India’s Unregulated Cosmetology Clinics

Basics – What are Dermatology & Cosmetology?

• Dermatology:
  • Recognised medical specialty under NMC.
  • Covers diagnosis and treatment of skin, hair, and nail diseases.
  • Includes medical (eczema, psoriasis, infections) and cosmetic (botox, fillers, transplants, chemical peels) treatments.
• Cosmetology:
  • Non-medical, related to grooming and beauty (makeup, hairstyling, manicures).
  • Has no clinical or therapeutic component.
  • In India, the term is misused to mislead the public, making cosmetic salons appear equivalent to medical clinics.

Relevance : GS 2(Governance , Health)

Nature of the Problem

• Mushrooming of aesthetic clinics across India with little oversight.
• Unqualified practitioners performing invasive procedures (hair transplant, PRP, chemical peels, fillers, botox).
• Often unsafe environments: no sterilisation, no infection control, no emergency backup.
• Result: Severe complications, permanent disfigurement, and even deaths.

Categories of Unqualified Practitioners

1. Dentists (BDS/MDS):
   1. Do weekend/online aesthetic courses, then perform complex procedures.
2. AYUSH practitioners:
   1. Not legally allowed to practise allopathy, but still administer cosmetic treatments.
3. Completely unqualified individuals:
   1. With fake certifications (₹1–2 lakh) or no medical training at all.
4. Doctors from unrelated fields:
   1. MBBS or specialists like ophthalmologists, general surgeons, practising dermatology without training.

Case Studies Highlighting the Dangers

• Kochi case (Hair transplant gone wrong):
  • Patient developed necrotising fasciitis (flesh-eating bacterial infection).
  • Multiple grafts/surgeries, skull exposed, finances ruined, lifelong trauma.
• Andhra Pradesh case (Fake PRP treatment):
  • Patient paid ₹3.5 lakh.
  • “PRP” done without drawing blood.
  • Given unlabelled steroid creams → led to topical steroid withdrawal.
  • Severe burning, scaling, long-term skin damage.

These cases show life-threatening risks + exploitation of vulnerable patients, especially women.

Scope of the Problem

• Market size:
  • Indian wellness market = $2.5 billion (2024).
  • Projected to grow to $4 billion by 2033 (IMARC Group).
• Drivers:
  • Rising middle class, beauty-conscious youth.
  • Social media influence & K-beauty/global trends.
  • Misperception: “cosmetic procedures are easy and safe.”
• Dangerous practices:
  • Clinics not tied to secondary/tertiary hospitals → no emergency backup.
  • Use of unlabelled/steroid-based creams without disclosure.
  • Fake advertising (e.g., “Hair in 7 days”, “Skin whitening in 10 days”).

Regulatory & Institutional Failures

• National Medical Commission (NMC):
  • Guidelines exist → only qualified medical practitioners allowed.
  • Enforcement weak.
• Conflict of jurisdiction:
  • NMC vs Dental Council of India on whether dentists can do aesthetics.
  • Creates loopholes.
• State failures:
  • Kerala Clinical Establishments Act not fully implemented → many clinics untracked.
  • Limited inspections, weak follow-up.
• Lack of oversight:
  • No dedicated regulatory body for aesthetic centres.
  • Few police investigations or license cancellations → not enough to deter quacks.

 Professional & Civil Society Action

• IADVL (Indian Association of Dermatologists, Venereologists, Leprologists):
  • Running anti-quackery campaigns.
  • Karnataka chapter (1,525 members) submitted memorandum to State Council for public warnings.
  • Created doctor WhatsApp groups to verify suspicious prescriptions.
• State medical councils (e.g., Telangana):
  • Started inspections.
  • Action under NMC Act Sections 34 & 54 (impersonation + unlawful practice).
• Limitations:
  • Quacks now use prescriptions in others’ names → harder to catch.
  • Enforcement patchy and reactive.

Consequences

• Medical:
  • Severe infections (necrotising fasciitis), blindness (from wrong filler use), permanent scars.
  • Steroid withdrawal syndrome, skin barrier collapse.
• Psychological:
  • Trauma, body image issues, loss of confidence.
• Economic:
  • Patients pay exorbitant fees (sometimes 10x the rate of qualified dermatologists).
  • Families pushed into debt after botched procedures.
• Public trust erosion:
  • Confusion between genuine dermatologists and self-styled “cosmetologists.”

Solutions & Way Forward

• Regulatory reforms:
  • Stricter licensing of clinics.
  • Mandatory tie-ups with tertiary hospitals for emergencies.
  • Periodic inspections and audits.
• Dedicated law:
  • Separate legal framework for aesthetic medicine & cosmetology clinics.
  • Penalties for impersonation, fake advertising, and malpractice.
• Professional accountability:
  • Stronger role of State medical councils & NMC.
  • Fast-track complaints system.
• Awareness & consumer protection:
  • Patients must verify doctors’ qualifications.
  • Ads must mandatorily disclose practitioner’s registration number.
  • Public awareness campaigns (“If it sounds too good to be true, it probably is”).
• Curbing quackery:
  • Ban short-term cosmetic “certifications.”
  • Crackdown on fake institutes selling medical-sounding diplomas.