Can We Trust the Influencer Dermatologist?
Spend five minutes on skinTok—a corner of TikTok dedicated to all things skin—and you’ll quickly learn its language. The ideal video has a big reveal: Skincare enthusiasts dangle the end result—skin that’s radiant with an almost wet-looking gleam—against photos of acneic “before” faces and an infinite reel of recommendations for gentle cleansers, vitamin C serums, and DIY hacks. There’s an aspirational quality to these videos, but they’re also prescriptive in nature. Consumers tell other consumers what to do, what to try, what to buy—and this advice can be rife with bad info. On skinTok, the algorithm allows anyone to be a viral skincare “expert.” Except, of course, for the fact that they’re not.
The real experts on skinTok are also the real experts IRL: dermatologists. This new breed of internet derms and derm residents have hundreds of thousands—even millions—of followers and share videos of themselves having conversations about skin conditions, discussing beauty marketing terms like “clean” and “natural,” debunking common skincare misconceptions, addressing viral trends like “slugging,” and ranking their favorite products. Fluent in influencer, these doctors dance around clinics with a choreographed flair, create content with trending sounds, and have mastered the fine art of posing with products in a post.
In comparison to the serious bedside manner we’ve come to expect from medical professionals, there’s an absorbing and even playful quality to these characters. Sometimes—and probably because we’re not used to seeing our physicians display such intimate candidness—the proliferation of their presence online can feel…off. At the most basic level, it’s objectively weird to see a medical professional make viral memes or sing into their cameras about SPF. These people are real-life doctors? How do they have time to grow a following while also treating patients and doing all the doctorly things that doctors do?
But here’s the thing—the majority of the Insta-famous or almost-famous dermatologists who I spoke to for this story said that they don’t think of themselves as influencers at all. They’re more likely to refer to themselves as “educators” or “myth-busters,” and many of them felt that they needed to grow their social media personalities not for self-promotion (or for a Revolve fest invite) but to fight the wildfire-like spread of skin-related misinformation online.
“Someone will post something untrue or unsafe and I’ll just start getting tagged in comments,” dermatology resident Muneeb Shah, DO, who has nearly 15 million followers on TikTok, told me, specifically referencing a new “trend” where people put lemon juice directly on their skin (which, btw, is bad skincare advice). These people aren’t sinister. They usually have a passion for skincare, so they google something or ask a friend for suggestions and then share incorrect information with the masses.
In addition to misinformation, the dermatologists I spoke with cited gaps in our health care system—such as inaccessibility and lack of affordability—as a driving force for why they now spend time growing their following on social media. While it’s recommended that everyone—regardless of age or skin tone—visit a dermatologist at least once per year, research suggests that only 16 percent of Americans ages 18 to 29 see a dermatologist annually and only one-third of Americans are concerned about skin cancer. Misinformation and lack of adequate health care are related, of course, and together their shortcomings cultivated a breeding ground for cure-alls, quick fixes, and trendy procedures to propagate on TikTok with a swift and sprawling strength.
The downsides of squeezing lemon juice on the skin, for example, came up again and again while reporting this story (it can cause a sun-induced skin sensitivity condition known as phytophotodermatitis—not to mention it can straight-up burn sensitive skin types). So did the dangers of hacking a hyaluron pen to DIY the look of lip fillers, using a nasal spray to get a tan, and getting a liquid rhinoplasty because they’re suddenly in vogue on TikTok.
“The amount of misinformation and the ease with which it spreads [on TikTok] is remarkable,” says dermatologist Ranella Hirsch, MD, who has 131,000 followers on Instagram and doesn’t take social media sponsorships. “I don’t think anything else has the ability to take that information and move it so quickly to so many people. If you see one bad video that tells you sunscreen is terrible, you’re going to be shown 20 more videos like that—it’s just the specifics of how their algorithm works. It creates a silo of whatever misinformation you’ve been given.”
