Bane of quackery in dermatology

A burnt face, an infected tattoo, permanent skin damage, internal complications, delayed diagnoses, and even death are on the rise due to the growing menace of unqualified individuals offering treatments for skin, hair, and cosmetic dermatology issues.

A harmless red blush on one’s cheek may actually be a sign of an auto-immune skin disease, or hair loss may indicate thyroid issues or nutritional deficiencies. A long-standing boil may be skin tuberculosis, and that odd-looking mole may turn out to be cancerous. Diagnosing and treating skin concerns and diseases requires in-depth knowledge and analysis of the physiology and pathology of our largest organ, along with its correlation to other systems in the human body.

This is why a qualified skin specialist spends five and a half years completing an MBBS degree, followed by a rigorous 2–3 year postgraduate specialization in Dermatology, Venereology, and Leprosy.

A hyperpigmented brown patch on the face, when treated with serums, peels, and lasers by an unqualified individual, may actually be an autoinflammatory skin disorder requiring medical treatment. This is exactly why the general public needs to be more skin-aware.

The Hon’ble Supreme Court of India has held that, “A person who does not have knowledge of a particular system of medicine but practices in that system is a quack and a mere pretender to medical knowledge or skill, or to put it differently, a charlatan.”

As per the National Medical Commission (NMC) Act, 2023, skin, hair, and nail care fall solely under the purview of certified dermatologists. Despite rules and regulations, many non-dermatologist doctors and unqualified practitioners pose as skin experts or specialists, using misleading terms like Cosmetologist, Aesthetic Physician, Aesthetic Medicine, etc. — none of which are recognized by any regulatory authority.

Many unqualified individuals operate clinics under labels like “Skin,” “Hair,” “Laser,” and “Aesthetic Dermatology” without the requisite medical qualifications in dermatology, amounting to misrepresentation of facts and misleading the general public.

The Ministry of Health and Family Welfare, in an RTI response dated May 2023, clearly stated that the minimum qualification required to perform a laser hair reduction procedure is an MD in Dermatology. Despite this, the medical-grade procedure — associated with potential complications like burns and scarring — is being carried out in unqualified centers without a dermatologist.

Patients need to be vigilant. They should check the degrees of their treating skin expert, which must be clearly mentioned on prescriptions, along with the Medical Council registration number. The only degrees recognized by law in India for a dermatologist/skin expert/skin specialist are MD, DNB, or DVD in Dermatology.

Public ignorance also fuels this problem. Many patients prefer visiting their neighbourhood pharmacy, where they are handed an “all-in-one” cream — mostly containing potent steroids mixed with other ingredients — that can cause life-threatening systemic complications if used for prolonged durations.

Similarly, many quacks prescribe topical steroids as magic creams for everything, from skin lightening to fungal infections. Oral steroids and steroid injections are also irresponsibly dispensed as “wonder drugs.” Unfortunately, by the time the patient reaches a certified skin expert, months or even years of drug misuse and abuse have passed, often resulting in severe side effects.

Another growing concern is the group of patients influenced by skin trends, social media influencers, aggressive marketing, false promises, and attractive cosmetic packages — disguised as cosmetology, wellness, or aesthetics.

We also call for strict action from respective medical and dental councils against doctors violating the code of ethics and indulging in malpractice. Hospitals and clinics must also follow ethical practices by employing certified dermatologists in their skin and cosmetic dermatology departments.

Strict regulations need to be implemented and enforced by the government, especially regarding the dispensing of Schedule H drugs like steroids by pharmacists and the unregulated sale of dermatology lasers in unqualified individuals and centers. This article is an awareness initiative by the North East States Branch of the Indian Association of Dermatologists, Venereologists and Leprologists (NEIADVL).