Prescription Only Medications in Aesthetics
Certain medications used in aesthetics are Prescription Only Medications (POMs), meaning they require a prescription from someone with prescribing rights.
Prescribing rights are restricted to those who have completed specific training in prescribing and who are registered with a regulatory body, for example:
- General Medical Council (GMC) for doctors;
- General Dental Council (GDC) for dentists;
- Nursing and Midwifery Council (NMC) for nurses; and
- General Pharmaceutical Council (GPC) for pharmacists.
Doctors and Dentists
Doctors and Dentists gain prescribing rights as part of their degree course, so are able to prescribe on graduation from Medical/Dental School. Doctors are able to prescribe any medication, whereas Dentists can only prescribe from the Dental Formulary, which has limited medications on it.
Nurses, Midwives and Pharmacists
In order to prescribe; nurses, midwives, pharmacists and other allied healthcare professionals (AHPs) like physiotherapists must complete an accredited prescribing course in addition to their university degree. Prescribing undertaken by a healthcare professional other than a doctor or dentist is termed non-medical prescribing (NMP).
There are two main types:
- Community Practitioner Nurse Prescribers (CPNP); and
- Independent Prescribers (IPs), including Supplementary Prescribers (SPs).
CPNPs are nurses who have successfully completed a NMC CPNP course (also known as a v100 or v150 course) and are registered as a CPNP with the NMC. The majority of nurses who have done this course are district nurses and public health nurses (previously known as health visitors), community nurses and school nurses. They are qualified to prescribe only from the Nurse Prescribers Formulary (NPF) for Community Practitioners. This formulary contains appliances, dressings, pharmacy (P), general sales list (GSL), and thirteen prescription-only medicines (POMs).
IPs are nurses who have successfully completed an NMC Independent Nurse Prescribing Course (also known as a v200 or v300 course) and are registered with the NMC as an IP. They are able to prescribe any medicine provided it is in their competency to do so. This includes medicines and products listed in the British National Formulary (BNF), unlicensed medicines, and all controlled drugs in schedules two-five.
In general, an IP can prescribe any medicine for any condition within their clinical competence, whilst a SP may prescribe any medicine within their clinical competence that is included in the patient specific CMP.
| Type of Prescriber | Description |
| CPNP (V100) & (V150) | 1. District nurse/health visitor formulary nurses and any nurse undertaking a V100 prescribing programme as part of a Specialist Practitioner qualification.
2. The V150 is a stand alone programme to enable nurses to prescribe from the same formulary as the community practitioners. 3. Can only prescribe from the NPF. |
| Nurse Independent/Supplementary Prescribers (V300) | 1. Previously extended/supplementary nurse prescribers. 2. IPs can prescribe all medicines and controlled drugs (CDs). |
| Pharmacist Supplementary Prescribing | 1. Pharmacists who can only prescribe under a CMP. |
| Pharmacist Independent/Supplementary Prescribing | 1. Pharmacists who have completed the current IP course.
2. IPs can prescribe all medicines and controlled drugs. |
| AHP Independent/ Supplementary Prescribing | 1. Podiatrists, physiotherapists and therapeutic radiographers who have completed the current IP course.
2. Diagnostic radiographers and dieticians can only prescribe as SPs under a CMP. |
| Optometrists Independent/Supplementary Prescribing | 1. Optometrists who have undertaken the supplementary and independent prescribing speciality course. |
Pharmacists
Currently, pharmacists cannot automatically prescribe on completion of their degrees. Like Nurses and other AHPs, they need to complete an independent prescribing (IP) qualification to enable them to prescribe. However, the GPC is changing the education and training process for future pharmacists. It means that by the summer of 2026, all pharmacists will be qualified IPs at the point of registration. This will allow them to prescribe medicines and lead clinics in their place of work.
Non Prescribing Aesthetic Practitioners
If you are an aesthetic practitioner without a prescribing qualification – such as a nurse, midwife, pharmacist, or AHP – you need to find a prescriber to prescribe POMs for your aesthetic clinic. Doing so will help to keep your patients safe, your registration safe, help you comply with the law, validate your insurance, and keep your business finances safe.
This also applies to non-healthcare professionals (e.g. beauty therapists) who provide aesthetic services. They require a prescription for POMs they use in order to comply with the law, validate cosmetic insurance and to maintain patient safety. There is no way for non-healthcare professionals to gain prescribing rights.
Checking Prescription Rights are In-Date
The first thing to do is ensure the prescriber is ‘live’ on the register of their medical governing body (NMC, GMC, GDC etc). An individual may have a prescribing qualification, but their registration could have lapsed or been suspended.
A Trained Prescriber versus An Aesthetically Trained Prescriber
Although important, having a qualification to prescribe is not sufficient, the prescriber should be trained in the aesthetic treatment(s) they will be prescribing for their own and your patients. You will need a prescriber who has the skills and knowledge to prescribe the correct treatment(s); without formal training it will be difficult to evidence that competency has been achieved.
An Insured Prescriber
In addition to being registered and aesthetically trained, the prescriber should be independently insured to prescribe the relevant aesthetic treatment(s) being offered. Importantly, if prescribing for other aesthetic practitioners, the insurance policy should cover this.
Safeguarding Your Patients and Your Registration
Without a registered, aesthetically trained, and insured prescriber you are putting your patient’s safety, and if you area healthcare professional, the safety of your registration at risk. In the unfortunate event of a complaint from a patient to your governing body, you will need to evidence you have put patient safety as the top priority in your practice to allay the potential threat to your registration.
What are the Financial Implications?
The financial consequences of a patient’s insurance claim could be catastrophic if you have not used a prescriber with the qualifications, knowledge and cover outlined above. Your insurance policy could be invalid, leaving the patient to target your personal wealth to get the compensation they believe they deserve.
Prescription-Only Medicines (POMs)
POMs that are often used in aesthetic clinics include Botulinum Toxin (Botox) used to treat lines and wrinkles. Another is Hyaluronidase, which is used to dissolve dermal filler, in case of an injection complication. These require a prescription from a qualified prescriber.
Anyone who prescribes a POM for administration to a patient by a third party must be appropriately trained in its use and must assess the patient in person prior to prescribing. This face to face assessment includes a full medical history and clinical assessment of the patient’s suitability for the intended procedure.
Healthcare Improvement Scotland (HIS) regulate independent clinics in Scotland and provide guidance for aesthetic prescribing. In November 2022, they updated their guidance to state that “non-prescribing medical practitioners are now prohibited from performing Botulinum toxin or dermal filler injections unless a prescriber is physically present on the site”. This means that all aesthetic practitioners who cannot prescribe, including beauticians, must have the prescriber present during these procedures.
The rationale behind this decision is that while dermal fillers are not prescription-based, managing potential complications arising from their use necessitates prescription medications.
Summary
Non-prescriber aesthetic practitioners must engage with registered, aesthetically trained, and insured prescribers who can verify their status as such.