Open Letter #2
Have We Privatised Skin?
To the UK Government and those shaping public health policy:
At what point did we decide that skin, the body’s largest, most visible organ, no longer belonged to national care?
We fund dental check-ups.
We screen for cancers.
We invite over-50s to heart health reviews.
But we do not check the skin.
There is no structured, preventive skin guidance.
No national check-ups.
No public messaging around barrier care or everyday skin health.
No roadmap from birth to old age.
Instead, skin has been quietly outsourced -
picked up by the private sector, absorbed by aesthetics,
and left to unregulated wellness trends and conflicting messages.
One of the clearest examples? Lesion care.
Once a medical concern, many lesions are now treated as cosmetic.
People are paying privately to have moles, skin tags, and other marks removed -
sometimes by medics, sometimes by non-medics,
often without any formal obligation to get them properly assessed first.
This isn’t just confusing for the public. It’s confusing for professionals too.
Other parts of the body - like teeth - have national systems in place to check if things are going well, even if access is uneven.
Skin doesn’t.
Unless something goes wrong, there is no check-up, no prevention, no guidance.
And like in mental health, private care often fills the silence - whether it’s affordable or not.
Because where there is no public responsibility,
commercial interest steps in.
And the result is what we have now: a patchwork of advice, services, and risks - without clear, national coordination.
It’s worth noting that much of the skin-related workforce—beauty therapists, electrologists, hairdressers, nail technicians, massage therapists, and even some non-medical aesthetics providers—falls under the personal care sector which is governed by the Department for Education.
These roles are trained through Ofqual-regulated qualifications, with National Occupational Standards set by HABIA. But there is no connection to the Department of Health and Social Care, and crucially, while some procedures—like cryotherapy, microneedling, or laser treatments—are occasionally offered within NHS settings, these are limited, condition specific, and typically require consultant referral, There is no broader NHS-supported skin therapy service, and no public facing skincare guidance or preventative support delivered through the national system.
While many of these qualifications are government-recognised—and sometimes publicly funded via further education colleges—their delivery is often shaped by private market needs. And the services these qualifications lead to are almost entirely delivered in the private sector, with no expectation for public health-aligned CPD and no updates when national skin-related health guidance changes—if it exists at all.
The result is that skin care has been quietly pushed into a parallel system:
Recognised in education,
Deregulated in practice,
Commercially driven in messaging,
And publicly invisible unless something goes wrong.
And this matters - because all of those roles touch skin. Some daily. Some deeply. And they often serve as the first, and sometimes only, point of contact for people concerned about their skin.
But without national guidance, updates, or public oversight, they’re left to navigate alone.
So yes - this is what privatised skin looks like.
And no, it’s not safe, fair, or sustainable.
The Skin Well® quietly asks:
If skin is a vital organ - and one that hundreds of thousands of professionals work with every day -
why isn’t it included in national health frameworks?
Why isn’t it protected, monitored, or publicly guided?
And if we didn’t mean to privatise skin…
isn’t it time we brought it back?
Respectfully,
The Skin Well®
Updated June 2025
Related Read: - Quiet Case for Statutory Oversight of Skin Work in the UK
📚 Connected Scenario(s):
Scenario Zero: Naming Skin in Public Health
Scenario Three: Policy at Every Level
Scenario Five: 224,000 Reasons for Regulation
The Skin Well®
A grassroots, evidence-aware initiative supporting public skin education.
👉 @theskinwell_
Disclaimer
A Quiet Case for National Skin Health is part of an independent advocacy series by The Skin Well™. These pieces are written from lived professional experience and personal reflection. They are intended to raise questions, highlight gaps, and explore opportunities for public health improvement.
They do not replace professional medical advice, and they do not represent the views of the NHS or any governmental body.
It should not be used as a substitute for professional medical advice, diagnosis, or treatment. If you have concerns about your skin or health, please speak with your GP or a qualified healthcare provider.
I welcome constructive feedback. If you notice any information that may be inaccurate or outdated, please let me know so I can review and improve.
© 2025 Jacqui de Jager | The Skin Well® & The Happy Skin Clinic®
All rights reserved. This leaflet is for personal use and education only. It may not be reproduced, distributed, or adapted without written permission.