Abstract Background The United Kingdom aesthetic botulinum toxin industry operates with limited regulatory oversight despite being a prescription-only medication. Following recent public scrutiny, regulatory reforms are imminent, warranting comprehensive analysis to inform evidence-based policy. Objectives The aim of the study was to characterize practitioner profiles, pricing patterns, premises types, and socioeconomic gradients in the provision of aesthetic botulinum toxin across the United Kingdom. Methods Cross-sectional analysis was conducted of practitioners administering aesthetic botulinum toxin and fillers across the UK (January–July 2025). Data were collected from publicly available websites and social media platforms. Geographic analysis used deprivation indices to examine socioeconomic patterns. Statistical methods included descriptive analysis, χ2 tests, and multivariable regression modeling. Results A total of 19,701 practitioners across 5589 clinics were identified, representing a 437% increase over 2 years. Doctors comprised 28.4% of practitioners, while the proportion of nonmedical aestheticians doubled from 12% to 24.8%. Practitioner density showed a 6.7-fold increase from the least (9.4 per 100,000) to the most deprived areas (63.2 per 100,000). Doctor representation declined from 34.4% in affluent areas to 27.0% in deprived areas, while odds of nonclinical botulinum toxin administering beauty salon exposure peaked in moderately deprived areas (odds ratio OR = 2.18). Specialist access (dermatologists/plastic surgeons) declined significantly in Quintiles 3 to 5 (ORs 0.70-0.77). Regression analysis identified practitioner profession as the strongest pricing determinant: doctors charged 32% to 38% more than aestheticians, dentists 28% to 33% more, and nurses 2% to 4% more (all P .001). Geographic context exerted modest effects, with higher-income and denser areas associated with 1% to 5% higher prices. Conclusions The UK aesthetic medicine market has expanded rapidly, with significant differences in practitioner qualifications and treatment settings across socioeconomic groups. These findings provide key evidence to guide upcoming regulatory reforms and highlight the need for stronger safety oversight of prescription-only aesthetic procedures. Level of Evidence: 5 (Therapeutic)
Zargaran et al. (Thu,) studied this question.