Recently, CCTV’s program “Focus Interview” aired an episode titled “Is Medical Aesthetic Live Streaming Bringing Prosperity or Peril?”, exposing irregularities within the medical aesthetic live streaming sector. This revelation has caused significant turmoil within the industry, leading to the suspension of medical aesthetic live streams across multiple platforms. The report directly highlighted unlawful activities within live streaming sessions, including merchants’ non-compliant advertising, the sale of medical aesthetic products without relevant qualifications, and false advertising.
In recent years, China’s medical aesthetic market has consistently maintained double-digit growth rates, with medical aesthetic institutions proliferating nationwide. However, the cost of offline customer acquisition for these institutions is often high, prompting medical aesthetic products to adopt live streaming sales channels similar to other commodities. Due to high transaction values and repeat purchase rates, traditional e-commerce platforms and social media channels have commenced live streaming sales of medical aesthetic products, leading to the emergence of specialized medical aesthetic sales applications. Unlike cosmetic beauty, medical aesthetics constitutes medical procedures, carrying significant medical risks and requiring high professional standards. To strengthen regulation, various regions have progressively begun to control medical aesthetic live streaming activities, issuing various guidelines and regulations that establish compliance requirements for each stage of medical aesthetic live streaming. Based on the current state of medical aesthetic live streaming and relevant regulations, the authors have summarised the key issues to be aware of during the live streaming process.
I. Key Points to Consider During the Onboarding Process
During the onboarding phase, it is essential to consider the qualifications of all parties involved and promptly sign agreements.
1. Qualifications of Live Streaming Platforms or Self-Constructed Websites
According to the “Regulations on the Administration of Internet Drug Information Services,” if live streaming involves the provision of information about drugs or medical devices, a “Qualification Certificate for Internet Drug Information Services” issued by the Food and Drug Administration must be obtained. Additionally, the certificate number must be prominently displayed on the homepage of the website. Currently, some live streamers who have not obtained the aforementioned qualification certificates attempt to circumvent this regulation by using alternative names. For example, when selling water light projects, they do not specify drug information, instead using terms like Water Light 1 or Water Light 2, and subsequently publish the specific drug information associated with these alternative names through other accounts. Such actions may still be deemed non-compliant.
2. Qualifications of Medical Aesthetic Institutions Providing Services
Institutions offering medical aesthetic services must obtain primary qualifications such as a “Medical Institution Practice License.” Without a license, they cannot commence practice activities and must provide qualification information to the live streaming marketing platform or other live stream operators. If there are changes to the information, it must be updated promptly and communicated to the platform for verification. Institutions operating without a license may face administrative penalties at minimum, and severe cases could involve criminal charges. For instance, on 6 February 2023, the Health and Wellness Bureau of Xihu District, Hangzhou, announced an administrative penalty against a beauty clinic that, between 12 August 2022 and 28 October 2022, conducted medical aesthetic activities such as injection fillers, water light needles, and photon skin rejuvenation for 13 customers without a medical institution practice license. The clinic was penalised with a confiscation of illegal gains amounting to ¥76,928 (after voluntarily refunding ¥23,000 of the total ¥99,928) and fined ¥499,640.
II. Key Points to Consider During Promotion and Marketing
1. Selection of Product Types for Sale
Different medical aesthetic projects involve varying levels of medical risk. Live streaming marketing platforms or websites should establish a negative directory for medical aesthetic live streaming, listing categories of medical aesthetic projects that are prohibited from production and sale, online transactions, commercial promotion, and those unsuitable for live streaming marketing. It is prohibited to promote unapproved or unregistered diagnostic and treatment subjects and service items, as well as to advertise drugs or medical devices that have not been approved or registered by regulatory authorities.
