Dark Clinics and Hair Transplants - The Red Flags in 2026

Hair restoration continues to be more acceptable by both men and woman, driven by improved techniques, greater visibility and changing attitudes toward cosmetic procedures. Yet despite this progress, the industry still carries real risk. Alongside established medical practices, unsafe or so-called “dark clinics” continue to operate in many countries, including South Africa - often temporarily, often under the radar - exposing patients to serious and lasting consequences.

According to Dr Kashmal Kalan, Medical Director at Alvi Armani South Africa, one of the most overlooked warning signs is clinic stability. “Patients need to establish whether a clinic is a permanent, registered medical practice in South Africa, or a short-term operation using another facility for a few weeks before disappearing,” he says. “Hair restoration is not a once-off transaction. It requires long-term planning, accountability and follow-up care.”

While temporary clinics may look polished online, permanence matters. A fixed location is a strong indicator of regulatory compliance, appropriate theatre standards and long-term responsibility for patient outcomes.

Medical oversight is another essential consideration. In South Africa, hair restoration is a surgical medical procedure and must involve a qualified doctor registered with the Health Professions Council of South Africa (HPCSA). “If a clinic promotes foreign teams without clearly identifying locally registered doctors, that should immediately raise concern. Patients have the right to know exactly who is responsible for their care.”

Pricing remains one of the most misleading aspects for prospective patients. Deep discounts, Black Friday-style promotions and time-limited offers may feel appealing - particularly to first-time patients - but often point to compromised standards. “When pricing and volume take priority over medical oversight and long-term outcomes, it’s a red flag. There is no discount when it comes to your health, your appearance or your mental wellbeing.”

In the short term, patients may be promised high graft numbers and rapid results. In reality, these figures are frequently exaggerated. High graft counts are often achieved through over-harvesting, which can permanently damage the donor area and leave patients with no options for future repair.

The long-term risks are more severe. Poor planning or unskilled implantation can result in unnatural hairlines, visible scarring, patchy growth and post-operative infections. In extreme cases, patients are left with irreversible aesthetic damage and may be forced to keep their scalp permanently shaved. “Hair restoration requires foresight, particularly for younger patients who may need additional procedures later in life.”

Post-operative care is another area where unsafe clinics consistently fall short. Ongoing medical follow-up is essential to monitor healing, manage expectations and guide long-term results. With mobile or temporary clinics, this continuity is often impossible. Once the clinic moves on or leaves the country, patients are left without medical support.

Prospective patients can reduce their risk by asking informed, direct questions before committing. What doctors are involved in a clinic and what’s their own expertise in the field? How long has the clinic been operating locally and internationally? What techniques and instruments are used? What does the post-operative care plan involve? Donor preservation should always take priority over inflated graft numbers.

A clinic’s track record also matters. Reputable practices typically have an established online presence, documented case studies and consistent before-and-after results across different treatment areas, including hairlines, crowns, beards and eyebrows. Results should appear natural and proportionate - not rushed or exaggerated.

In 2026, hair restoration is about more than appearance. It directly affects confidence, mental wellbeing and long-term quality of life. One of the most common mistakes patients make is choosing a clinic based on price or marketing alone, rather than medical credibility and experience.

Dr Kalan’s advice is clear: “Start early and start with a reputable clinic. Don’t be influenced by offers that appear to be too good to be true without doing your homework. It’s far better to do the procedure correctly the first time than to face the emotional and financial cost of fixing mistakes later.”