In these times of increased social interactions, the transient nature of trends and the constant need to fit in, the definition of beauty is changing. While once you went gaga over that latest face cream or lipstick, times have changed – from altering your complexion, to even your metabolism – pills and needles are the new go-to. These procedures, while beneficial, are not free of risks, and unfortunately, the dark side of such procedures is brought into the limelight only when they turn fatal.
India’s obsession with fair skin is not new, and getting fair is just a few injections away now. Owing to aggressive marketing by pharma-cosmeceutical companies and the hype created by celebrities, Glutathione has emerged as the ‘magical skin whitening’ molecule. Glutathione comes in three forms – oral, topical, and injectables. In the oral form, as a supplement, Glutathione should be consumed only in the recommended dosage prescribed by a doctor. Topically, glutathione as a cosmetic is used in lotions and creams and is generally said to be safe. It is the use of glutathione in its injectable form for skin lightening, which has raised a lot of eyebrows, especially following the speculations around the death of a popular celebrity in India. The Indian drug regulatory authority, CDSCO, has approved Glutathione in its injectable form as a drug. However, the said approval has been given for the treatment of alcoholic liver diseases and hepatitis, and not for skin lightening. Experts have stated that there is a lack of proper clinical studies establishing the effect of Glutathione injections/IV drips for skin lightening; limited clinical studies that support this skin lightening benefits are riddled with inadequacies like improper sample size, testing on healthy subjects, and extremely short study period with an even shorter follow-up.
A number of doctors have warned against the use of such IV drips, stating that anything that enters the bloodstream directly could lead to extremely hazardous repercussions, including death. However, the use of Glutathione as a skin whitening agent is undertaken on an off-label basis by physicians. Off-label use means the usage of an approved drug for purposes other than for which it has been approved. Legally, in India, a drug may only be used for the purposes it has been approved for by the regulator. Therefore, using Glutathione for its whitening effect, which is not an approved usage of the drug, paves the way for a number of ethical and medical doubts, especially on account of the lack of clinical studies backing the said use and the number of side effects associated with the same.
Since the usage of Glutathione IV drips for a whiter skin tone has gained much hype, the administration of these drips is being widely undertaken at med-spas, salons, etc., without proper doctor supervision, and sometimes through self-medication at home. Such a lackadaisical approach can make the procedure risky, as the administration of IV drips is a medical procedure and should be undertaken by a healthcare professional like a doctor or nurse with relevant training. Further, the premise from where such should adhere to the requirements of a ‘clinical establishment’ under appropriate legislation. Aesthetic procedures should be carried out by registered medical practitioners who have adequate training to do so, and assistants, nurses, and technicians, if involved, should work under a doctor’s supervision. Therefore, the administration of IV drips in unregulated and shady clinics, salons, and spas is a cause for concern.
Similarly, Botox and fillers, though approved medical procedures in India, are also riddled with issues of administration by unqualified individuals in non-clinical settings, which can lead to incorrect dosages and improper injection techniques. Doctors have stated that the danger of getting these treatments from non-professionals could give rise to wrong dosage, faulty technique, or contamination.
Weight loss is yet another sphere where self-medication and excessive off-label use of drugs have gained traction. While drugs like Ozempic and Mounjaro are CDSCO-approved drugs, the use of the said drugs for weight loss is approved only in cases of diabetes; such drugs are not medications for isolated weight-loss programmes. With celebrities swearing by Ozempic as the ‘weight loss miracle’, lethal doses of such drugs are being used for weight loss without prior consultation with a doctor. Doctors have reiterated the importance of consultations with an endocrinologist or physician before consuming such drugs as these are not meant for cosmetic weight-loss. Recently, following a PIL, the Hon’ble Delhi High Court expressed concern regarding the ease with which these weight-loss drugs are available over the counter without proper medical guidance. The Hon’ble Court has asked DCGI to consult experts and stakeholders, along with the manufacturers of the drugs regarding the said issue.
Therefore, while medical procedures might promise ‘killer looks’, it is no more a surprise, that when done incorrectly, these procedures might turn lethal or leave you with life-long health issues. The major issue is the lack of a proper regulatory regime for such procedures. Considering the easy availability of these drugs in the market, and the procedures being undertaken at shady salons, spas, and unregistered clinics, it becomes pertinent that the regulator carries out proper inspection of such places and ensures that the risk of by-passing the requirement of a prescription on account of misleading and evasive labelling of the packages of such drugs is thwarted at the source of the supply chain. It is high time that proper guidelines for off-label use of drugs are drafted and implemented at the earliest.
Given the rising demand for anti-ageing and aesthetic treatments, there is a growing need for clearer regulatory pathways that address the unique nature of such procedures. As these offerings increasingly blur the lines between wellness and clinical care, it becomes essential to define standards around the use of drugs and therapies tailored for aesthetic purposes. Smaller facilities often operate outside a traditional clinical framework, but engaging medical professionals also warrants closer attention to ensure safety and accountability. Equally important is the establishment of robust training norms for healthcare providers performing these procedures. As the beauty-medical market expands, regulatory vigilance will be key to safeguarding public health and ensuring that individuals receive treatments from qualified professionals, rather than being exposed to the risks of unregulated practices.