Patralekha Chatterjee | What Anti-Ageing Trade Hides Beyond the Glow

While actor-model Shefali Jariwala’s sudden death at 42 has triggered widespread speculation, to frame it merely as a celebrity’s lapse in judgment is to ignore a deeper crisis: a system that allows dangerous, unregulated “aesthetic” treatments to flourish.

Jariwala died following a suspected cardiac arrest. Best known for her iconic appearance in the early 2000s hit Kaanta Laga, she had reportedly undergone intravenous anti-ageing therapies — glutathione and vitamin C drips among them — before her untimely death. Preliminary findings point to a sharp drop in blood pressure, possibly worsened by these interventions. The final post-mortem report is awaited.

Jariwala was not an outlier. As Dr Soumya Jagadeesan, additional professor of dermatology and consultant at Amrita Hospital, Kochi, puts it: “The focus should be on the ecosystem that facilitates this.”

The film industry, social media filters, and influencers are cranking up the pressure to look forever 21.

“There is a fear of missing out (FOMO),” says Dr Jagadeesan. That fear — of ageing, of irrelevance, of being left behind in a beauty race staged daily on digital platforms — is what lures so many into risky procedures.

“There are innumerable video clips on social media promoting glutathione injections for cosmetic purposes, pushed by influencers with no medical background. One can order it online. Dangerous advice is doled out under the guise of harmless skin care. Prescription-only medicines are freely available. Many of those administering Botox, fillers, laser, and glutathione do not know how to deal with complications because they are not medically qualified. We have regulations, they are not enforced,” she adds.

According to research by IMARC Group, a global management consulting firm, India’s anti-ageing market reached $2.5 billion in 2024 and is projected to balloon to $4 billion by 2033. Mumbai, Delhi and Bengaluru have emerged as key hubs for anti-ageing treatments, with clinics witnessing substantial hikes in bookings for such services.

The other side — vast swathes of the anti-ageing market operate in a regulatory grey zone where beauty becomes a high-stakes gamble. One of the fastest-growing segments in this space is injectable glutathione, a so-called “miracle” antioxidant hailed for its detoxifying properties and skin-lightening effects.

Clinics offering invasive procedures like glutathione drips, Botox, and vitamin infusions often masquerade as wellness spas or beauty lounges, evading the oversight required of medical establishments. This lack of accountability puts countless lives at risk.

Jariwala’s death demands we confront the chaos head-on.

India’s regulatory framework for aesthetic medicine is a patchwork of half-measures and loopholes. There is no specific legislation addressing “aesthetic procedures,” no standardised protocols for their administration, and no enforced certification for practitioners. Oversight is fragmented among the Central Drugs Standard Control Organisation, State Medical Councils, and state health departments, leading to inconsistent enforcement and a dangerous vacuum.

The explosive popularity of intravenous glutathione, a so-called “miracle” antioxidant marketed for its detoxifying and skin-lightening properties, serves as a stark lens through which one can view the broader, troubling landscape of anti-ageing treatments and aesthetic clinics in India. Clinics in cities like Mumbai, Delhi, and Bengaluru charge between ₹5,000 and ₹12,000 per session, with premium packages costing much more. These treatments, often administered in boutique lounges rather than medical facilities, promise radiant skin and anti-ageing benefits but lack robust evidence of efficacy and safety. There is scant documentation of what happens when people combine such anti-ageing procedures with other medicines and treatments without medical supervision.

In a sobering critique of intravenous glutathione (Glutathione as a Skin Whitening Agent: Facts, Myths, Evidence, and Controversies), published in 2016 in The Indian Journal of Dermatology, Venereology and Leprology, dermatologists Sidharth Sonthalia, Deepashree Daulatabad, and Rashmi Sarkar highlight the dangers of intravenous glutathione. “Although the use of intravenous glutathione injections is popular, there is no evidence to prove its efficacy. In fact, the adverse effects caused by intravenous glutathione have led the Food and Drug Administration of the Philippines to issue a public warning condemning its use for off-label indications such as skin lightening.”

“Pharmaceutical companies that manufacture intravenous glutathione have a marketing agenda and pursue dermatologists to administer this drug to such patients. Not surprisingly, the trend of recommending and administering intravenous glutathione has increased within months of it becoming available, despite the potential adverse effects and lack of evidence,” the authors note. The journal also highlights the alarming reality that cheaper versions of glutathione may be counterfeit, containing harmful additives that increase the risk of severe reactions.

While the media spotlight remains fixed on Jariwala’s untimely death, few are asking what regulatory bodies in Maharashtra, or anywhere else in India, for that matter, intend to do next. Where is the accountability? How many so-called “aesthetic clinics” have been inspected in recent days in the aftermath of Jariwala’s death?

“The cosmetic industry is absolutely the Wild West,” says a Mumbai doctor. “But demand is huge. Regulation is a mirage.”

Many wellness spas operate with no qualified physicians on staff and no emergency protocols in place. The absence of a robust system for reporting adverse events means complications often go undocumented, leaving regulators in the dark and consumers vulnerable.

Arguably, Maharashtra’s FDA (Food and Drug Administration), responsible for overseeing drug and cosmetic regulations, faces severe resource constraints. This limits its capacity for widespread inspections unless prompted by high-profile incidents or specific complaints. The nationwide picture is no better.

This, however, can no longer be used as an excuse.

Other countries offer roadmaps. The Philippines has severely restricted the use of intravenous (IV) glutathione for cosmetic purposes. Singapore mandates licensed practitioners for aesthetic treatments. Japan requires strict informed consent and post-treatment monitoring. These are basic safeguards to protect public health.

India has no national policy to regulate an industry that is growing faster than the laws meant to govern it.

Jariwala’s death must be a catalyst for change. The government must establish a central body dedicated exclusively to regulating anti-ageing treatments and aesthetic procedures, ensuring consistent oversight across states. All aesthetic clinics must be required to register under the Clinical Establishments Act, with mandatory audits to enforce compliance. Invasive procedures must be restricted to licensed medical professionals with specialised training. A national system for reporting and addressing adverse events is essential to track complications and enable swift regulatory action. Finally, public awareness campaigns are needed to educate consumers about the risks of unregulated treatments and the importance of seeking qualified providers.

The pursuit of beauty is not the problem. The absence of informed choice, medical oversight, and regulatory safeguards is. Shefali Jariwala’s death should not be remembered merely as a celebrity tragedy — it should be a wake-up call.