On the social media platform X (formerly known as Twitter), a Filipino doctor named Erin Santos with the handle @thenerdyderma asked users to send over their skincare routine questions. One user’s question was phrased like a math problem: If they were only outside for 30 minutes and stayed in a building for 1.5 hours, do they need to reapply sunscreen once they go outside? The doctor’s response to the tweet cited a 2019 study by Rungananchai et. al., where they found only a 28 percent reduction in sunscreen after an eight-hour shift.
“If there is minimal sun exposure and you don’t sweat a lot, and you don’t wipe your face often, I don’t push for reapplication,” Santos advises at the end of her response, which was seen by her 115,000 followers, as of writing.
Santos is one of many medical practitioners with alternative careers as content creators. Dermatologists on TikTok are creatively incorporating popular audio and memes into their content, using relatable elements (and even dance challenges) to educate users about skincare. This trend marks a significant departure from the conventional image of doctors as serious, overly professional figures. However, it raises questions about the ethical implications of blending medical practice with content creation.
While the majority of content from these dermatology influencers focuses on education, there is a noteworthy subset of global influencers who collaborate with beauty brands to endorse specific products. This practice has sparked concern among more traditional doctors who fear potential conflicts with the ethical responsibilities inherent in medical practice. The juxtaposition of dermatologists as content creators and product endorsers prompts a nuanced exploration of the ethical boundaries within the evolving landscape of healthcare and social media.
By now, there’s a content creator to be found in every profession, and doctors are no exception. Studies have shown that more people began seeking out medical advice on social media following the global pandemic, which explains the popularity of educational content that demystifies public health issues. Dermatologists have become particularly popular on social media platforms, perhaps in tandem with the rise of makeup and skincare content online. A November 2021 study observed that the continuous lockdowns in the Philippines caused a significant decline in clinical consults among dermatologists. It pushed more derms to go online and reach out to a wider audience.
When Derms Broke Through TikTok
Food for your skin:
🍊🍋 has Vitamin C for collagen formation
🍃🍵 has antioxidant/anti-inflammatory effect
🍅🥕🐟 may help decrease sun damage
Food to avoid/lessen:
🍦🍩🍫🍬🥛 lots of sugar and dairy increases risk of moderate to severe acne
Eat a well-balanced diet! 😋— The Nerdy Derma® (@thenerdyderma) February 29, 2020
As a tactile and visual medical specialty, the use of photos and videos act as helpful guides for many seeking answers to their skincare questions. While the beauty space was initially saturated with layperson influencers (non-doctors) who share their passion and knowledge on these topics, there has been an increasing appreciation for the science behind people’s favorite beauty products and practices.
In a time when verifying information online has never been more necessary, many have turned to the voice of dermatological experts. On TikTok, the hashtags #dermatologist and #dermatology have 17 billion and 5 billion views respectively, as of writing. From a handful of celebrity doctors, social media now has thousands of skincare doctors from all over the world shelling out their insights on popular procedures, trending products, and myths worth debunking. A Davao City-based study published in August 2023 identified Instagram and TikTok as the most popular platforms utilized by Filipino dermatologists, followed by YouTube and Twitter.
Many derms on TikTok trendjack popular audio and memes to make educational content relatable to their users — never has there been a bigger concentration of dermatologists doing dance challenge videos to talk about the dos and don’ts of treating acne.
Many of these board-certified derms have gained popularity on both TikTok and Instagram for dispensing skincare tips and advice. The online presence also means that doctors can address skin concerns that are specific to Filipino complexions. For example, Santos, a diplomate of the Philippine Dermatological Society, and who runs pages on Facebook and Instagram under The Nerdy Derma, shared in an interview with Preview Magazine that morenas are prone to skin conditions that can be addressed with proper skincare interventions.
Education is an important component of most derma influencers’ content, and it’s worth noting that the most popular creators find success in speaking the language of their chosen platforms. On a text-based app like X, derma influencers use threads to condense answers to frequently asked questions in one place. On Instagram, the carousel feature is favored by doctors like board-certified dermatologist Dr. Meg Sison to make digestible infographics on various dermatological topics. Many derms on TikTok trend jack popular audio and memes to make educational content relatable to their users — never has there been a bigger concentration of dermatologists doing dance challenge videos to talk about the dos and don’ts of treating acne.
A Cause for Concern?
