Hygiena 2026, 71(2):48-52 | DOI: 10.21101/hygiena.a1918

Procedures breaching skin integrity in the context of cosmetic services, public health protection and healthcare services: a practical review for hygiene practice

Roman Šmucler^{1, 2, 3}

¹ Společnost estetické a laserové medicíny České lékařské společnosti J. E. Purkyně, Praha, Česká republika

² Asklepion - Lasercentrum Praha, s. r. o., Praha, Česká republika

³ Slovenská zdravotnícka univerzita v Bratislave, Bratislava, Slovenská republika

Objectives: To provide a practical and legally as well as medically grounded review of procedures involving breach of skin integrity and to define the boundary between cosmetic services, body-care services subject to public health supervision, and procedures that should be provided as healthcare services.

Methods: Narrative review of Czech and European legislation, official methodological documents, the technical standard ČSN EN 16844+A2 and current medical literature on microneedling, tattooing, permanent make-up, dermal fillers, botulinum toxin and energy-based devices.

Results: For regulatory practice, three groups should be distinguished: cosmetic services without skin breach, body-care services subject to public health supervision in which skin integrity is breached, and procedures that belong to healthcare because of their invasiveness, use of medicinal products or high-risk devices, anatomical location, risk profile and need for clinical decision-making.

Conclusions: A coherent interpretation of these boundaries is essential for public health supervision, legal certainty and patient safety. A functional approach is recommended: once a procedure goes beyond routine care of intact skin and at the same time requires medical judgement, management of complications or the use of medicinal products or high-risk medical technologies, the hygienic regime applicable to body-care services does not by itself make such a procedure permissible outside healthcare services.

Keywords: aesthetic medicine, cosmetic services, hygiene, public health protection

Received: April 2026; Accepted: June 2026; Published: June 2026  Show citation