From patients arriving with influencer videos instead of describing symptoms to the pressure for “instant results”, Dermatologist Dr Avinash Pravin breaks down why science-backed care, not viral hacks, is the only way to truly understand your skin.
Published Nov 26, 2025 | 7:00 AM ⚊ Updated Nov 26, 2025 | 7:00 AM
Synopsis: Dermatologists in India’s semi-urban districts are witnessing a rise in complex skin conditions shaped by climate, lifestyle changes, and an overwhelming wave of viral skincare advice. Nagercoil-based dermatologist Dr Avinash Pravin, in an exclusive interview with South First explains how misinformation, social media pressure, and delayed medical care are reshaping the way patients understand their own skin.
What happens when everyday skin problems in India’s tier two towns collide with a booming online aesthetic culture? In places like Nagercoil, Tamil Nadu, dermatologists are seeing a sharp rise in fungal infections that do not respond to over-the-counter creams, stubborn pigmentation, steroid-abuse damage, and chronic tanning that is often misdiagnosed as “skin dullness”.
Yet instead of seeking timely medical help, many patients first turn to home remedies, advice from friends, or viral skincare hacks long before they walk into a clinic.
In an exclusive interview with South First, Dr Avinash Pravin, Dermatologist at Pravin Skin Clinic, Nagercoil, explains how the landscape of dermatology in smaller towns is changing.
As he treats increasingly complex cases shaped by misinformation, he also sees how social media has blurred the line between genuine skin diseases and aesthetic anxieties. From patients arriving with influencer videos instead of describing symptoms to the pressure for “instant results”, Dr Pravin breaks down why science-backed care, not viral hacks, is the only way to truly understand your skin.
Edited excerpts follow.
Q: Nagercoil is a semi-urban or rural district in Tamil Nadu. When we talk about dermatology, people usually associate it with skin health, anti-ageing, aesthetics and so on. But in your practice, what does the patient profile actually look like there?
Dr Avinash: Nagercoil essentially a tier two town. So we see a lot of patients who need proper, urgent medical care. Many people come with severe itching, blistering disorders, or life-threatening conditions, like severe psoriasis flare-ups or other acute skin disorders. We also see elderly patients who are on multiple medications and experience itching due to comorbidities like diabetes, kidney issues, or liver problems.
Fungal infections are also very common, and many of them are so severe that patients cannot sleep. So around 80 percent of my patients come with clinical or emergency dermatology needs, and the remaining 20 percent come for aesthetic concerns.
For example, acne is a medical disorder of the sebaceous glands. If someone comes with severe, pus-filled acne, we first stabilise it and bring it under control. Only after it subsides do we perform procedures for acne scars.
So yes, my practice is 80 percent clinical dermatology and 20 percent aesthetic dermatology.
Q: The region is quite tropical, the temperature is often high and the humidity is also significant. How does the environment there affect skin health?
Dr Avinash: If you look at lifestyle patterns, many women spend long hours in the kitchen, so sweating is very common. And if you see the national trend, India is becoming the diabetes capital of the world. Many women gain weight post-pregnancy and are unable to lose it, which increases the risk of pre-diabetes or diabetes.
Diabetes affects immunity, so the skin’s protective ability reduces. Even small infections take longer to heal. A fungal infection in a non-diabetic person resolves faster than in someone with diabetes, that is a big difference we see every day.
Environmental exposure also matters. Some people use local lakes or ponds where buffaloes are washed. These water sources carry infections and the same gets transmitted to humans. Similarly, frequent travellers use public restrooms, which increases exposure to communicable skin infections.
So overall, heat, humidity, lifestyle, water sources, and rising diabetes all play a major role in the kind of skin problems we see in this region.
Q: You mentioned diabetes and hypertension, and we know wealth and affordability have grown across the country. People can afford more now compared to ten or twenty years ago. Do you think this rising affordability in a tier two town is also contributing to certain diseases, not just diabetes or hypertension, but dermatology-related issues as well?
Dr Avinash: Yes, definitely. From a dermatology perspective, patients want glowing skin. But what is actually happening is linked to lifestyle. Today, sitting is the new smoking. Work is completely sedentary, people are not exercising, and this leads to hormonal imbalances.
One of the first signs we see is “dark neck”, which is often due to being overweight or having insulin resistance. Insulin resistance also causes face darkening. Many patients come saying, “Doctor, my skin tone below the neck and above the neck is different.”
When I examine them, most have gained weight, do not exercise, and have very poor lifestyle habits. Think of it like a bottle into which you keep pouring water continuously with no outlet, no activity to burn it. This cycle leads to insulin resistance, which then causes a vicious cascade:
For dermatologists, one of the most common complaints is facial darkening. And the first thing we advise is not creams or serums, it is exercise, proper diet, and good sleep.
These are the three fundamentals of skincare.
Only after fixing the basics can we build the next phase of treatment. No topical product, not even salicylic acid, can replace that foundation.
Q: How much is social media influencing or controlling doctors’ practice these days?
Dr Avinash: A lot. For a simple example, patients check Google reviews even before meeting a doctor. Google has become the mother of social media, everything starts there.
Now, dermatologists are trained medical professionals. We study MBBS and then MD, around eight-and-a-half to nine years of specialised training in skin and hair. But what is happening is that non-dermatology influencers, people without any dermatology degree, some alternative practitioners, and even salon or parlour workers talk extensively about skincare products, serums, and treatments.
They promote very attractive claims, “magic serums” that erase marks in ten days. Since these claims sound too good to be true, patients are drawn to them. To counter this misinformation, doctors, especially dermatologists, need to be present on social media. Otherwise, patients get misled online and come to us only after damage or side effects occur.
