Dr Rajetha Damisetty speaks about who is a quack in dermatology, some procedures that could go seriously wrong if not done right, and her fight against quacks claiming to be dermatologists and performing dangerous cosmetic treatments.
Published May 25, 2025 | 7:00 AM ⚊ Updated Jun 11, 2025 | 9:17 AM
Dr Rajetha Damisetty.
Synopsis: Incidents of cosmetic procedures harming people have been grabbing news headlines even as authorities struggle to check quacks offering treatments. Advice on social media adds to the concern.
A disturbing pattern is emerging across India — a pattern of lives coming to an abrupt end, and bodies damaged in pursuit of beauty.
In Kochi, a man is battling for his life after he suffered a near-fatal infection following a hair transplant. In Lucknow, two engineers were not that lucky: they died following hair transplants. In Thiruvananthapuram, a female software engineer had four of her fingers and five toes amputated after undergoing liposuction.
Even as clinics offering quick makeovers mushroom across cities and small towns, Dr Rajetha Damisetty, Dermatologist and Chairperson of the Anti-Quackery Cell of the Indian Association of Dermatologists, Venereologists and Leprologists (IADVL), spoke exclusively to South First about her battle against quackery, the trolling she faced from her medical fraternity, and the urgent need to regulate the booming cosmetic industry. Redacted excerpts:
Q: We are seeing a horrifying rise in botched cosmetic procedures. What’s going wrong?
A: The core issue is that people who are not trained medical professionals are performing procedures that require years of education and expertise. These aren’t simple beauty parlour treatments. Lasers, chemical peels, hair transplants, Botox — these are medical procedures. But they are being performed in unregulated settings by people with no medical qualifications.
Q: You were recently in the news for calling out this unhealthy trend. But instead of support, you faced trolling, even from other doctors. What were your reactions?
A: Initially, it was a shock because whatever work I had done, and the association had done, was not in front of the media. We were working through government organisations and authorities, mostly writing complaints, giving representations, and even seeking judicial interventions. So, social media for me was new. It was very disappointing and painful. But then these things teach us lessons. I am a quick learner.
Q: Let’s first define what ‘quackery’ means in the context of dermatology and aesthetic medicine in the Indian context?
A: To explain it in simple terms, I could be an ethical dermatologist, but if I try to do cardiac surgery, I become a quack. So it’s about what you do.
The Supreme Court has defined a quack as someone who does not have knowledge of a particular system of medicine but practices it. For example, if I have done MBBS but have zero knowledge of Ayurveda and start practicing Ayurveda, I am a quack and can be reported.
In dermatology, we have specific criteria. We use a Google form to collect data from dermatologists across the country. Any doctor giving medical advice or claiming to be an allopathic doctor, but who is not registered as such, is considered a quack. For example, physiotherapists, BMS (Bachelor of Medical Sciences), BHMS (Homoeopathy), or BDS (Dentistry) have the “Dr.” prefix but do not have allopathic medical degrees. If these people prescribe dermatology medication or Schedule H drugs (drugs that only registered medical practitioners can prescribe), that is quackery.
A Registered Medical Practitioner (RMP) is someone who has done MBBS and is registered with the National Medical Commission (NMC), formerly the Medical Council of India. Anyone else prescribing Schedule H drugs is a quack.
If someone does clinical dermatology procedures like injecting into a keloid or doing acne scar treatments or peels, and they are not qualified, that is quackery too.
If an MBBS doctor claims to be a dermatologist but does not have a recognised dermatology degree, it, too, amounts to quackery.
Q: Could you explain who a cosmetologist is and who a dermatologist is?
A: A cosmetologist, in the Indian context, is essentially a beautician or a beauty therapist. They do important work — haircuts, colouring, makeup, threading, waxing, etc. These are skilled aesthetic services, but they are not medical procedures. The confusion starts when a salon begins offering peels, laser treatments, or micro-needling — that’s stepping into medical territory without medical training.