It’s a stark contrast from how doctors are traditionally perceived: serious, overly professional, and governed by ethical rules, therefore making them highly regarded. This is where some find some cause for concern regarding the ethical boundaries of practicing medicine and being content creators. While the majority of content posted by these derma influencers is educational in nature, there are cases of global derma influencers who have been tapped by beauty brands to endorse certain products. More traditional doctors see this as a cause for concern, as it may conflict with doctors’ ethical responsibilities.
Dr. Gemma*, a board-certified Filipino dermatologist with a private practice in Metro Manila, who agreed to be interviewed upon anonymity, says that some of her colleagues have been in disagreement over the potential harm of derm-influencing. “There are ultra-conservative people who will say, no, you’re not even supposed to endorse a restaurant that you ate in. You’re not even supposed to show brands when you take a video, even if it’s accidental,” she says.
This belief is in line with the Philippine Dermatological Society’s (PDS) rules and regulations for fellow derms posting on social media. The PDS released its first social media guidelines last November 2020, which its members are expected to follow. The guidelines advise doctors to practice extreme caution when posting online to maintain professionalism. On Chapter 10 of the same document, derms are advised that they can only state their name and contact details as an approved form of advertising.
Derms becoming endorsers on social media may be a new concept, but doctors have always been involved in product marketing within their clinics — a one-on-one endorsement. The main difference between endorsing within a clinic consult and a TikTok video is the size of the audience.
“Physicians shall not commercially endorse any medical or health product,” the guidelines state, and which also includes the appearance of products onscreen when discussing particular topics, lest it be construed as an endorsement.
“[The PDS] wants to totally stop [influencers on social media.] Any endorsement, even just a hashtag, they’re trying to police it, especially now.” Dr. Gemma* says. “It’s a hot topic, actually. We’ve been very careful. So right now, we’ve been told that we’re not allowed to have paid collaborations with any brand.”
Derms becoming endorsers on social media may be a new concept, but doctors have always been involved in product marketing within their clinics — a one-on-one endorsement. Though doctors are encouraged to prescribe generic names as much as possible, pharmaceutical companies encourage doctors to review and endorse brand-name products to their patients. The main difference between endorsing within a clinic consult and a TikTok video is the size of the audience.
Dr. Gemma* acknowledges that these practices essentially function the same way: by endorsing a product to a patient or an online follower. “Which is why there’s that gray area,” she says. “Because technically, what you say within the four walls of your clinic should be what you’re also promoting outside of that. And even your ethical principles should hold inside your office as it does outside.”
She adds that doctors endorse certain brand names when they’ve been able to see how it works on their patients and even on themselves. “We’ve seen it; not all generic products have the same effectiveness,” Dr. Gemma* says. “So you weigh these things out, right? I try to give patients options, but there are really tried and tested brands that I will outright say, stick to this, it works.”
The ethics of derma influencers may still be a debated topic within their medical field, but there is no doubt that having dermatologists provide informative videos has democratized skincare for more Filipinos.
A New Career Trajectory
As the PDS cracks down on derma influencers who may be going against their published guidelines, Dr. Gemma* says that younger derms object to the limitations set regarding their online presence. “It’s very controversial at the moment, because obviously, the younger generation, those who are social media savvy, are of course complaining because it’s really not fair. There’s a whole spectrum of influencers — some are going overboard, but many are keeping to the reasonable guidelines.”
For Filipino derm content creators who seek out more freedom to post online, it seems that the most they can do at the moment is to use their platforms as a professional marketing tool. With the absence of commercial opportunities, their accounts mainly function their virtual business cards for potential clients. What’s key then is an appreciation for how their social media platform can maximize their reach — be it through a new trend or challenge that’s making the rounds on the internet.
The ethics of derma influencers may still be a debated topic within their medical field, but there is no doubt that having dermatologists provide informative videos has democratized skincare for more Filipinos. Dermatologists like Dr. Gemma*, who sees the positive impact of derma influencers, understand the need for traditional doctors to adapt to the changing landscape. “I feel like so much has changed in the past few years,” she says. “And when the ethical guidelines were created for us dermatologists or doctors in general, social media wasn’t in existence yet.”
Despite opposing opinions, the Filipino derma influencer community continues to exist on various social media platforms, their popularity suggestive of how trusted opinions matter to the public. Seeing dermatologists doing dance videos may not be how they’ve always been perceived, but it does indicate a new direction that this field is taking. These days, you can simply send your favorite derm influencer a skincare question, and you’re likely to hear back — a reminder that even virtually, medicine is a practice of forming human connections.
*Name has been changed to hide the identity of the subject.
