Expert guide: Aesthetic & Cosmetology 2015 8 June 2015 June 2015 9 During the last 25 years nurses have been at the forefront in the treat-ment of non-surgical aesthetic pro-cedures. These include the use of dermal fillers, the botulinum type A toxin cosmetically, chemical peels, and laser treatments. As well as treating patients many are instruct-ing and mentoring their medical col-leagues.Recognising that a new specialty brought with it responsibili-ties, a group of entre-preneurial nurses es-tablished a forum for aesthetic nurses. This afforded nurses net-working and educational opportuni-ties. They also published guidance for best practice, and the interna-tionally acclaimed accredited com-petencies. Because their professional organi-sation felt that aesthetics was not part of mainstream healthcare, we founded the British Association of Cosmetic Nurses (BACN). Part of its remit is to educate and foster good practice so that patient safety in this new specialty may be safeguarded. The medicalisation of ageing and beauty There are many examples of condi-tions other than disease processes per se, which attract the attention of the medical and nurs-ing professions, obesi-ty and the menopause being the most obvi-ous. Now the ageing process and the en-hancement of beauty can be added to the list. It was during the Enlightenment that the idea of per-fecting health began1. The Georgian public self-medicated, bought man-uals and purchased products2 which they hoped would help restore health. The 18th Century also saw the advent of marketing including advertising and product distribution. As the nation became more pros-perous through an improved market economy, so people became more Elizabeth Bardolph Liz@bardolph.wanadoo.co.uk +44 (0) 1329 661 835 The changing face of aesthetics from a nursing perspective By Elizabeth Bardolph united kingdom wealthy with an increase in dispos-able income. In addition to these factors anti-age-ing treatments were crossing from America to the UK. Collagen which was used in the treatment of burns was found to restore skin integrity, and Drs A and A Carruthers were de-veloping the use of the botulinum type A toxin cosmetically. Initially treatments were taken up by celeb-rities, and encouraged by the results, it was not long before the media promoted many of these treatments as ‘lunch time’ fixes. Alongside this was the realisation among some that physical appearance mattered in or-der to improve self-confidence, and secure a job or a partner. This too was encouraged by the media, and has become more potent with the advent of social media and the pop-ularity of ‘selfies’. Although the public were initially cautious about anti-ageing treat-ments, the momentum rapidly in-creased resulting in the popularity of non-surgical treatments we are familiar with today. To cope with the increase in demand more practition-ers are entering this field. There is therefore a requirement for educa-tion and training which is not deliv-ered in the National Health Service. Education and Training Currently education and training un-dertaken by doctors and nurses is product based, a format that seems set to change. The legal test for doc-tors and nurses is competence judged by the Bolam3 /Bolitho4 standard and underpinned by education and train-ing. The BACN have updated their competency framework5 which rec-ognises the requirement for special-ist knowledge and skills at different levels of practice6. The document provides a benchmark for good prac-tice and is being used in the structur-ing of an educational framework for Higher Education Institutions in line with Department of Heath recom-mendations. As recommended in the Keogh re-port7, Heath Education England