What the public considers a cosmetologist is often someone who does chemical peels, lasers, treatment of acne, acne scars, anti-aging treatments, fillers, face tightening, Botox, or similar proteins that relax muscles and make you look youthful. We call that aesthetic medicine, aesthetic dermatology.
A dermatologist is a trained medical professional. We do 5.5 years of MBBS, followed by either a 2-year diploma or a 3-year MD or DNB in dermatology. We are trained to treat conditions related to the skin, hair, and nails — medical, surgical, and aesthetic. This includes acne, eczema, hair loss, pigmentation, and even skin cancers. Cosmetic dermatology — like fillers, lasers, and Botox — is just one part of what we do.
Q: Where do dentists come in? We see many now offering aesthetic procedures too.
A: This is where things get murky. The Dental Council of India (DCI) has not authorised BDS graduates to perform aesthetic dermatology or cosmetology. As per their guidelines, only MDS with certain facial surgery specialisations (OMFS) — and even then, with proper training and equipment — can perform limited procedures like hair transplants or some facial surgeries. But many dentists take short fellowships and begin offering fillers, Botox, and lasers. That’s where it becomes unsafe.
Hair transplant procedures have been clearly defined by the NMC. Only dermatologists and plastic surgeons who are properly trained and have the right infrastructure are allowed to perform them.
Many deaths in hair transplant cases occurred not because of the transplant itself but due to issues with anesthesia. So you need ICU access, stretcher lifts, and facilities that allow you to convert local anesthesia to general anesthesia if needed.
So, even if you’re a dermatologist, without the proper infrastructure and training, you should not be doing hair transplants.
Q: How do you monitor social media influencers who promote skincare or dermatology products?
A: Sadly, there is no effective way to monitor all social media handles because of the sheer volume and speed of information flow. Traditional advertising has some regulation through bodies like the Advertising Standards Council of India (though it’s not statutory), but social media regulation is far behind the explosion of content. We can only appeal for an ethical approach and create awareness, urging people to be mindful about whom they follow and trust.
Botox or similar brands—or any botulinum toxin, basically—requires special training. You need to understand facial anatomy in three dimensions. There are specific courses and workshops for this.
It’s not something you can learn by watching a few YouTube videos or shadowing someone. You must know how deep the muscle is, what the dilution should be, how to reconstitute, where to inject, and what complications to expect.
Even among dermatologists, only those who are trained should be doing it.
Q: What is being done to control misinformation about dermatology on social media?
A: Associations like IADVL have recently approved social media guidelines for dermatologists to help regulate the conduct of professionals online. Meanwhile, awareness campaigns encourage the public to check credentials before trusting advice.
Q: How is the training and regulation of doctors offering aesthetic treatments like hair transplants monitored?
A: There are reports of MBBS doctors learning hair transplants over a weekend, which is problematic. IADVL is not a statutory body but actively works to police its members. Unethical practitioners can be removed from professional associations and have their licences revoked by the National Medical Commission (NMC) or State Medical Councils.
Q: What action is being initiated against dermatologists who engage in unethical practices like unauthorised cosmetic procedures?
A: Such dermatologists are expelled from associations like IADVL. The NMC can revoke their licences. Professional misconduct is taken seriously, and those found violating rules face strict penalties.
Now, in some states like Maharashtra, there is a Clinical Establishments Act, which mandates that clinics be registered and regularly inspected. So if a non-qualified person is found operating a clinic or performing procedures, the clinic can be sealed and a case filed. But in many parts of India, enforcement is weak. That’s why we are constantly talking to policymakers and trying to bring this into public awareness. We want stronger penalties and stricter enforcement.
Q: Why is it important to see the right, qualified doctor for skin and cosmetic treatments?
A: Sadly, now everybody is aware that hair transplants done wrongly could lead to death. The most shocking part was that the same person was involved in both. One death happened in November, and nobody heard of it, and then the other one happened in March or so. We started hearing about it in the national media just recently, I think two weeks ago.
Qualified dermatologists undergo years of medical training to diagnose underlying causes of skin problems and to safely perform treatments. Unqualified individuals may miss serious diagnoses (like tumors or hormonal disorders) or cause harm through incorrect procedures.
