India mandates dermatologists-only rule for $2.1B cosmetology market

New Delhi is tightening its grip on the $2.1 billion cosmetology market. The Union health ministry has published mandatory standards for clinics, designed to push out the so-called ghost clinics – centres that display a doctor's credentials but have no doctor on site – where laser resurfacing and injectables are left to untrained technicians, according to a government official and ministry documents reviewed by Mint.

The rules require that any establishment restoring or altering skin, hair or nails be operated exclusively by a registered dermatologist or plastic surgeon. The practitioner must be registered with the State Medical Council or the National Medical Commission, and a minimum level of support staff must be present. State and District Registering Authorities under the Clinical Establishments Act will enforce the rules, in coordination with State Medical Councils and Pollution Control Boards for biomedical waste monitoring, the documents show.

The guidelines classify procedures into two tiers. Level 1 covers Botox shots, chemical peels, dermal fillers and microneedling, conducted in a 10x12 ft procedure room. Level 2 covers ablative lasers and vitiligo surgeries, requiring a 12x12 ft operating room with a wider door. Laser and energy-based device setups require protective eye goggles and a crash cart with emergency drugs.

Non-compliant clinics risk cancellation of registration, fines and closure.

The push follows two high-profile deaths. Actor Shefali Jariwala died in June 2025 after a cardiac arrest linked to anti-ageing and skin-brightening injectables. Actor Chethana Raj died in 2022 during a fat-removal procedure. Authorities have also flagged facial burns from salon chemical peels, blindness from botched filler injections and fatal infections from unmonitored hair transplants.

India has roughly 15,000 registered dermatologists represented by the Indian Association of Dermatologists, Venereologists and Leprologists, and 2,500 to 3,000 board-certified plastic surgeons. Industry estimates put the total number of cosmetology clinics, medical aesthetic salons and hair transplant centres at over 40,000, with medical associations saying 50-60% lack a qualified full-time specialist on site.

Indian cosmetology players broadly support the measures. Dr Aparna Santhanam, head of medical operations and R&D at Kaya Clinic, called the new standards "a significant step towards eliminating, or at least restricting, low-quality and unsafe practices." By spelling out who can perform procedures and mandating consent, emergency readiness and infrastructure, the guidelines bring accountability, she said.

"Once a beauty intervention becomes clinical, qualified medical supervision, informed consent, hygiene, emergency preparedness and accountability cannot be optional," said Dr Abraham Lee, managing director and CEO of Atomy India. Regulation builds the trust needed for India's beauty industry to grow sustainably, he added.

Ashish Jha, co-founder of medical aesthetic device supplier Photonence, said equal attention is needed to certify device quality and safety. "We need robust regulations covering equipment certification, maintenance, calibration and performance, so that every procedure is supported by safe and reliable technology," he said.

The guidelines bring India closer to regimes in the UK and the US, where only credentialed practitioners can perform invasive laser treatments and prescription injectables in verified clinical facilities.

Queries emailed to a health and family welfare ministry spokesperson Thursday remained unanswered till press time.

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