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Information and shooting methods necessary to avoid violations in before-after photo posting of c...



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Attorney at Law
Attorney at Law

Marunouchi Soleil Law Office

Familiar with the business related to beauty and health, he is active as a team leader of the "Health & Beauty Team" at the legal office of Marunouchi Soleil. Many seminars and lectures on advertising regulations, landscape law, medicinal machine law, and special commercial law.

Information and shooting methods necessary to avoid violations in before-after photo posting of cosmetology

Before-after photographs used mainly in the field of cosmetology to showcase the effects of treatment. Visually easy-to-understand photographs are one of the most useful information for readers who examine the effects of treatment and examine medical institutions. However, for advertisements related to medical care such as treatments and examinations, "Guidelines for advertisements related to medical practice or dentistry or hospitals or clinics" (hereinafter referred to as "medical advertisement guidelines") are stipulated, and before and after photos must also be posted. It is necessary to meet the specified conditions. Please check that it is a necessary condition for posting before and after photos on SNS.

Before-after photos that may mislead the patient are prohibited

Since medical advertisements are information that affects human health and life, unjustified advertisements can threaten health and life. In addition, misleading and biased expressions on the part of the recipient can hinder the choice of the right care.

For example, the following expressions that correspond to false advertisements or comparatively good advertisements are prohibited because they may lose appropriate consultation opportunities or unfairly induce consultations and treatments.

[Advertising NG example]
This treatment is 100% safe (false advertising)
・ Please leave it to our hospital, which has the largest number of treatments in Japan (comparative excellent advertisement).

Even in cosmetology, if a patient suffers health problems after receiving treatment or does not achieve the desired effect, troubles that lead to complaints occur.

Therefore, the medical advertising guidelines stipulate a number of prohibited advertisements other than the above false advertisements and comparatively good advertisements, and one of them is before-after, which may mislead patients about the content or effect of treatment. There are pictures etc. Since it is a photo "etc.", it includes not only photos but also videos and illustrations .

Of course, in order to convey the effect of treatment, it is important to describe the details of the treatment and the changes after the treatment in detail, but what impresses the recipient is the visual "image". In particular, before-after photographs, which are images comparing before and after treatment, show the effects of treatment, so many medical institutions are actively posting them on their websites.

However, on the other hand, if the before-after photograph is inappropriate because of its strong visual impression, it can be identified by giving the recipient a false perception or excessive expectation about the result of the treatment and causing a misunderstanding. It may lead to the act of unfairly attracting customers to medical institutions.

Therefore, the medical advertising guidelines prohibit advertising such as before-after photos that may mislead patients about the content or effect of treatment .

In addition to that, there are some advertisements prohibited by the medical advertising guidelines. Below is a summary of the advertisements prohibited by the Medical Advertising Guidelines.

  1. False advertising
  2. Comparison good advertising
  3. Hype
  4. Advertising with content that is offensive to public order and morals
  5. Advertisement with content that impairs dignity
  6. Advertising with content prohibited by other laws
  7. Experiences about the content and effects of treatment
  8. Before and after regarding the content and effect of treatment that may mislead the patient

Advertising / media regulated by the Medical Advertising Guidelines

Definition of ads regulated by the Medical Advertising Guidelines

I explained that the advertisements prohibited by the Medical Advertising Guidelines include before-after photos that may mislead patients about the content or effect of treatment, but the advertisements that are subject to the regulations of the Medical Advertising Guidelines in the first place Let's check what is included.

Advertisements that are regulated by the Medical Advertising Guidelines are considered to meet the following two requirements.

  1. Intention to attract patients to see a doctor
  2. The name or name of the person who provides the medical practice or dental practice or the name of the hospital or clinic can be specified.

Media subject to regulation of medical advertising guidelines

Therefore, not all medical information is considered an advertisement and is not regulated by the Medical Advertising Guidelines. A rough understanding can be divided into the following.