2. Pre-Approval of Medical Advertisements
According to the “Guidelines for the Enforcement of Medical Aesthetic Advertisements,” medical aesthetic advertisements are classified as medical advertisements. Advertisers must adhere to the principle of “one advertisement, one certificate” by legally obtaining a “Medical Advertisement Review Certificate.” Medical institutions cannot publish medical aesthetic advertisements under the guise of internal departments. Advertisers, publishers, designers, and agents involved in medical aesthetic advertisements must legally verify the “Medical Advertisement Review Certificate” and strictly publish content as approved. Therefore, during promotion, in addition to ensuring consumers’ right to information and choice by comprehensively, truthfully, accurately, and promptly disclosing necessary medical aesthetic information, if there is a need to directly or indirectly introduce the promoted beauty medical institution (medical institution) or medical aesthetic services, the institution must submit for review in advance and legally obtain a “Medical Advertisement Review Certificate.” Live stream operators must verify this compliance.
According to Article 5 of the “Guidelines for the Enforcement of Medical Aesthetic Advertisements,” any content constituting a medical advertisement must not include:
1. Content that contravenes social ethics, creates “appearance anxiety,” improperly associates poor appearance with negative factors such as “low intelligence,” “laziness,” or “poverty,” or improperly links outstanding appearance with positive factors such as “high quality,” “diligence,” or “success.”
2. Advertising drugs or medical devices that have not been approved or registered by drug regulatory authorities, in violation of drug, medical device, and advertising laws and regulations.
3. Promotion of diagnostic and treatment subjects and service items that have not been approved or registered by health administrative departments.
4. Guarantees of diagnostic and treatment effects or assurances regarding the safety and efficacy of such treatments.
5. Use of the names or images of industry associations or other social organisations, or the names or images of patients to compare or demonstrate pre- and post-treatment effects.
6. Use of advertising endorsers to recommend or certify medical aesthetics. Terms such as “recommendation officer” or “experience officer” appearing in medical aesthetic advertisements, which recommend or certify medical aesthetics using one’s own name or image, should be recognised as advertising endorsements.
7. Disguised advertising through formats such as health and wellness information, personal interviews, or news reports.
8. Promotion of food, health supplements, disinfectant products, or cosmetics with disease treatment functions related to medical aesthetics.
9. Any other behaviour that violates advertising laws and regulations and seriously infringes upon public interests.
Many medical aesthetic live streams, apart from necessary information, contain promotional content that qualifies as medical aesthetic advertisements but have not undergone pre-approval or obtained a “Medical Advertisement Review Certificate.” On 25 February 2023, the State Administration for Market Regulation published a typical case involving a Hangzhou-based e-commerce partnership that allegedly disseminated illegal advertisements during live streaming. In May 2022, the company conducted a live stream themed “Beauty Transformation Session” on its Weibo live room, promoting medical aesthetic services. In addition to necessary service information, the stream advertised claims such as “Super Pico without explosion, mainly used for whitening, wavelength 755 is the golden wavelength for melanin absorption, suitable for black spots” and “Fuman Collagen + new imported face slimming 30U, after treatment, skin is white and tender.” These contents were not reviewed by advertising authorities, and in November 2022, the Hangzhou Market Regulation Bureau imposed an administrative penalty of ¥539,600. In May 2023, another Hangzhou-based medical aesthetic institution that repeatedly published medical advertisements without approval was fined ¥1,000,000.
Some medical aesthetic institutions or platforms use before-and-after photos of patients to promote the effects of their products, or even recruit individuals to create complete vlogs, which also violate the aforementioned regulations on medical advertisements, resulting in multiple administrative penalties.
Naming live streaming products using diagnostic and treatment effects directly, such as “Bare Face Whitening Card” or “Pore Reduction Kit,” may constitute the promotion of diagnostic and treatment effects, leading to non-compliance.
Medical aesthetic advertisements are currently the segment most frequently subject to administrative penalties. According to information released by the Hangzhou Market Supervision Administration, between January and October 2022, the city’s market supervision system investigated 112 cases of illegal medical aesthetic advertisements.
3. Compliance with General Advertising Regulations
Commercial advertising activities that directly or indirectly introduce the goods or services being promoted must comply with the “Advertising Law,” “Measures for the Administration of Internet Advertising,” and relevant local advertising regulations, such as refraining from using terms like “national level,” “highest grade,” or “best.”
