Linda Strachan had been working as a mental health nurse for 10 years when she got her first taste of Botox.

It was 2008 and one of her friends admitted that the muscle paralysing injections - at the time still a comparatively new cosmetic treatment in the UK - were the reason she had no lines or wrinkles.

"I was always of the opinion that people who do that would be crazy - but she didn't look like a crazy person, so I thought 'I'm going to give that a try'," said Ms Strachan, now 48.

She liked the effect, and in 2009 decided to launch her own business - Aspire Aesthetics - as a sideline to her main job in the NHS.

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Ms Strachan had graduated with a first-class degree in nursing from Aberdeen University in 1998 and along with her husband, also a nurse at the time, had settled in Aberdeenshire where she spent the first decade of her career working for NHS Grampian.

By 2009, however, she was frustrated.

Linda Strachan, an award-winning cosmetic nurse and owner of Aspire Aesthetics in Inverurie, is among a growing number of nurses who have left the NHS for a career in aesthetic medicine (Image: MICHAEL TRAILL)

She said: "Both my husband and I were working in the NHS, we had a young family, and we were struggling financially.

"I felt stifled and frustrated in the NHS. We had just had the financial crash.

"We were in austere times. We were really short-staffed, there were loads of job vacancies but no permanent contracts, and no room for professional development.

"There just wasn't the financial reward for people who worked hard.

"I wanted more for my family - that's what motivated me."

The 'Zoom Boom'

A career in cosmetic - or "aesthetic medical" - nursing seemed to offer an exciting opportunity.

She said: "I thought it would be a really good way to use my clinical skills as a nurse, but I've always been quite creative and artistic as well.

"It took me a few years to build up the confidence to leave, but also the expertise and skill.

"I didn't just go gung-ho into it - I studied, I did a lot of courses."

Ms Strachan set up a limited company and began working part-time in aesthetics, both as a mobile practitioner and from a converted room in her home.

She completed a Masters degree in non-surgical aesthetic medical practice and, in 2015, finally quit the NHS in order to run her business full-time.

Linda Strachan qualified as a nurse in 1998, but eventually left the NHS to work full-time in her aesthetics business in 2015. She said the growth in demand has been 'exponential'Linda Strachan qualified as a nurse in 1998, but eventually left the NHS to work full-time in her aesthetics business in 2015. She said the growth in demand has been 'exponential' (Image: MICHAEL TRAILL)

Her clinic in Inverurie has gone from strength to strength ever since, and earlier this year she was named Nurse Practitioner of the Year at Scotland's Aesthetic Excellence Awards.

She said: "It's grown year-on-year. Even in austere times there's been growth, but since 2021 the growth has been exponential.

"Lockdown played a part in that because everyone moved online.

"We call it the 'Zoom boom'.

"There's a lot more working from home, a lot more online meetings, and people are seeing themselves on a screen more than ever before.

"We had absolutely exponential growth in demand.

"In consultations patients would say to us 'I see myself on the Teams now and I can't believe my face looks like that'."

The boom in non-surgical rejuvenation treatments such as Botox, dermal fillers, and other injectables over the past 15 years has driven a huge expansion in the cosmetic sector which was never possible in the past, when procedures were limited to plastic surgeons.

Dentists, nurses, midwives, dental nurses, and non-plastics doctors have poured into the sector.

Since 2017, the number of regulated independent clinics in Scotland - most of which offer some kind of cosmetic treatment - has increased from 200 to more 500.

More controversially, there is also nothing to stop unregulated non-healthcare professionals - such as beauticians - from entering the market, although the Scottish Government is considering tighter restrictions.

'Exponential increase'

Ms Strachan, who recently stepped down after five years as the Scotland representative for the British Association of Cosmetic Nurses (BACN) fears that too many young people now perceive nursing solely as a gateway into aesthetics.

She said: "In the last three to five years there's been an exponential increase in people seeking a qualification in nursing just so that they can get into aesthetics, especially in Scotland, because there is a suspicion that the government is going to crack down and limit it to people with a healthcare qualification.

"It stresses me to hear of student nurses solely doing nursing just so that they can do aesthetics.

"I don't think they realise the complexity of aesthetics - they see it too much as a beauty procedure.

"There's so much wealth of knowledge and experience that comes from actually nursing that is transferable. I've been a nurse for nearly 30 years.

"My daughter is a student nurse and she would never think it's okay to just pick up a syringe and start injecting stuff into someone's face, but that's what's happening."

The turnover rate in nursing has reached record levels in recent yearsThe turnover rate in nursing has reached record levels in recent years (Image: Turas/ScotGovt)

Record numbers of nurses have also been leaving the NHS in recent years.

In the seven years leading up to March 2020, an annual average of 4,851 nurses and midwives left NHS Scotland according to official statistics.

In the three years since March 2021, that figure has risen to 7,226.

While some are quitting nursing altogether and others are retiring or opting to work as agency nurses instead, a growing number are pursuing new careers in cosmetic nursing while some are cutting their NHS hours to work part-time in aesthetics.

UK-wide, the BACN has seen its membership surge from around 80-90 shortly after it was formed in 2009 to some 1,300 today, although BACN chair Sharon Bennett estimates that the true number of cosmetic nurses working in the UK is probably five or six times higher.

BACN chair and aesthetic nurse, Sharon Bennett, said people entering the profession must understand that they are performing 'medical procedures with cosmetic outcomes'BACN chair and aesthetic nurse, Sharon Bennett, said people entering the profession must understand that they are performing 'medical procedures with cosmetic outcomes' (Image: Getty)

Ms Bennett said: "We're seeing massive growth. People see it as an easy way to make money, they're disenfranchised with the NHS for sure, and they're looking at shifting into something else.

"What we have [at BACN] are the 'serious' nurses - the ones who really want to change their profession and work to best practice. They're not your 'hobby' practitioners, if you like.

"We have a lot of senior nurses from the NHS who are also working as aesthetic practitioners.

"We have advanced nurse practitioners, we have nurses who are undertaking doctorates.

"These are medical treatments, they're not aesthetic. The outcomes might be cosmetic, but the process is medical.

"It needs to be hammered home that these are potentially quite dangerous treatments.

"It's not just about anatomy, you need to have someone who understands how to manage a patient who has an adverse event, an infection, a blockage of the blood vessel."

Ms Strachan said the customers who come to her salon 'don't want to look like Bratz dolls'Ms Strachan said the customers who come to her salon 'don't want to look like Bratz dolls' (Image: Michael Traill)

Back in Inverurie, Ms Strachan is now one of two cosmetic nurses employed in her clinic and she hopes to recruit additional staff to meet growing demand from patients.

She said: "Having clinical skills isn't enough - you need to have a passion for this, and an eye for it.

"That's where things go wrong, I think, when people create massive jawlines and disproportionate cheekbones - we shouldn't be doing that.

"We shouldn't be augmenting lips out of proportion from facial features. That's when people look bizarre.

"The patients who come to me are safety conscious. They don't want to like a Bratz doll. It's all about 'how can we make them look fresher?'.

"The things that we're most popular for are injectables - we use Bocouture [Botulinum toxin anti-wrinkle injections].

"That's probably what we do the most of, followed by dermal fillers, but very soft, subtle, restoring what's been lost or preventing it worsening.

"We offer our own skincare as well because not all solutions are in an injection.

"I always say to my patients, 'it's not a magic wand: I can do so much with the syringe, but what you do every day is going to make the biggest difference'."