New Delhi: India is cracking down on mushrooming salon-like hair transplant clinics after botched procedures, serious medical complications and fatalities raised concerns over patient safety. In a first, the health ministry has framed guardrails for such centres, to ensure qualified medical staff, surgical-grade facilities and emergency preparedness, according to two government officials and documents reviewed by Mint.
The Union health ministry's standard operating procedures (SoPs) aim to check clinics operating without accreditation, lacking emergency preparedness, trained doctors and technicians and standard infection control measures, the officials said.
The guidelines have been finalized at the expert committee stage under the Directorate General of Health Services (DGHS), government documents show. States and Union Territories will implement this within their jurisdictions, as health is a state subject.
Major gaps at such hair transplant centres include absence of pre-anesthetic checkups, poor hair graft handling and missing emergency resuscitation infrastructure, including crash carts, the offiials said. To bridge these gaps, the guidelines will mandate a full daycare surgical setup, a dedicated operation theatre, mandatory backup anaesthetists, transparent pricing, strict sterility protocols, and qualified medical leads holding postgraduate degrees in plastic surgery, dermatology, ear, nose, and throat (ENT), general surgery, or maxillofacial surgery with specialized trichology training, the officials said.
Under the framework, centres that fail on the prescribed standards and registration norms face severe regulatory crackdown and penalty of up to ₹5 lakh under the Clinical Establishments (Registration and Regulation) Act. Furthermore, depending on the nature of the offence, the operators could also be prosecuted under other relevant laws, legal experts said.
The urgency for strict regulation follows a string of fatal incidents reported across the country. In May 2025, two engineers died in Kanpur after developing severe post-operative infections and brain swelling at an unregulated clinic operating without standard pre-surgery screenings or qualified surgical personnel. Similarly, earlier fatal cases—including the November 2021 death of a 30-year-old executive in Delhi who succumbed to sepsis and multi-organ failure, and a March 2019 incident in Mumbai involving fatal anaphylactic shock—exposed severe lapses, including the absence of emergency resuscitation setups and procedures being carried out by untrained personnel.
The SoPs, reviewed by Mint, mandate a “transparent display of charges for hair transplantation services with booklet of rates for other services at reception”, alongside other details on doctors, registration, and safety signage covering electrical, fire, and biomedical waste requirements.
This development assumes significance for India’s $307.83 million hair transplant market, according to industry estimates by the IMARC Group.
Mint had earlier reported about the government reclassifying the procedure from the ‘cosmetic salon’ category to a strictly regulated ‘surgical practice’, and all hair transplant centres to register under the Clinical Establishments (Registration and Regulation) Act.
A hair transplant centre is now defined as a “standalone centre or part of the specialty practice where facilities for surgical restoration of hair are available,” as per a document titled “Hair Transplant Centre” reviewed by Mint. The operational scope covers a “daycare surgical facility/hospital with facilities of hair transplantation with facilities for handling emergency situations”.
What the guardrails say
The SoPs on statutory compliance mandate that these centres must execute a “prior informed consent in the language that a patient understands and in the presence of an unrelated witness,” and establishments must maintain registers for outpatient services, pre- and post-operative records, biomedical waste management and sterilization autoclave logs readily available for inspection.
The guidelines establish strict physical infrastructure norms; wherein facilities must follow local bylaws and provide dedicated spaces for reception, waiting areas, consultation rooms, an operation theatre measuring at least 12x12 feet, and a “minimum 4 feet width of door of procedure room”. To monitor patients following surgery, centres must maintain “minimum one postoperative room for one bed for each OT to monitor the patients after the procedure,” the guidelines said.
On staffing, the guidelines prescribe a “one-year comprehensive training in trichology and hair transplantation surgery for dermatologists and other doctors who have no experience in hair transplantation during their PG course”. Also, a clinical team comprising “minimum one doctor (full time), one qualified nurse and one qualified OT technician /OT assistant” alongside a “back-up anaesthetist on call” is mandatory. Treating physicians must hold an “MBBS with MCh or DNB or PG degree in plastic surgery/dermatology/ENT/general surgery (full time/part time/visiting)/BDS with MDS in oral and maxillofacial surgery”.
Apart from basic necessities for patients and attendants, the guidelines mandate specialized graft harvesting and placing tools, resuscitation kits, defibrillators, oxygen, and a crash cart of emergency medicines and intubation equipment. They must also maintain a “back-up of ventilator, resuscitation and monitor either inhouse or outsourced through MoU with a nearby 24 hours hospital,” with mandatory annual maintenance.
Queries emailed to the health and family welfare ministry on 18 August remained unanswered until press time.
Expert view
Hair transplant clinics have mushroomed as early-onset of hair loss and growing awareness spur demand, particularly among younger consumers, said Dr Madhuri Agarwal, founder of Yavana Skin and Hair Clinic in Mumbai. “We are seeing a lot of early-onset hair loss, especially in the ages of 20 to 30s,” she said.
Many hair transplant centres are being run by technicians, rather than qualified doctors, raising safety concerns, said Dr Agarwal, urging for verifying doctor qualifications and not choosing clinics purely on the price factor.
Undergoing the process at unregulated facilities by untrained practitioners can be hazardous, say experts. “Major risks include severe local infections, permanent scalp scarring, drug overdosage, and complete surgical failure. Often, thousands of donor grafts are harvested but only a fraction are implanted, permanently damaging healthy follicles,” said Dr Maneesh Singhal, head of the department of plastic surgery at AIIMS, New Delhi, who also performs hair transplant at the hospital. “Unqualified setups also fail to handle emergency drug allergies or systemic complications, which can quickly become life-threatening.”
Strict enforcement is seen key to curbing malpractices and bringing patient safety.
“Like any emerging tech or medical science, the regulation needs to be proportionate, and the stringency of enforcement typically sets compliance discipline standards," said Akash Karmakar, advocate at laws & strategic transactions practice at Panag, Babu & Sarangi. “Given the seriousness of the risk of non-compliance, which is intermingled with medical malpractice risk, the stringency of enforcement should be tracked carefully.”
On prosecution for malpractices, he said: "The Clinical Establishments Act has only monetary penalties, but this does not in any way dilute the risk of prosecution under other laws such as the National Medical Commission Act, 2019. So, lack of criminal penalties is not by itself the problem, the lack of enforcement is a bigger challenge.”
Dr Arika Bansal, cofounder of Eugenix Hair Sciences, which has centres in Gurugram, Mumbai, Hyderabad, and Bhubaneswar, said she expects the framework to lift the standard of care. "Facilities will need to invest in real surgical infrastructure and in qualified medical teams, which will bring far more consistency to how procedures are performed," she said. “For patients, the more important outcome is that they will finally have a clear and reliable way to evaluate a facility before choosing where to undergo treatment, rather than relying on advertising.”
Welcoming the regulations' safety push, Dr Dinesh Kumar Devaraj, former president of the Indian Association of Dermatologists, Venereologists and Leprologists, Tamil Nadu, said: "In Tamil Nadu, there were recent raids by the state government on quack hair transplant centres, where it was found that unqualified untrained personnel who hadn’t even completed their high school were performing hair transplants in an unsterile environment.”