Subject to regulation Flyers, pamphlets, e-mail newsletters, posters, signboards, advertisements on newspapers and magazines, landing pages, TV commercials, radio commercials, slides, videos, peace content, etc. used in briefing sessions and catch sales for the general public , Medical institution websites / SNS, word-of-mouth sites that require posting fees, etc.
Not subject to regulation Academic treatises, newspaper and magazine articles, word-of-mouth and experiences that patients voluntarily send on SNS, posters posted only in the hospital, pamphlets distributed in the hospital, job advertisements related to staff recruitment, etc.

What is considered an advertisement

As long as "attractiveness" and "specificity" are recognized, not only websites and leaflets sent by medical institutions, but also e-mail newsletters and SNS are included in the regulation of medical advertising guidelines. Basically, think of anything that leads to attracting customers to a particular medical institution as subject to regulation .

What is not considered an advertisement

On the other hand, word-of-mouth information that patients voluntarily post on SNS, pamphlets that are posted only in the hospital, etc. are basic even if they include various medical information such as an outline of the disease, the content of the treatment, and the cost. Is not subject to the medical advertising guidelines because it is not recognized as "attractive" or "specific" to a specific medical institution. Therefore, even if you post before and after photos on these, you will not be subject to any special restrictions.

A medium that makes it easy to misjudgment whether or not it is subject to regulation

Article-style advertising is subject to regulation

Articles in regular newspapers and magazines are not subject to advertising restrictions. This is because an article that contains only information such as illness or treatment is not attractive or specific to a specific medical institution.

However, "article-style advertising", in which medical institutions pay for publication fees and publish articles in newspapers and magazines and aim to attract customers, is subject to advertising restrictions.

In-hospital pamphlets and posters are not subject to regulation

Pamphlets and posters are typical advertising media. However, pamphlets and posters distributed or posted in the hospital are not subject to advertising restrictions because the recipient has already visited the medical institution and is not attracted to the consultation.

Unlimited requirements are required for advertisements that introduce treatment details along with before-after photos

SNS sent by medical institutions is subject to the regulations of the Medical Advertising Guidelines. So, as many beauty medical institutions do, posting before-after photos on SNS does not violate the medical advertising guidelines?

In the first place, the Medical Care Act limits the items that can be advertised, and in principle, other items cannot be advertised .

Specific example of "advertising possible items"

  1. Being a doctor or dentist
  2. Advertiseable clinical department name stipulated by the Medical Care Act
  3. Location of medical institution, contact information, name of administrator, etc.
  4. Whether or not to make an appointment for a medical examination and means
  5. Current scale of medical institutions and number of staff
  6. Information such as consultation counter, management of personal information, safety measures, etc.
  7. Examinations such as insurance medical treatment, surgery, and other treatment methods
  8. Some free medical examinations, surgery, and other treatment methods, such as treatment with drugs approved by the Pharmaceutical Machinery Law


"Advertising items" do not include the effects of treatment. Therefore, in principle, before-after photos that show the effect of treatment cannot be advertised .

The reason why the items that can be advertised are limited is that in the medical field, the damage caused by receiving inappropriate medical care due to unjustified advertising is large, and since medical care is highly specialized, it is necessary for the patient to select information. The reason is that it is difficult. However, it is undeniable that it may be difficult for the recipient to obtain the information that they really need, and it may not be possible to select the appropriate usage based on the items that can be advertised.

Against this background, it is permitted to advertise content other than what can be advertised if certain conditions are met . This certain condition is called "requirement to release the limitation of advertiseable items".

Before and after photos can also be advertised if they meet the requirements for unrestricting the items that can be advertised .

Requirements for releasing restrictions on advertiseable items

Two conditions must be met in order to remove the restrictions on the items that can be advertised.

  1. Information that helps patients make appropriate medical choices and that patients, such as websites, seek and obtain information on their own.
  2. The information required for "Unlimited advertising" must be clearly stated.

