When Dr Rashmi Sharma was invited to a wedding in south Delhi, she had hardly bargained for the IV glow bar around a pool where guests were being invited to undergo anti-ageing injections and drips. Some were taking so-called vitamin shots, some were taking high-powered antioxidant jabs while others were queueing up for injectable collagen, the protein that firms up our skin. “None of these are approved therapies, not even recognised by the US Food and Drug Administration (FDA). I do not advise these myself. They were being administered by beauty therapists in the open. There was no clinical setting or drugs to arrest a severe allergic reaction to these chemicals being pumped into the skin,” says the clinical dermatologist at Fortis, Vasant Kunj, Delhi.
Such unregulated injectables can trigger an anaphylactic reaction, when the body’s immune system overreacts to a foreign substance it perceives as harmful, releasing chemicals that can cause a cascade of symptoms. It can lead to shock, respiratory and cardiovascular collapse, and even death. Dr Amit Langote, nephrologist, kidney transplant physician and hypertension specialist at Apollo Hospitals, Navi Mumbai, had handled one such case in 2023, where glutathione shots had badly damaged the kidneys of a 28-year-old woman with no prior comorbidities. She developed acute kidney injury (her creatinine or protein waste rose from 0.9 to 2.8 mg/dL) after eight “glow sessions” at a Bandra salon. “She required hospitalisation, steroids and a prolonged renal rehab. No physician had reviewed her medically prior to infusion,” he says. High dose glutathione also affects levels of nitric oxide, which keep blood vessels relaxed and wider, and can be a risk for those with irregular heartbeats or any other cardiac condition.
One such shot could have led to the death of actor-performer Shefali Jariwala, who, according to police files, self-administered anti-ageing medication and therapies. The quest for an ageless future and a billboard face on social media has fuelled a cult of eternal youth-seekers who are looking at the quickest fixes through a syringe filled with chemicals that they know nothing about. In their obsessive rush, they bypass medical professionals, resort to “safe” bio hacks being peddled online and fall prey to a greedy and unregulated supplement industry.
“Many justify their use, saying they are just antioxidants, vitamins and polyphenols, considered beneficial for health. What people don’t realise is that too much of a good thing can be poison too. These cocktails of chemical compounds in high doses can trigger side effects, especially when done by untrained hands. Any medical procedure, even minimally invasive ones, has risks. That’s why they need to be done in a clinical setting after a thorough medical checkup and tests to assess the person’s underlying risk factors. For example, those with diabetes can have an increased risk of complications like delayed wound healing and infection, but with guided protocols, these risks can be minimised. We always keep a crash cart and an anti-anaphylactic tray ready with epinephrine shots to arrest any reaction,” says Dr Sharma.
A myth called anti-ageing medication
“There is no clinical classification as such,” says Dr Reshma T. Vishnani, dermatologist, trichologist and aesthetic dermatologist at Kokilaben Dhirubhai Ambani Hospital, Mumbai. “These are basically concentrated supplements, the efficacy of which has not been proved in any clinical study so far,” she adds. Dr Sharma says the loose term is bandied about by influencers to refer to collagen powders and shots, quercetin — one of the most abundant polyphenols found in fruits, vegetables, nuts, wine, and black tea — tablets, curcumin, NR (Nicotinamide Riboside, a form of vitamin B3), NMN (Nicotinamide Mononucleotide, a compound broken down from Vitamin B3) and resveratrol (antioxidant in grapes) capsules.
But the more potent ones are injectables like glutathione, a peptide with three amino acids or the building blocks of life, and NAD+, (nicotinamide adenine dinucleotide), which transfers the energy from the food we consume to cell functions, most importantly in the brain. NAD+ is necessary to regulate the genes that accelerate ageing. “Both glutathione and NAD+ are present in our bodies for anti-inflammatory functions and are prescribed strictly for clinical use in degenerative disorders. But there is no proof that their infusion for ageing skin works,” says Dr Sharma.
