Superdrug tightens mental health checks on Botox customers

Superdrug is tightening its screening for people seeking Botox, to ensure that those with mental health problems are not having injections because they are dissatisfied with their body.

The high-street beauty and pharmacy chain has acted after NHS bosses criticised it for not conducting “medically responsible” checks before customers start treatment.

It has agreed to introduce enhanced screening specifically designed to see if those asking to have Botox or similar anti-ageing procedures have body dysmorphic disorder (BDD).

People with BDD worry obsessively about their appearance and some may seek cosmetic treatments or surgery to correct what they they see as flaws.

Prof Stephen Powis, NHS England’s medical director, welcomed Superdrug’s move. After the firm announced last September that it was making Botox available in its outlets, he had demanded it do everything possible to protect potentially vulnerable customers.

In a letter this week to Peter Macnab, the company’s chief executive, Powis said that at a recent meeting between the two about the issue “Superdrug acknowledged that further, specific protections could be put in place to safeguard people whose motivation to undergo cosmetic treatment was driven by, linked to or could trigger mental health issues like body dysmorphic disorder.”

He added: “It is encouraging to hear that you are taking this matter seriously and have agreed to put in place these additional protections.”

Superdrug said its enhanced screening would draw on a questionnaire approved by the Body Dysmorphic Disorder Foundation, but would not use it in its entirety.

Kitty Wallace, a trustee of the foundation, said most people with BDD remain unsatisfied with their appearance even after paying for steps to try to improve it.

“Studies show that fewer than 10% of patients with BDD are satisfied with the results of cosmetic procedures,” she said.

“It is important that these measures are in place to protect such individuals from potentially damaging and unnecessary procedures.

“Although their anxiety might ease temporarily, they will often find themselves fixating on another part of their body that they want to change.”

Wallace suggested Superdrug should refer anyone identified through its new screening process as having BDD to their GP and Mind, the mental health charity.

Superdrug said nurses specialising in “aesthetic medicine” would undertake an hour-long “full and extensive consultation” with anyone seeking anti-ageing treatments such as Botox, examining their motivation, before they could start treatment.

“This enables us to ensure we understand our patients’ reasons for wanting aesthetic treatments. It also flags to our team any risks or concerns related to a patient’s mental health.” it said.

“Following a productive meeting with the NHS, and as part of the ongoing development of our Skin Review service, we have added additional questioning specific to body dysmorphic disorder, in line with NHS recommendations. These inclusions far exceed current standards.”

Last year NHS England’s chief executive, Simon Stevens, criticised ITV for screening advertisements for cosmetic surgery in breaks during Love Island. He has also called for a new levy on social media platforms to help fund the rising cost to the NHS of treating children and young people with mental health problems.

Powis voiced concern that the cosmetic treatment industry was self-regulated.

“The lack of tough checks on cosmetic procedures means that the public is dependent on businesses taking voluntary steps to get their house in order, leaving people avoidably exposed to dangerous practices,” he said.

Catherine Gamble, the professional lead for mental health at the Royal College of Nursing, said it was not convinced Superdrug’s action went far enough.

“To be effective, any mental screening must be carried out by a qualified clinician such as a mental health nurse. We would also like to know who will safeguard this highly personal patient data, whether practitioners will be able to refer to other services, and understand more about the quality of the online assessment.”

Dr Agnes Ayton, vice-chair of the eating disorders faculty at the Royal College of Psychiatrists, said: “We share Prof Powis’s concerns regarding the potential exploitation of vulnerable people with mental health problems by this new business initiative.”

She said cosmetic treatment providers should alert a person’s GP if they had significant concern about their wellbeing.