What patients, such as websites, seek and obtain information on their own

This includes websites, e-mail newsletters, SNS, and pamphlets sent at the request of the recipient of the advertisement, where the recipient of the advertisement searches and browses the information on his / her own will.

However, for example, the listing advertisement displayed when searching with a search engine is delivered regardless of the intention of the recipient of the advertisement, and is not the information requested by the patient etc., so the limitation on the items that can be advertised is lifted. not.

Information required for "unlimited advertising"

If the advertisement applies to the above-mentioned patients who request and obtain the information by themselves, by specifying the following information, there is no limitation on the items that can be advertised, and before-after photos can also be advertised. In other words, when introducing treatment details on SNS, you will be able to post before-after photos by clearly stating the following information .

  1. Clarification of contact information such as telephone number and e-mail address where you can inquire about advertisement contents
  2. In the case of free medical care, clarify information on the contents and costs of treatments that are usually required
  3. Clarification of major treatment risks in the case of free practice
  4. Clarification of major side effects in the case of free medical care

For treatments using unapproved drugs and medical devices, the following must also be stated.

  1. Clarification of unapproved drug or medical device
  2. Clarification of the acquisition route of unapproved drugs and medical devices If the drug is obtained by personal import, etc., provide information on the "Pharmaceuticals, etc. that should be noted in personal import" page .
  3. Clarification of the presence or absence of domestically approved drugs and medical devices with the same ingredients and performance
  4. Clarification of information related to safety in other countries

This information needs to be written in an easy-to-understand manner , and it is inappropriate to write it in small letters or on another page linked to it.

Medical institution phone number or email address

We will include contact information such as the telephone number and e-mail address of the medical institution so that the reader can easily inquire about the treatment contents of the posted before and after photos.

Free medical care includes treatment details, costs, risks, and side effects

Most of the treatments performed in cosmetology are free medical treatments, and the treatment contents and costs vary greatly depending on the medical institution. Therefore, in order to prevent troubles due to misinterpretation on the part of the recipient of the advertisement, information on the treatment content and cost is described in an easy-to-understand manner.

Specifically, the contents are as follows.

  1. Names such as treatment
  2. Usually required treatment
  3. Range from standard cost or minimum to maximum amount of treatment normally required (including frequently occurring additional costs)
  4. Treatment period and frequency
  5. Risks and side effects of treatment

For example, regarding the cost, it is inappropriate to describe only the minimum amount because it may mislead the recipient of the advertisement. In addition, since content that emphasizes only the advantages and advantages may unfairly attract the reader, the risks and side effects are also specified.

Precautions when advertising before and after photos

By satisfying the requirements for removing the limitation of advertiseable items, before and after photos can also be posted. Then, what should we be careful about so that it does not fall under the advertising prohibition matter "there is a risk of misleading the patient about the content or effect of treatment, etc." before and after.

In this regard, the Medical Advertising Guidelines state that a detailed explanation of the treatment, costs, major risks, and side effects normally required for before and after will not mislead the patient. The items listed here are the same as the delimitation requirements for advertiseable items above. However, as long as it is "detailed", it should be considered that more specific description is required than required by the requirement for unrestriction of advertiseable items. In particular, it should be noted that the description of risks and side effects tends to be simple . Even if you post only before-after photos on SNS, not as an introduction to the treatment details, it is essential to describe the treatment effects, costs, and risk side effects .

Even if the above conditions are met, before-after photos are prone to false and hype. Let's take a look at what you should be careful about so that before-after photos do not become false advertisements or hype.

Do not change conditions such as the presence or absence of makeup, brightness and angle before and after the treatment

It is no exaggeration to say that the images of cosmetic dermatology and cosmetic surgery, which are highly aesthetically pleasing, affect the ability to attract customers. The more noticeable the changes are in the before and after photos, the more effective the treatment will be, so of course, when posting, we will strive to take pictures that clearly show the changes.

