England's top doctor says practitioners offering cosmetic procedures should have training to help them protect vulnerable clients from "quick fixes".
Prof Stephen Powis believes providers should be officially registered and trained to spot people with body-image or other mental-health issues.
NHS England says only 100 out of 1,000 practitioners are currently registered.
And a charity says procedures such as Botox can have a damaging effect on the mental health of young people.
Prof Powis, medical director at NHS England, wants professionals who provide procedures such as fillers and injections to join the new Joint Council for Cosmetic Practitioners.
He says too many providers are "operating as a law unto themselves".
He welcomed the move by some practitioners to undertake training on how suitable their customers are for cosmetic anti-aging treatments, calling it a "major step forward".
But he said the numbers were still too low.
'Quick fix'
And he warned clients that they still needed to vet firms properly before having cosmetic procedures, which include botulinum toxin injections – such as Botox – fillers, skin peels, lasers and hair restoration surgery.
Prof Powis said: "We know that appearance is the one of the things that matters most to young people, and the bombardment of idealised images and availability of quick-fix procedures is helping fuel a mental-health and anxiety epidemic."
But the NHS could not be "left to pick up the pieces", he added.
"We need all parts of society to show a duty of care and take action to prevent avoidable harm."
By registering with the council, a new professional body, practitioners will agree to undergo online training on:
- recognising the signs and symptoms of vulnerability and mental ill health
- the psychology of appearance
- telling customers where to get help if they show signs of being vulnerable
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