2021, UK advertising codes have banned targeting cosmetic-intervention ads at under-18s.⁴ Botox is a prescription-only medicine, so it cannot be advertised to the public at all.⁴

The government has signalled more to come. In August 2025 it said consultation responses had "strengthened our intention to mandate age restrictions" for other non-surgical cosmetic procedures.⁸ It also said it would consider which procedures under-18s might still have if approved by a doctor.⁸

Scotland goes further, from 2027

Scotland's parliament passed the Non-surgical Procedures Bill on 17 March 2026, with 124 votes in favour.² It will "prohibit non-surgical cosmetic procedures for under-18s", with a maximum fine of £20,000.² It is expected to take effect in September 2027.²

The bill also changes where treatment can happen. All aesthetic procedures will have to take place in clinics registered with Healthcare Improvement Scotland, with a qualified prescriber on site.² The health committee that examined it said it "fully" backed making the procedures illegal for under-18s.⁹

The report reviewed here does not mention a doctor's exemption for under-18s.² If none exists in the final text, Scotland's rule will be stricter than England's.

Australia regulates the practitioner instead

Australia's health practitioner regulator took a different approach. Its guidelines for non-surgical cosmetic procedures, in force from 2 September 2025, allow treatment for under-18s, with a condition.³ They must wait seven days between the first consultation and any procedure.³ Advertising aimed at under-18s is banned.³

What the rules leave out

None of the sources reviewed publishes prosecution numbers under England's Act. Whether it is enforced is a question this article cannot answer.

The rules also differ on who counts as safe. England trusts a doctor's judgement for under-18s.¹ Scotland's committee backed a flat prohibition.⁹ Australia relies on a cooling-off period and the practitioner's standards.³

Travel is the gap all three share. A rule tied to where an injection is given does not follow a young person who books treatment abroad.

How to use the rules

If you are a parent, ask who will give the injection and what their registration is. In England, only a doctor, or a nurse, dentist or pharmacist under a doctor's directions, may lawfully treat someone under 18.¹

Check the age-check process. A clinic that does not ask for identification is relying on a defence it may not be able to prove.¹

If the plan involves treatment abroad, none of these rules applies there. Ask the clinic in writing what its own country's rules say about patients under 18.

Footnotes

1. https://www.legislation.gov.uk/ukpga/2021/19/section/1 — UK legislation, "Botulinum Toxin and Cosmetic Fillers (Children) Act 2021", section 1. Accessed Oct 3, 2026. ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹²

2. https://aestheticsjournal.com/news/scottish-parliament-passes-non-surgical-procedures-bill — Aesthetics Journal, "Scottish Parliament passes Non-surgical Procedures Bill" (published Mar 18, 2026). Accessed Oct 3, 2026. ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹

3. https://www.claytonutz.com/insights/2025/june/navigating-the-2025-ahpra-guidelines-on-cosmetic-procedures-heres-what-you-need-to-know — Clayton Utz, "Navigating the 2025 Ahpra guidelines on cosmetic procedures" (published Jun 16, 2025). Accessed Oct 3, 2026. ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸

4. https://www.asa.org.uk/resource/cosmetic-interventions.html — Advertising Standards Authority, "Cosmetic interventions" guidance. Accessed Oct 3, 2026. ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶

5. https://en.wikipedia.org/wiki/Botulinum_Toxin_and_Cosmetic_Fillers_(Children)_Act_2021 — Wikipedia, "Botulinum Toxin and Cosmetic Fillers (Children) Act 2021", on Royal Assent and commencement dates. Accessed Oct 3, 2026. ↩

6. https://www.legislation.gov.uk/ukpga/2021/19/section/2 — UK legislation, "Botulinum Toxin and Cosmetic Fillers (Children) Act 2021", section 2. Accessed Oct 3, 2026. ↩ ↩² ↩³

7. https://www.legislation.gov.uk/ukpga/2021/19/section/3 — UK legislation, "Botulinum Toxin and Cosmetic Fillers (Children) Act 2021", section 3. Accessed Oct 3, 2026. ↩

8. https://www.gov.uk/government/consultations/licensing-of-non-surgical-cosmetic-procedures/outcome/the-licensing-of-non-surgical-cosmetic-procedures-in-england-consultation-response — Department of Health and Social Care, "The licensing of non-surgical cosmetic procedures in England: consultation response" (published Aug 7, 2025). Accessed Oct 3, 2026. ↩ ↩²

9. https://www.parliament.scot/about/news/news-listing/cttee-backs-bill-to-regulate-non-surgical-procedures-industry — Scottish Parliament, "Committee backs bill to regulate non-surgical procedures industry" (published Jan 27, 2026). Accessed Oct 3, 2026. ↩ ↩²

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