Doctors want new rules for botox injections, tattoo removal, and other esthetic surgical procedures.

The College of Physicians has drafted a report with 14 recommendations for activities that in some cases are currently unregulated.

Doctors say that all of the activities discussed in their report come with a medical risk, and should be supervised by a medical professional.

The primary recommendation is that anyone who wants a cosmetic procedure, such as wrinkle removal, see a properly-trained doctor first and then get a prescription.

Plastic surgeon Sandra McGill said she's noticed a worrisome trend in her field.

"There's a movement lately where there's nurses who have set up their own clinics and they have, like, a ghost doctor that will prescribe the botox and the filler for them to purchase," she said. "However, the doctor whose name is on the prescription has never actually evaluated any of the patients."

That type of unethical practice will be harder to conduct starting next year, when new regulations come into effect dictating that a doctor must administer the first injection before referring the patient to a nurse.

The College also wants to make sure that doctors interested in performing tattoo removal, injecting botox, or engaging in similar procedures get proper training first, pointing out that it's currently not required for anyone to have training in these procedures.

Dr. Yves Robert of the College said his primary concern is tattoo removal, which currently can be done by anyone with access to a laser.

"In the short term, this is where the highest risk is at present and for which there is no regulation at all," said Dr. Robert.

"You can open tomorrow a commerce on the corner street and start injecting people and removing tattoos and there is a risk of that, of having chemical burns."

The College's recommendations are that properly-trained doctors provide the initial treatment, but that in many cases subsequent treatments be handled by nurses or similar medical staff.

The College does not think that non-medical staff should be allowed to remove tattoos.

Montreal's Adrenaline is a tattoo shop that offers laser removal and manager Jennifer Wiet said while they engaged in in a lot of reading and research while seeking out training, they would welcome new regulations.

"The health and safety of our clients has always been one of our main concerns, so if we aren't doing enough, we will definitely make sure to remedy that," she said.

Doctors are also concerned about tattoo artists and piercers, with their report suggesting strict hygiene requirements.