The challenge is that patients are pulled more towards influencers because of product endorsements, freebies, and dramatic promises. But what they need to understand is:
We dermatologists know what is possible and what is not, so we do not make exaggerated claims. But to correct misinformation, our presence online is necessary. Without it, social media can “kidnap” patients even before they reach qualified professionals.
Q: Do you feel pressured to be on social media? And, when you put out genuine content for awareness, it may not go viral, but others deliberately create viral content. How much do these algorithms influence your decisions? How much does social media force you to be present and active?
Dr Avinash: That is absolutely true. Many of my friends are introverts; they were never comfortable making reels. But now they are forced to do it because patients expect their doctor to be visible on social media. They want someone who is “viral”, because virality has somehow become equal to credibility.
But not every reel can go viral. The algorithm does not work that way.
Being on social media has become a rat race. If you post, there will always be someone doing better, some influencer posting more content, more dramatic stuff, more viral topics. Doctors are not trained for that. We are busy seeing patients, managing clinics, dealing with emergencies. On top of this, we now have to shoot content.
Personally, I shoot only once a month, maybe one-and-a-half to two hours after lunch. That is all I can afford. I cannot chase virality. We doctors are not “viruses” to go viral every day, right?
But yes, it is a tricky situation. Finding the right balance is difficult because non-dermatologist influencers are crossing new limits every day, posting more and more sensational content. And the public gets attracted to that.
Q: We recently saw the case of Dr Sivaranjani Santosh and others who fought against ORSL misuse. She has been raising this issue for years, and I also saw your posts on ORSL. But only now she has become viral on social media. Many doctors who put out genuine content still do not get reach. Then comes a third factor, the platforms themselves. They give more weight to creators who attract certain types of audiences, especially those who keep watching reels repeatedly. How do you deal with platforms like Instagram, YouTube, TikTok, Facebook, where reels go viral so unpredictably?
Dr Avinash: If you look at movies or TV serials, they have a UA certificate or some kind of filter. But platforms like Meta have no such filter. Anyone can post anything, hate, misinformation, half-baked knowledge. There is no accountability.
In fact, China recently introduced a rule that influencers cannot talk about certain topics unless they are qualified or at least graduates. Some form of regulation like that is needed here too. Otherwise, with the rise of AI, anyone can mug up information, read out a script, and appear like an expert in a one-minute reel. But the reality is they only know things superficially. People like the presentation, not the depth.
For ethical doctors, this is a big struggle. Doctors who do not endorse products naturally reach fewer people. But those who endorse products get a bigger reach. The grey area is that NMC regulations clearly say doctors cannot endorse products, that rule exists since 2002.
In 2023, NMC even brought a regulation saying doctors cannot be on social media, but it was withdrawn within a week. I strongly feel NMC needs to revise these rules. In the US or Europe, doctors are allowed to endorse OTC products because dermatologists have long waiting periods, three to six months, so patients can use safe OTC solutions meanwhile.
Our influencers see that and start copying it, “Use this, use that”, without understanding the science behind it. Last year, Karnataka Medical Council even issued a notice to a doctor for endorsing products, but enforcement is inconsistent. Meanwhile, every day you see doctors endorsing serums and supplements.
In my own email inbox, I get offers of ₹30,000 to ₹50,000 per reel. If I did just ten reels a month, without even going to OPD, I could earn ₹5 lakh. There are doctors who have completely left clinical practice and only make reels now.
This is a bad trend because hardworking, ethical doctors get overshadowed. It creates a false impression that “doctors with more followers are better doctors”, which is not true at all. Someone can have 500K followers, but that does not reflect their clinical skill.
We desperately need proper regulations for doctors on social media.
One is social media advice, and the other is doctor advice. What is the difference? How different are they in reality?
Dr Avinash: The difference is huge. Serums and creams marketed online work only on the surface. They cannot penetrate deep into the skin. Think of it like pouring water, it will not go beyond a certain layer. The skin’s upper layer, the stratum corneum, acts as a barrier. Anything topical can only go so far.
If a problem lies deeper, for example deep dermal pigmentation, no serum can fix it. Acne pigmentation has two components: superficial (epidermal) and deep (dermal). Serums work only on the superficial part.
And acne itself may be due to hormones, junk food, stress, weight gain, or lifestyle issues. If you do not fix the root causes, no magical serum will work.
In fact, my practice has grown because people try too many products suggested by influencers, do not see results, and then finally come to a dermatologist. Instead of taking the straight road, they take a long detour and ultimately realise they needed professional help from the beginning.
Is honey and turmeric an effective treatment to remove tanning?
Dr Avinash: First of all, tanning is a normal adaptive mechanism of the body. Indian skin usually does not burn, it tans. Our skin produces more pigment to protect itself from the sun. It is actually a natural shield.
But people treat tanning like a villain. They think it needs to be removed immediately. In reality, if you simply stay indoors for a week or two, most of the tan will fade on its own.
Putting honey, curd, turmeric, none of that will make any meaningful difference. If you eat curd or honey, that may help your nutrition, but applying them on your skin will not reverse tanning.
The bigger issue is that people mistake any darkening of the face as “tan”, even when it may be due to hormonal imbalance, insulin resistance, or pigmentation disorders.
Influencers make it worse by showing “tanning removal” videos, smearing black paint on the face and wiping it off dramatically to show a fake before-after. Serums cannot remove tan like that. Tan is not a pathology; it is a normal response of the skin.
The real solution is simple:
And honestly, if your self-esteem drops just because you are tanned and your colleagues treat you differently, the problem is not your skin tone. You may need to change your circle, not your complexion.
