“Health tourism” is very much a buzz phrase in Kerala, and resorts such as Kovalam and Varkala are packed with places to de-stress and detox – the majority of them based on principles of Ayurveda medicine. The Keralan approach to India’s ancient holistic system of medicine has two distinct elements: first, the body is cleansed of toxins generated by imbalances in lifestyle and diet; secondly, its equilibrium is restored using herbal medicines, mainly in the form of plant oils applied using a range of different massage techniques. A practitioner’s first prescription will often be a course of panchakarma treatment – a five-phase therapy during which harmful impurities are purged through induced vomiting, enemas and the application of medicinal oils poured through the nasal cavity. Other less onerous components, tailored for the individual patient, may include: dhara, where the oils are blended with ghee or milk and poured on to the forehead; pizhichi, in which four masseurs apply different oils simultaneously; and, the weirdest looking of all, sirovashti, where the oils are poured into a tall, topless leather cap placed on the head. Alongside these, patients are prescribed special balancing foods, and given vigorous full-body massages each day.

Standards of both treatment and hygiene vary greatly between establishments, as do the prices. Female travellers also sometimes complain of sexual harassment at the hands of opportunistic male masseurs; cross-gender massage is forbidden in Ayurveda. The application of dodgy oils that can cause skin problems is another risk you might be exposed to at a backstreet clinic. Your best bet is to follow tips from fellow travellers and, if you’re unsure, check the state of any treatment rooms in advance.

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