A government body is to investigate whether "aesthetic fillers" used in cosmetic surgery clinics to reshape faces could transmit variant CJD or other infections to patients.
A report for the government by an expert group on cosmetic surgery, chaired by patients' tsar Harry Cayton, raised concerns about injections administered to raise cheek bones or otherwise improve the appearance of the face. Some are synthetic but others might contain human tissue or tissue from animals or birds, he said.
The report said that biodegradable fillers had a good record, but that "semi-permanent and permanent fillers have been reported to produce significant, longer-term inflammatory reactions in the skin, leading to discomfort, scarring and disfigurement".
The chief medical officer, Sir Liam Donaldson, accepted the recommendations of the report, and that of the inspectorate, the Healthcare Commission, for tightening controls over cosmetic surgery clinics. He said there were several areas of cosmetic surgery and more minor procedures that were inadequately regulated and could put patients at risk, including the increasingly popular Botox injections offered in high street clinics and beauty salons.
On the risk of infection from tissue injections, he said: "We have asked our expert committees to give some advice on the use of aesthetic fillers which might come from animal or human tissue."
As well as the possible risk of variant CJD, other infections, such as hepatitis, and blood or tissue-borne viruses, were also possible, said the report.
Botox injections are also a concern. Because Botox is a licensed medicine - although it is being used for a purpose outside the licence - it is against the law to advertise it to the public. Yet adverts can be found in magazines, on the internet and in shop windows.
Clinics that allow beauticians or staff other than doctors to give the injections are breaking the law.
"The Botox area has escaped some aspects of regulation," said Sir Liam. "We are aware of stories of Botox parties in people's houses where they inject each other after a few drinks.
"They are not like Tupperware parties. This is serious stuff. Anyone injecting this needs clinical and medical training. It can cause harm if it goes wrong."
Simon Gillespie, the head of operations at the Healthcare Commission, which inspects registered cosmetic clinics, estimated there were more than 20,000 businesses offering Botox and other apparently minor procedures. Most are not registered. "This is a massively growing market," he said. "People seem to think this is normal practice - part of everyday life."
Sir Liam said any doctor found to have supplied Botox for somebody medically unqualified to inject would be liable to be brought before the General Medical Council.
The Healthcare Commission said 34,646 cosmetic surgery procedures were carried out in 2003-04. That excludes minor procedures such as Botox injections. Breast surgery made up 43% of the total.
