By Geoff Bloom, Partner, Meghan Carruthers, Special Counsel, and Dr Teresa Nicoletti, Partner

In December 2024, Queensland Health released the Medicines in beauty treatment/cosmetic businesses factsheet which provides guidance on the buying, storage and use of Schedule 4 (prescription only) cosmetic injectables to help businesses comply with the requirements of the Medicines and Poisons Act 2019 (Qld) and the Medicines and Poisons (Medicines) Regulations 2021 (Qld).

The position taken in the factsheet threatens the commercial viability of the estimated 1,000 or more nurse-led cosmetic clinics across Queensland.

What does the factsheet say?

S4 cosmetic treatments, including botulinum toxin (sold under the brand names Botox® and Dysport®) and dermal fillers including collagen, hyaluronic acid and polylactic acid can only be administered in Queensland if they are prescribed by a medical practitioner or nurse practitioner.  A prescription to administer can be written or verbal.

The factsheet reminds prescribing practitioners that they must personally assess a patient and determine that the medicine is reasonably necessary for their therapeutic treatment before issuing a prescription.   Once a prescription has been issued, a registered nurse (or enrolled nurse under the supervision of a medical practitioner or registered nurse) can then administer the cosmetic treatment to the patient.

The factsheet also reminds clinics of the need to ensure medicines are stored in accordance with the legislation, comply with infection control requirements under the Public Health Act 2005 (Qld) as well as the prohibition on advertising Schedule 4 cosmetic medicines to the public.

So, what is the cause for alarm?

The factsheet records Queensland Health’s view that it is ‘unlawful for registered nurses, enrolled nurses, admin staff or other unauthorised persons to buy cosmetic injectables for a beauty treatment/cosmetic business even ‘on behalf of’ or ‘with the approval’ of a doctor or nurse practitioner.’

Further, it states that ‘doctors and nurse practitioners cannot buy stock for a place that they do not practice from, which includes locations for which telehealth is provided.’

The vast majority of nurse-led clinics do not have a medical practitioner or nurse practitioner physically practising on site.  Patients seeking cosmetic injectables have telehealth consultations with medical practitioners and nurse practitioners.

Queensland Health’s view is contrary to the long-standing industry practice of medical practitioners ordering cosmetic injectables which are then consigned to nurse-led cosmetic clinics at which the ordering medical practitioner does not physically practice.  Reputable operators in the cosmetic industry maintain remote supervision of the cosmetic injectables consigned to clinics and require nurses at the clinics to comply with minimum standards and submit to compliance audits.  However, the factsheet states that this common industry practice is not permitted under Queensland law. 

What has happened since the fact sheet was issued?

The factsheet has cause great concern amongst nurse-led cosmetic clinics because of fears it threatens their businesses.  We are working businesses which consign medicines to nurse-led cosmetic clinics and facilitate consultations with prescribing practitioners to engage with Queensland Health about the factsheet and try to resolve the regulatory issues to both protect the public and ensure the ongoing viability of nurse-led cosmetic clinics.

Please contact us if you would like to discuss the impact of the factsheet on your business.