Q: What are the risks involved in unqualified individuals performing aesthetic procedures?
A: Many people don’t realise that licences are required to practice, and the government’s role can be limited. In Telangana, the District Medical and Health Office has the power to conduct raids and issue licences. However, with hundreds of clinics and sometimes three or four practitioners in one area, enforcement becomes very difficult.
Regarding hair transplants, risks range from death to severe, disabling, and disfiguring infections. While such outcomes are rare, I once treated a patient who developed a severe herpes infection after a hair transplant. Although he survived with his overall health intact, he lost all the transplanted hair as well as part of his original hair. These complications must be avoided.
Serious complications can occur, including infections, disfigurement, and in extreme cases, death. There have been documented deaths linked to improperly performed hair transplants.
Q: What can happen if a filler procedure is done incorrectly?
A: You could lose vision. There have been reports of a brain stroke. Fillers have been found inside the skull, about something called the dura, which is a layer above the brain. Again, I don’t mean to scare people—I just did one and it took me 10 minutes. But if you do it wrongly, things can get worse.
Q: What about something as simple as acne? What goes wrong if the wrong person treats it?
A: One, you might not get the right result. You will lose hope, faith, money, time, and effort. You might be taking time off from work or whatever you do, visiting the clinic, and ending up disappointed. You might lose faith in the system. I get a lot of patients who say, “Oh, I’ve been to so many people, nothing works.”
I understand where they’re coming from. Money can be earned, but life won’t come back. You could end up with permanent disabling scars. You could end up with a keloid or permanent disfigurement. For example, if someone is doing a laser on under-eye dark circles without putting the intraocular eye sheet, without protecting the eye properly, it could be risky. We dermatologists are scared because we see so many such cases every day.
Q: How do the government or regulatory bodies respond to these incidents?
A: Medical authorities like district medical and health offices have the power to inspect clinics and grant licences, but due to limited resources and the large number of clinics, enforcement is challenging.
There are often hundreds of clinics, sometimes with multiple practitioners in one area, making monitoring and enforcement difficult. Lack of stringent rules and manpower also contributes to the problem.
Q: What about steroid abuse?
A: We have a limited set of antibiotics and antifungals. If these are misused, we will go back to the pre-penicillin days. Since about 1950, antibiotics came and helped us not to fear bacterial infections, but 50 years down the line, if the misuse continues, there will be no antibiotics left to use.
Steroid cream abuse is rampant. Just the other day, a friend from Mumbai told me a therapist in her clinic is running a parallel clinic after work hours, giving cyclosporin, an immunosuppressive drug, and oral steroids, plus isotretinoin, which can cause permanent birth defects if given to a pregnant woman. These things happen because the person doesn’t know. People should be vigilant. In the right hands, treatments are great, otherwise, they can be very bad.
Q: Are there any five treatments or surgeries that you need to be careful about?
A: Hair transplant is number one. Any kind of skin problem–now you don’t know whether it’s eczema or psoriasis, or a fungal infection, please visit a dermatologist. An MBBS person is okay, but if they are not able to crack it, then it is best to seek help.
Canadian model Linda Evangelista.
Next are the injectables, like Botox or fillers. If something goes wrong, things can be quite serious. At least with Botox and Dysport, you will have only temporary side effects, typically, but with fillers, you could have permanent ones.
And the next one would be body contouring. Body contouring is now trending because they say that the body is the new face. So, you know, from cryolipolysis—so fat freezing—to non-invasive things to liposuction. People have died in liposuctions. You must have heard of Linda Evangelista, a supermodel whose career and life have been ruined because of this fat freezing (cryolipolysis) thing. So it’s not enough if somebody’s got the money to have a fancy clinic or buy a fancy machine. You need the expertise.
Q: What is your message to the public regarding health advice on social media?
A: The public should be cautious and critical about health advice on social media. Verify the credentials of those giving advice, be wary of personal testimonials that seem too perfect, and prefer information from qualified medical professionals and credible sources.
(Edited by Majnu Babu).