The main goal of most of these platforms is to keep you on the platform, says dermatologist Dustin Portela, MD, who has more than 2 million followers. “They want more watch time, clicks, Likes, comments, and shares and ultimately, they reward things that make people engage with the platform, so there’s no standard or requirement for them to curate and only put forth high-quality, accurate information.” So we see a lot of bad information go viral, just because for some reason, people start interacting with it and it resonates. “I kind of see my role in that as a curator of good information,” says Dr. Portela.
Combating misinformation is one thing, but curating and giving out good information can be murky territory for internet derms. Legally and ethically, medical professionals can’t “treat” their followers—and they shouldn’t. Seeing a doctor is a customized experience. To get individualized care, you provide context on your medical history, family history, social situation, and occupational risks. It’s impossible for a physician to get a person’s proper medical background and perform a physical examination over DM, not to mention that fake accounts run rampant on both TikTok and Instagram. The global reach of social media doesn’t take into account that physicians are licensed to practice in certain states or that HIPPA can easily be violated if a social platform is hacked and mined for personal information.
For what it’s worth, most of these dermatologists have disclaimers in their bios saying “no medical advice, only information,” but that doesn’t stop the personal questions from flooding in. Dermatologist Divya Shokeen, MD, who has 20,000 followers across Instagram and TikTok, sees this as the biggest hurdle as she’s been working on growing her online presence. “It has become a way for people to reach out to you with their particular problems, asking you to fix it,” she says. “It’s not that I don’t want to help them, it’s that legally, it’s just not a good idea. In my [in-person] practice, I am with people one-on-one, and I have an understanding of what their skincare is so we can achieve the best results. There’s no way to tell on social media what is going to work for patients.”
Despite the fact that most of the derms I spoke to don’t label themselves as influencers, many consider their social media presence “a hobby” and most of them make money from the platforms. One dermatologist told me he gets upwards of 50 sponsorship offers per week (FYI, depending on follower count and platform that many sponsorships can generate an extra $20,000 to $200,000+ a week in income according to Influencer Marketing Hub).
Before you roll your eyes and wonder how a doctor can ethically make cash from sponcon, know that all of the doctors I spoke with said they only promote products that they would actually recommend to their patients or family members. "I'll be honest—the brands that have offered me the most money were offers I turned down because they didn't align with my core principles of only recommending products I would recommend to my own Mom," says Dr. Shah.
Also: Product marketing isn’t new in the health care industry. Before big pharma infiltrated your social feeds, they had salespeople promoting drugs in doctors’ offices. And these doctors have always been compensated for pushing certain products or prescriptions, whether it be with a fancy dinner or an all-expenses-paid trip to Hawaii. Maybe this way—on TikTok and Insta—is better? At least we have #ad tags and discerning community of viewers to keep things in check.
Every one of the dermatologists I spoke with is still a practicing physician, with most of them working 40- to 60-hour weeks in clinics. “When you build a following, people just expect you to keep putting out videos,” dermatology resident Chris Tomassian, MD, who has more than 1.4 million followers on TikTok. “So I’ll go to my day job, which is work, and then I’ll come home and dedicate a few hours to either consuming content or just making content.”
Dr. Portela told me that he balances the workload of both seeing patients in person and making content by hiring a team of freelancers to help him research viral trends and edit videos. Dr. Portela wouldn't explicitly share how much money he spends on content creation, but at one point during our phone call, he compared TikTok to “a slot machine” and I got the sense that being a social media–famous doctor might be a distinctly exhausting job on top of, well, being a doctor.
Even though these social media derms are trustworthy experts, at the end of the day, it’s important to remember that they aren’t your doctors. Sure, they’ll guide you toward a simple pared-down routine (“If you came to my bathroom you would be blown away just how few products people like me actually use, because we know better,” Dr. Hirsch told me), encourage you to wear sunscreen, and remind you that Botox is optional, not necessary. But the health information on these platforms should be consumed with the awareness that it’s not meant for you. Dr. Shokeen put it simply: “I’m teaching you how to slug, but I’m not saying you should slug.” When I mentioned to Dr. Shokeen that I’m thinking of getting a chemical peel for dark spots on my face, she respectfully didn’t respond.
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