On Tuesday, Saroj Dahal, a 28-year-old follically challenged man, was waiting outside the dermatologist’s room at a clinic in Shantinagar, Kathmandu for his follow-up appointment. It would be his second treatment for his receding hairline.

Dahal said he was frustrated with his baldness. “It made me a laughing stock everywhere I went,” Dahal told the Post. “Now there is some hair growth and that has improved my self-confidence, all thanks to dermatology procedures.”

Due to the growing demand for cosmetic surgery, the skin and hair care industry in Nepal is thriving. Although there is no record of their number, insiders say there could be hundreds providing such services, with most of them based in the Kathmandu Valley.

There are benefits of cosmetic surgery. It improves appearance and self-image and helps people deal with anxiety related to their body.

Undergoing surgery as a beauty-enhancing treatment service has become a lifestyle choice for an increasing number of people. Until a few years back, the procedure was largely limited to elite groups.

Reports show that men are opting for surgery in greater numbers than ever before, but it is still women who predominantly undergo such treatments.

The business has become lucrative in Kathmandu.

A preliminary visit can cost anywhere between Rs5,000 and Rs15,000 for minimally invasive surgeries like botox and the cost of skin care products like retinoid creams.

Kathmandu Clinic of Cosmetic Surgery was established in 2012 as one of the leading names in the market.

The treatments for laser hair removal for upper lips start at Rs4,000 per session.

Lavana Skin and Hair Clinic places special emphasis on providing anti-ageing treatments. An injection for eye lifts starts at Rs13,000.

Doctors say that people in their late-40s opt for eye bag surgery—which is a procedure that lasts for two to three hours and costs around Rs42,000.

Services like acne scar removal and intense pulsed light (IPL) treatments, which use waves of light to address a range of skin concerns, cost about Rs6,000 and Rs3000 a session, respectively. These are popular among teenagers and young adults and their demand is increasing despite the high cost.

Lavana Skin Care said it has a week-long waitlist.

According to dermatologists, the impact of influencer culture on social media platforms and the desire to look presentable and youthful has fueled the surge in demand for those procedures.

Akarshan Skin Laser and Hair Clinic, which was launched by Dr Smriti Shrestha eight months ago, is already packed with clients.

“It’s TikTok that helped me increase the clients,” Shrestha said. “We used to create TikTok videos providing details on various treatment procedures.”

But with TikTok banned in the country, the number of new inquiries at her clinic has almost halved, she said.

For startups like Shrestha’s, TikTok was a free medium of advertisement.

Shrestha has been working in this field for the past seven years. She previously ran another clinic with her husband, who is also a dermatologist. She now has her independent venture.

The cost of starting the venture, however, is very high.

“It is difficult to set up the clinic,” Shrestha said. “The costs of machinery are exorbitant.”

They are imported from countries like China and Spain.

Laser hair removal and wrinkle removal devices can cost over Rs4 million, said Shrestha.

The clinics are receiving inquiries from Nepalis living abroad too, as the procedures are affordable in Nepal. Most clinic owners the Post talked to said they receive 10 to 30 clients a day.

Established clinics like Avaran Skin and Hair Clinic in Durbarmarg have also seen a surge in demand and are even attracting foreign clients.

The business is booming. But there is a catch.

Many cosmetic surgery clinics are not registered. There is no law governing them either. And it’s not a recognised medical specialisation in Nepal.

Transplant surgery involves cutting the skin, and even though people are happy to have a few hairs back and make their skin glow, there is a lack of supervision.

Transplant tourism has also exploded, particularly for diaspora Nepalis, who the clinics offer package deals.

The surgery is expensive abroad.

Insiders say without proper law and supervision, the surgeon is not held accountable as some institutions don't follow high codes of conduct when it comes to patient care.

Insiders say many new clinics have failed to follow proper medical procedures.

The skin- and hair-related cosmetic services are registered at the ward and district level but not under the health-related category. They are not properly regulated or monitored by any authority.

Dermatologists say patients can lodge complaints about the problems caused during treatment at the Nepal Medical Council. The medical council’s role, however, is to conduct licensing examinations of the doctors and to monitor and regulate medical education in the country.

Krishna Prasad Adhikari, spokesperson for Nepal Medical Council, said they only keep records of doctors and not their clinics. “Such records are kept by the Department of Health Services,” he said.

Dr. Anup Bastola, director of the Curative Service Division of the Department of Health Services, said that there are no laws related to cosmetic surgery. “We have been working to prepare the standards related to cosmetic surgeries since last year. It’s taking time.”

So, until the standards or laws are prepared, the respective authorities at the local government or provincial government should monitor the activities, he said. “We also conduct inspections.”

He said that most clinics performing cosmetic surgeries are not registered.

Lalit Thapa, deputy registrar at the Office of the Company Registrar, said smaller clinics are advised to register in the Department of Cottage and Small Industries due to the faster and more convenient process.

The department generally registers health-related polyclinics rather than cosmetic clinics, said Shivaram Bohara, its spokesperson.

Dr Prakash Budhathoki, spokesperson for the Ministry of Health, said cosmetic surgery clinics are thriving and many are operating even though they don’t meet basic standards.

In Nepal, hydrafacial has been the most popular service among people of all ages, said Smita Karki, a staff of Avaran Skin and Hair Clinic. “Especially in the wedding season, customers come for skin rejuvenation to look better in the photos,” she added.

Hydrafacials are facial treatments performed by a specialised machine that carries out suction, cleansing, and the infusion of rejuvenating chemicals into the pores. An hour-long hydrafacial session costs about Rs5,000.

Other popular services are laser hair removal for a full face, which can begin at Rs40,000 for a package of six sessions.

The increase in demand for extravagant cosmetic procedures and expensive aesthetic skin care has, however, hit the traditional beauty parlours and salons, which were quite popular until a few years ago.

Sushila Pradhan, who has been running her beauty parlour in Maitidevi for the past nine years, said the number of her regular customers has nosedived.

“Some have switched to machine-based facial treatments,” she said.

While decades-old beauty parlours are dying, cosmetic surgery is attracting middle-class millennials.

Shrestha, owner of the Akarshan Clinic, said that “cosmetic tourism” would even help the country bring in foreign currency. “For this, Nepal needs to develop its dermatology and cosmetic surgery services, train new professionals and promote skilled ones,” she said. “But the law to govern the industry is a must.”