Some are repurposed concoctions made from drugs meant for other diseases. “The problem with repurposed drugs is that they may have US FDA (Food and Drug Administration) and even CDSCO (Central Drugs Standard Control Organisation) approvals for a certain disease. But then their components are played around with by certain supplement makers claiming anti-ageing properties. That unregulated mix is the problem,” says Dr Rishi Parashar, Chairman, Dermatology, Sir Gangaram Hospital, Delhi.
Is glutathione safe?
As an antioxidant, it is approved for intravenous use in conditions like alcoholic fatty liver, fibrosis, cirrhosis, alcoholic hepatitis and as a complementary drug for chemotherapy. However, it is often used off-label for skin lightening because it manages to suppress the levels of melanin that regulate skin pigmentation, which had been seen in some patients of the above conditions. Hence its popularity in skin creams, serums and lotions, all meant for topical application.
“The same cannot be said of IV (intravenous) glutathione, which is not approved by the FDA or our drug authorities simply because there is no scientific evidence to back up the fairness claim. In fact, injections can cause skin breakouts in some,” says Dr Vishnani. Besides, one cannot rule out risks like transmission of infectious pathogens, such as HIV, hepatitis C and B when a non-medical practitioner administers this treatment in a non-sterile facility.
“In clinical settings, I increasingly encounter patients who self-administered injectable glutathione without a prescription and are now experiencing unexplained symptoms — fatigue, altered kidney parameters, rashes or breathlessness. The madness is cultural, not clinical, fed by digital beauty filters, colorism and the desire for instant transformation,” says Dr Langote.
Oral glutathione supplements are allowed under the FSSAI (Food Safety and Standards Authority of India), but even here, cosmetic claims (like fairness or anti-ageing) are not permitted under current guidelines. “Unfortunately, due to poor regulatory enforcement, both oral and IV versions are marketed freely with misleading claims,” says Dr Langote.
The recommended daily dose of glutathione for adults ranges from 500-2,000 mg per day when taken orally, or 10-20 mg/kg body weight when administered intravenously for disease supportive therapies. “Who knows how much is being given for the skin?” asks Dr Vishnani.
What are approved anti-ageing therapies?
Dr Sharma says that there are conservative minimally invasive procedures like PRP (platelet-rich plasma) therapy. “The procedure concentrates platelets from the patient’s own blood and injects them into targeted areas to stimulate collagen production, reduce wrinkles and improve skin texture. So you are using your own cells and sending them to targetted areas,” she says.
Then there is the non-invasive HIFU (High-Intensity Focused Ultrasound) treatment, which uses ultrasound energy to heat targeted tissue deep within the skin, stimulating collagen production and eliminating fine lines and wrinkles.
The commonest though are filler injections and botox. Fillers are injectable molecules that are used to add volume to the face, smooth wrinkles and enhance facial contours. The commonest compound is hyaluronic acid, which retains water molecules and plumps up the skin. Botox is a neurotoxin produced by the bacterium Clostridium botulinum, which is used in small doses to temporarily block nerve signals to muscles, leading to muscle relaxation and smoothening of lines. “If done by trained dermatologists, these are safe procedures. Besides, fillers can be undone by flushing them out while Botox can wear off in three months,” says Dr Sharma.
What tests do you need before a procedure?
Dr Vishnani advises a basic liver and kidney function test. The person should not have any active infection at the time of procedure. “We check for G6PD deficiency. G6PD is an enzyme which looks after red blood cells (RBCs). Without it, RBCs can break down faster before getting replaced, causing anaemia. We don’t administer treatments to pregnant patients. We’ve had so many patients from mushroom centres, where no such preventive standards are taken, come with terrible blotches. We have had to admit some of them for a couple of days, give them steroids. So the risk-benefit ratio is questionable,” she says.
Ageing is a complex process that is influenced by many aspects, including genetics, lifestyle and environmental factors. And smoothening wrinkles will never give your face the glow that living healthy and eating clean will.
Shefali Jariwala self-administered anti-ageing medication and therapies, said the police. 
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