Aesthetic Laser Treatments and the Medical Monopoly: Can an Aesthetician Practise Legally?
The use of so‑called “new technologies” (laser, intense pulsed light, lipolysis, radiofrequency, ultrasound, peeling, cryotherapy, mesotherapy, etc.) by aestheticians is increasingly being challenged by public authorities and medical professionals. The boundaries of the medical monopoly remain unclear, giving rise to numerous legal disputes regarding the use of new technologies. What is the current legal position?
The Medical Monopoly under Belgian Law: What Does the Law Say?
The legal framework is unclear. Both the medical profession and the profession of aesthetician are regulated professions, yet the precise limits of their respective scopes of practice are not well defined.
The Consolidated Act on the Practice of Health Care Professions of 10 May 2015 includes, within the scope of “medical practice” reserved to physicians, aesthetic procedures defined as:
“Any technical medical act involving penetration through the skin or mucous membranes, primarily intended to alter the patient’s physical appearance for aesthetic purposes, excluding any therapeutic or reconstructive objective.”
In the Walloon Region and the Brussels-Capital Region, access to the profession of aesthetician is restricted to holders of a recognised qualification in aesthetics. This qualification allows the practice of all treatments on the human body intended to maintain or improve a person’s aesthetic appearance that requires professional accreditation. This includes facial treatments, hair removal, and semi‑permanent makeup.
Aestheticians therefore also benefit from a protected professional field, provided that they do not encroach upon the medical monopoly and that they hold the required qualifications within the French‑speaking part of the country (even though the situation differs in Flanders).
How Can One Obtain Access to the Profession of Aesthetician?
The required professional skills may be demonstrated in three different ways:
- by holding a recognised diploma or certificate in aesthetics;
- by passing the examination of the Central Jury organised by the competent regional authorities;
- by proving professional experience of either three years full‑time or five years part‑time during the last fifteen years.
In practice, proof of professional competence must be submitted to an accredited business counter when registering with the Crossroads Bank for Enterprises.
Which Practices Should Aestheticians Avoid?
Aestheticians must refrain from performing acts reserved to medical practice, in particular any act involving penetration of the skin or mucous membranes intended to modify a person’s appearance. By way of example, injections of botulinum toxin (“Botox”) or hyaluronic acid are strictly reserved to physicians.
In order not to mislead consumers, it is also essential that aesthetic institutes and treatments are not presented as medical in nature. Aestheticians should therefore avoid expressions such as:
- “medical aesthetics centre”;
- “my patients are delighted with the results”;
- “skin healing”;
- etc.
Aestheticians and Technological Devices: Where Does the Illegal Practice of Medicine Begin?
Laser hair removal, intense pulsed light, radiofrequency: are these techniques medical acts?
At present, it is unfortunately not possible to provide an exhaustive list of devices that aestheticians are authorised to use and those that are prohibited. Aesthetic devices are numerous and highly diverse:
- both in terms of their functions (hair removal, lipolysis and skin tightening, reduction of pigmentation spots);
- and in terms of their operating methods (laser, intense pulsed light, radiofrequency, ultrasound, peeling, cryotherapy, mesotherapy, etc.).
In this context, decisions have been taken in widely differing directions by various public authorities (FPS Economy, police, public prosecutors, courts, etc.), with the FPS Public Health also intervening, sometimes with limited consistency.
Each situation must therefore be assessed on a case‑by‑case basis, considering the characteristics of the device and the technology used.
If you would like further information, please do not hesitate to contact us.
Criminal and Civil Sanctions: What Are the Risks in Case of Infringement?
An aesthetician who lacks proper access to the profession or who performs unauthorised acts may be exposed to several sanctions:
- administrative fines;
- criminal fines and, in some cases, imprisonment;
- cessation of activity.
These sanctions can be severe: the illegal practice of medicine constitutes a serious offence.
In addition, the aesthetician’s civil liability may also be engaged in the event of damage caused to consumers.
Our advice:
The police, the FPS Economy and the FPS Public Health periodically carry out inspections of beauty salons; prosecutions and sanctions are sometimes imposed. At the same time, several physicians operating aesthetic centres have rightly taken legal action against competing aestheticians who failed to comply with the medical monopoly.
Are you questioning the legality of practices carried out by beauty salons?
Are you being prosecuted for the use of new aesthetic technologies and require legal defence?
Do you wish to diversify your activity but are unsure whether certain new technologies and/or practices are permitted?
Contact us without delay.