A health watchdog is concerned that people having beauty treatments like Botox could be at risk of infection from dirty needles.
The National Institute for Health and Care Excellence says growing numbers of people are injecting tanning agents, dermal fillers and Botox at home and in salons, and some are lax about hygiene.
Sharing needles can spread blood-borne diseases like HIV and hepatitis C.
Nice is updating its advice for England and Wales accordingly.
The guidelines, which are out for public consultation, aim to encourage people to use sterile needle and syringe programmes to stem the spread of infections.
Most blood-borne diseases occur among people who inject drugs like heroin and anabolic steroids.
But NICE says people seeking out cosmetic fixes are also at risk.
A spokeswoman said: “We are seeing an increasing issue with drugs that are used for vanity purposes.”
This includes the anti-wrinkle treatment Botox, dermal fillers and tanning agents.
Prof Mike Kelly, Director of the NICE Centre for Public Health Excellence, said: “Since we last published our guidance on needle and syringe programmes in 2009, we’ve seen an increase in the use of performance-and-image-enhancing drugs such as anabolic steroids, Botox, tanning agents and the use of dermal fillers like collagen.
“We’ve also heard anecdotal evidence that more teenagers are injecting these performance-and-image-enhancing drugs too.
“We’re updating our guidance – and our public consultation on the draft update is an important part of this process – to make sure all of these groups of people are considered in the planning and delivery of needle and syringe programmes.”
One of the recommendations proposed in the new guidelines is that local councils consider providing sharps boxes for people to dispose of used needles and syringes.
Rajiv Grover, consultant plastic surgeon and president of the British Association of Aesthetic Plastic Surgeons (BAAPS), said: “Due to the lack of regulation in the cosmetic sector it is impossible to know how many patients could be at risk of blood borne diseases from needle sharing with either Botox or fillers.
“These should be considered medical procedures and BAAPS has campaigned for over a decade to have this field of non-surgical cosmetic treatments tightly regulated. The dangers of sharing needles in cosmetic injectables are so great that any practitioner who does this should be considered guilty of a criminal offence and nothing less.”