Medical aesthetic advertisements involving patented content must indicate the patent number and type. Patents that have not been granted, or those that have been terminated, revoked, or invalidated, must not be advertised. It is essential to verify patent information meticulously. For example, a Hangzhou-based medical aesthetic hospital that mentioned three invalid patents in its product details was fined ¥20,000.
Additionally, promotion of botulinum toxin products requires special attention. Type A botulinum toxin is widely used in medical aesthetics for wrinkle reduction, facial slimming, and shoulder slimming. However, according to Article 15 of the “Advertising Law,” medical toxic drugs must not be advertised. Type A botulinum toxin falls under this category and cannot be advertised in any form. Violations can result in fines ranging from ¥200,000 to ¥1,000,000 for advertisers, with severe cases potentially leading to the revocation of business licenses. Advertising review authorities may revoke advertising approval documents and suspend advertising review applications for one year. For advertisers and publishers, market supervision departments may confiscate advertising fees and impose fines between ¥200,000 and ¥1,000,000. Severe cases may also result in the revocation of business licenses. In 2022, a Chengdu-based medical institution was fined ¥500,000 for advertising botulinum toxin in live streams and short videos.
4. Prohibition of Disguised Advertising in Non-Advertising Content
In addition to directly promoting sold products or institutions, live streaming marketing entities may also broadcast related educational or public welfare content. According to the “Zhejiang Province Advertising Management Regulations,” such content must not covertly promote medical aesthetic products or hospitals, nor should it contain advertisements.
Live streaming marketing entities cannot display the address, website, telephone number, or other contact information of medical aesthetic institutions (medical institutions) in publicly funded advertisements or live streams designed, produced, published, or sponsored by these institutions. Additionally, they must not occupy more than one-fifth of the live stream page or display board area with the name (trade name) and trademark of the medical aesthetic institution (medical institution). The display duration of the institution’s name and trademark must not exceed five seconds or one-fifth of the total duration. When using overlay formats to display the institution’s name and trademark, the display time must not exceed three seconds or one-fifth of the total duration.
All other promotional content must ensure the authenticity of information to avoid misleading or deceiving consumers.
III. Key Points to Consider During the Live Streaming Process
According to the “Interim Regulations on Standardising Promotional Activities,” when using price comparison methods for promotional activities, live streaming marketing platforms and live stream operators must prominently display in text form the selling price, the compared price, and their meanings, including the basis for discounts or reductions. If price promotions have additional conditions or time limits, these must also be clearly indicated in text form. It is essential not to use prices that have never been actually transacted as discount, reduction, or comparison prices. For example, a Hangzhou-based health management company claimed during a live stream that a medical aesthetic product originally priced at ¥9,800 was now available for ¥980. Upon investigation, it was found that the actual sales price had always been ¥980, resulting in an administrative penalty of ¥500,000.
For prize-based promotions, such as screenshot lotteries allowing users to win free orders, gifts for spending a certain amount, or the redemption of medical aesthetic projects or other items within a few days, it is necessary to clearly disclose information such as the types of prizes, participation conditions, participation methods, draw dates and methods, prize amounts or values, prize names, types, quantities or winning probabilities, prize redemption times, conditions, methods, delivery methods, forfeiture conditions, and organiser contact information. These details must not be altered, additional conditions must not be imposed, and prize redemption must not be affected, except where it benefits the consumer. In prize-based sales activities with on-site immediate draws, prize redemption details for prizes exceeding ¥500 must be publicly disclosed at all times. The maximum prize amount must not exceed ¥50,000. This ¥50,000 limit applies not only to single draws but also to cumulative amounts for purchasers with multiple winning opportunities from a single purchase.
Conclusion
Regulation often lags behind reality. As various regions gradually issue corresponding regulations, medical aesthetic live streaming will inevitably progress towards a legalised and standardised path of healthy development. Practitioners in the medical aesthetic live streaming industry need not only professional medical aesthetic knowledge but also a thorough understanding of relevant laws and regulations to ensure compliance throughout the entire live streaming process.
