Generations of women have tried to defy the ageing process. But with magazine adverts and television commercials suggesting countless options to help them achieve the seemingly impossible, it is easy to forget that there are risks involved. And as four women discovered in October, the cost can be way beyond the financial burden. The city's beauty centres, which offer procedures as radical as blood extraction, injection of stem cells and body-contouring surgery, are bracing themselves for a wide-ranging crackdown after the four women contracted a superbug. One has since died, while the others remain in hospital. Each had reportedly handed over HK$50,000 for a blood-transfusion treatment more commonly used to help cancer patients. They suffered septic shock, leading them to contract the superbug. Later, Dr Stephen Chow Heung-wing, founder of the DR Beauty chain where they were treated, admitted there was no evidence the controversial treatment - intended to renew and refresh the blood - actually did what it was supposed to. The incident left the beauty industry's reputation in tatters. It also prompted calls for a basket of measures to ban certain medical procedures from being used for cosmetic purposes. Business has fallen 40 per cent since October, with DR losing 95 per cent of its custom. The government also faced criticism for its lax supervision of the industry and has since ordered a review of the so-called "medical-aesthetic treatments", a term nobody can clearly define. Health Minister Dr Ko Wing-man is determined to clamp down on unscrupulous practices in the industry. He says the first step will be to draw a line, based on the danger of the treatment, between what can be handled by beauty practitioners and what must be handled by medical professionals - though critics point out that this alone would not have prevented the tragedy. The new guidelines are likely to shake up a beauty industry that, according to industry insiders, employs 100,000 staff in 6,000 centres. Doctors and lawmakers say beauty parlours should be regulated under a licensing system, with an authority set up to evaluate the suitability of the applicant, the premises and practices, and to perform regular inspections. Aggressive promotional tactics should also be banned, and centres that violate the rules should be reprimanded. But given that such changes can not be implemented without a change in the law, it appears that women will continue to take high risks in the pursuit of beauty. Regulations will also have to balance the interests of the two partners in the trade - beauty practitioners and doctors. Federation of Beauty Industry chairman Nelson Yip Sai-hung estimates that several hundred doctors work for the beauty salons, either as employees or on a freelance basis, with each earning hundreds of thousands of dollars per month. "Together, the beauty industry and doctors have pushed the industry to another limit as more clients have been attracted to undergo aesthetic treatment." Yip said. Beauty parlours hire doctors or specialists to perform high-risk treatments such as Botox injections, eyelid surgery or laser skin therapies, which are becoming more and more popular. For medical practitioners, the salons offer a stable, lucrative income and a much more relaxed working environment than public hospitals. Another reason they are keen to work with beauty centres, Yip says, is that doctors are banned from advertising or promoting medical treatments by law, while the beauty industry is free to market therapies in the name of "cosmetic treatment". Just two months before the tragedy in October, Professor Andrew Burd, head of plastic, reconstructive and aesthetic surgery at Prince of Wales Hospital in Sha Tin, warned that young doctors were turning their backs on those suffering terrible burns or skin conditions to seek lucrative work in beauty centres. Meanwhile, just 12 specialist plastic surgeons operate in the city's public hospitals, which are suffering from a chronic shortage of doctors. The Medical Association says it is time for the relationship between doctors and the beauty industry to end. "There should not be room for co-operation between doctors and the commercial companies that aim to make money," said chairman Dr Tse Hung-hing. "There is no such thing as 'medical-aesthetic treatment'. That is a misleading term." He and several doctors' groups are calling for urgent measures to forbid people who are not medical practitioners from performing invasive treatments. But the call has outraged the beauty industry, which accuses doctors of trying to dominate the lucrative sector. Yip said: "When the doctors finished taking advantage of the business, they said we should be banned from providing these therapies. This is not fair to us." Yip's group staged a protest against the doctors in November, and said the government should allow an industry representative to join the review committee. Joseph Ho Shiu-chung, chairman of the Cosmetics and Perfumery Association, accused doctors' groups of having a conflict of interest. "It is clear that the doctors were trying to use the new guideline to benefit their own peers. "When the doctors said we should be banned from carrying out therapies, it means only their own peers can perform the service." Ho, like Yip, says the DR blunder should not be blamed on beauty salons. "The DR brand was founded by a doctor," Ho said. "And the deadly therapies were also performed by qualified doctors. It was clearly a medical blunder. Why should it be blamed on us?" The beauty centres fear the new guidelines will lead to mass closures of salons and leave thousands of staff out of work. But doctors' groups insist safety must come first. They say new guidelines or legislation should classify all manner of treatments - from injections, the application of strong acids and eyelid surgery to high- energy laser, light radiofrequency and ultrasound treatments - as risky and invasive. "There is an increasing trend for beauty salons to handle invasive and high-risk treatments," said Dr Walter King Wing-keung of the Society of Plastic and Reconstructive and Aesthetic Surgeons. "There is considerable risk if there is malpractice in these procedures." For example, when patients are injected with Restylane - used as filler to reduce wrinkles and create fuller lips - they can be left disfigured if blood veins on the face are blocked. King notes that private hospitals are seeing more and more patients suffering infections and are having to correct mistakes by local beauty salons, as well as mainland and overseas clinics. "A higher quality is needed if the beauty industry is to be further developed. Now someone has already lost her life. Affecting the business should not be the excuse for a delay," he added. Tse, Doctors Union president Henry Yeung Chiu-fat and lawmaker for the medical sector Dr Leung Ka-lau, all agree. Leung said: "The former administration was reluctant to put the beauty industry under any control, as it feared intervention may hinder the development of the business. It is time to correct that."