'Anyone can give Botox jabs in Sweden': report

Using fillers, substances that are injected under the skin to fill out wrinkles or saggy areas, is becoming increasingly common in Sweden and in the rest of the world.

But in Sweden, these are classified as medical devices (and not drugs) and can therefore be administered by anyone, regardless of training and without any demands of specialist knowledge in anatomy, nerves or muscles, according to SVT.

Ulf Samuelsson, a surgeon and chairman of the Swedish association of aesthetic plastic surgery (Svensk förening för estetisk plastikkirurgi) thinks that it is important that anyone administering fillers should have solid training.

“You must know exactly what you are doing and deal with any complications that might arise. I definitely think that they should be qualified medical staff,” said Samuelsson to SVT.

He thinks that the reason that the rules are so lax is that when they were written fillers weren’t around and the market hadn’t yet exploded to the extent it has today.

“The National Board of Health and Welfare (Socialstyrelsen) has been caught by surprise, although the road to here has been long,“ Samuelsson said to SVT.

According to Stina Auer, a qualified nurse at the Stockholm beauty salon Ellipsekliniken, the hazards of having unqualified staff administering fillers and botox is substantial.

“To avoid the facial nerve, or facial bones for that matter, is tricky. Maybe you’ll manage with nine patients, but the tenth could be paralysed for the rest of their life. Then it is not as fun, and not as easy,” Auer told SVT.

Up until last summer, anyone administering the neurotoxin Botox to customers had to be medically qualified.

But today, anyone can do it, whether it is the nail technician, the beauty therapist or the weekly cleaner, just as long as the manager of the salon has approved them for the job.

And the manager of the salon does not need to be medically trained either, according to SVT.

At the beginning of SVT’s interview with Per Anders Sunesson, director at the department of supervision at the National Board of Health and Welfare, he defended the existing rules.

“It is up to the manager to decide. It does seem a little confusing, but these are the rules we go by,“ he said to SVT.

Sunesson first said that he believed having unqualified staff injecting Botox to be ‘absolutely’ safe for customers but when probed a little further by the journalist he started to change his mind, according to SVT.

“My personal opinion is that the regulations need to be tougher. And especially regarding Botox, definitely. We ought to quickly look into whether this area might need its own set of rules,“ he said.

To surgeon Ulf Samuelsson it is inconceivable that someone without medical training should be allowed to administer a substance like neurotoxin Botox.

“I think that it sounds very strange that a drug can be administered by unqualified staff without a medical presence. It sounds very odd to me,“ he said.

And when SVT spoke to a doctor in France, where the rules are different, the reaction was one of horror.

“To me it is absolutely impossible to understand that anyone who isn’t a doctor is allowed to do this. I can’t believe that what you say is true! This is super-dangerous. You could die! I could mistakenly inject the stuff into an artery and then it would be the end,“ the doctor told SVT.