However, processing the photo itself or changing the shooting conditions between before and after photos is not a change due to pure treatment, so it is a "false advertisement" or a "hype" . For example, the following photos are NG, so you have to be careful.

  • In the double-shaped before-after photo, the before photo is a photo of the eyes without any makeup, while in the after photo, the eye makeup is applied and the impression of the eyes is changed by effects other than double shaping. Photo
  • Before-after photo of treatment that can be expected to have a whitening effect, brighter the lighting of the after photo than before photo, or adjust the brightness with a photo processing tool to change the impression of skin color
  • Before-after photo of the treatment that forms the contour of the face, the photo that emphasizes the treatment effect by changing the facial expression or the angle of the face between the before photo and the after photo

Things to watch out for in before-after photos other than guidelines

Be sure to get consent before posting before and after photos

Many medical institutions record pre- and post-treatment photos as part of their medical records (medical records). This is to keep a record of treatment, whether or not it is placed in the advertisement.

If the photo taken as a medical record shows the treatment effect very well and becomes an easy-to-understand before-after photo, it is NG to use it for advertising without permission . When advertising as a before-after photo, you must obtain the consent of the person. This applies not only to your website and advertisements, but also to posting images on other media.

Before-after photos used in academic presentations and seminars are not subject to the regulations of the Medical Advertising Guidelines, but since they are greatly related to personal privacy, photos are used without permission to prevent troubles. You should avoid this and get your consent in advance.

Example of consent form in before and after photos

Expected effects of posting before and after photos

Nowadays, many medical institutions post before-after photos on their websites and SNS. In order to survive in the competition of many medical institutions, it is thought that sending easy-to-understand before-after photos that leave an impression on the recipient side in a format that complies with the medical advertising guidelines will lead to attracting customers.

As stated in the "Internet Usage Status" released by the Ministry of Internal Affairs and Communications in the first year of Reiwa, smartphones (hereinafter referred to as smartphones) are the most common Internet users in 2018, and the percentage of people using SNS is high. Most of them were in their 20s and 30s. Therefore, by actively posting before-after photos on SNS, you can publicize your own hospital targeting people in their 20s and 30s who are generally considered to be highly interested in cosmetology. It is presumed that there are many cases where people are interested in before-after photos that caught their eyes while browsing SNS and consult a medical institution.

"Internet usage" announced by the Ministry of Internal Affairs and Communications

How to take before-after photos in an easy-to-understand manner

It is NG to post before-after photos with different conditions before and after the treatment as advertisements, but it is not illegal to shoot with the shooting equipment and environment in place. In addition, by grasping the tips of how to take a picture, the picture will be finished to convey the effect of the treatment in a legitimate and easy-to-understand manner.

Ideally, you should use lighting or a single-lens reflex camera to convey the actual skin quality and color, but in reality it can be difficult for medical institutions to have such equipment. In that case, you can take before-after photos with your smartphone.

It is necessary to understand the basic shooting method and posting conditions according to the medical advertising guidelines, and create an advertisement that leaves an impression on the recipient side.

Penalties for violating medical advertising guidelines

The medical advertising guidelines are established by the Ministry of Health, Labor and Welfare based on the Medical Care Act, and if you violate them, you will be subject to administrative guidance and penalties.

If you violate it, the health center in your jurisdiction will stop the advertisement or order you to correct it. If you do not comply with the order and it is judged to be extremely malicious, a criminal accusation will be filed, and in the worst case, you may be punished such as revoking the permission to open a medical institution.

Medical advertising guidelines have an important role to play in protecting the health and lives of the recipients of the advertisement. In order to protect the interests of patients, please follow the contents of the medical advertising guidelines.

Attorney office with Dr. Makai Narumi

Marunouchi Soleil Law Office Marunouchi Soleil Law Office
Contact: 03-5224-3801