Diagram of Ayurvedic marma points which are stimulated on head, face and neck during Indian head massage
Concept, origin and development
Indian head massage has been practised for thousands of years in South Asia and still often plays a role in daily or weekly routines. The face, neck and scalp are stimulated through manual pressure based upon Ayurvedic medicinal conceptions of bodily health. Oils are traditionally used as lubrication and to nourish the hair. The type of oil used largely depends on local prevalence – for instance, on the south coast of India where coconut tree are prevalent, coconut oil is used while in the north, mustard seed oil is more common. In contemporary practice, particularly outside of South Asia, the use of oils is often omitted.
While Ayurveda is not considered a legitimate medicinal system, the WHO recognises the its potential benefits and is benchmarking them for safety. A report on traditional, alternative and complementary medicinal practices noted that “When practised correctly, TM/CAM can help protect and improve citizens’ health and well-being. The appropriate use of TM/CAM therapies and products, however, requires consideration of issues of safety, efficacy and quality.” 
Traditionally, the practice of Indian head massage is separated by gender. Men typically receive head massages from their barbers, though it also plays a part in private erotic massage and can be offered as a service by sex workers and hijra.  Women, who are usually more tied to the domestic sphere and immediate surrounding area, tend to massage other women in the privacy of the home, a practice also carried out in hijra households.
Children also receive head and body massages. Babies are massaged daily, while children between the ages of 3 and 6 receive weekly massages. From around the age of 6, children are taught to give massages. 
The benefits are traditionally considered to be cosmetic – geared towards encouraging hair growth and its maintenance which would dry out with the use of oils.  However, the physical pressure and stimulation of the scalp have other benefits, such as easing mental stress and encouraging blood flow through the manipulation of the muscles of the neck and head. The ritual, which is often performed weekly – sometimes even daily – also has social benefits in that it binds together members of a household or family in configurations of mutual care.
In South Asia the massage practised by barbers is widely termed champi, a shared term in Urdu and Hindi which means massage. In the UK, the practice was formalised as Champissage by Narendra Mehta, a blind massage practitioner who formulated the technique for use in the west in the 1970s.
The objectives of the treatment depend in part on where Indian head massage is received. As noted above, it remains a live, traditional practice in many households across South Asia and further abroad. Different countries and contexts (i.e. paid, familiar or domestic spheres) alter its significance.
The primary objective is relaxation. This can have an array of benefits, often furnished through the endocrine system or the cardiovascular system. These include: lowered blood pressure, the alleviation of symptoms of mental conditions such insomnia, stress, anxiety and depression, and physical conditions such as irritable bowel syndrome, headache and peptic ulcer.    However, the long-term benefits in treating these symptoms are not established. Indian head massage is not a substitute for clinical medical treatment, but rather a complementary practice.
Good clinical practice
Clients self-refer or may be offered treatment as part of in-patient services. They should be orally assessed for contraindications which may include transmissible infections such as head lice, ring worm or shingles which could be passed on to the masseuse and/or subsequent clients. Partial contraindications such as blisters, boils, cold sores and warts should be noted and avoided during massage treatment. Care should be taken during treatment of any signs of these not noted at the beginning of the treatment. Congenital skin conditions such as eczema and psoriasis should be avoided during treatment. Conditions such as stroke, osteoporosis, diabetes, heart conditions and spondylitis are also fully or partially contraindicated. Medical advice should first be sought by the client from a doctor in these instances.
Indian head massage can be taught through single day diploma courses or in informal settings such as in family settings or in grassroots groups. Gaining professional insurance through the latter may be difficult. Self-employed practitioners should hold a treatments license from their local authority and a good working knowledge of anatomy and physiology (for instance through a diploma) is advised as good clinical practice.
 WHO report, Ayurveda: Benchmarks for training in traditional/complementary and alternative medicine link This is particularly important in the practice of Ayurveda as heavy metals have been found to be contained in harmful levels in traditional poultices and medicines. It is also a source of acute concern in medical and policy circles that the current BJP government in India is pursuing a policy whereby in some cases, funding for clinical research becomes contingent upon conducting research into traditional medicines. While some compounds found in ayurvedic treatments have been found to be of potential medical interest, the clinical efficacy of these treatments has not been established.
 The New Humanitarian, Taboo heightens risks for male sex workers, 2006 link
 Indian Head Massage By Francesca Gould link
 Vogue India, Does oiling hair really help make it grow faster, healthier and thicker? Jerusha Ratnam Chande link
 Indian Head Massage By Francesca Gould link
 Nursing Times, Using Indian head massage to aid recovery, 2013 link