"It isn’t about making profits but staying afloat,” says Meghna Gupta, founder of the Delhi Skin Centre. She shifted into a new, upgraded clinic with expensive equipment in south Delhi just days before last year’s lockdown. Her business has since been “down by 70%” but her focus remains on staying relevant, mostly through online consultations.
As it has done with many other practices, the covid-19 outbreak is changing the face of dermatology. Besides offering online consultations and becoming more active on social media with DIY and skin hacks, doctors have to add the costs of safety protocols to their monthly bills in physical spaces, alongside EMIs for equipment, rentals and salaries. Their customers are more knowledgeable too; many have spent the pandemic months educating themselves on beauty and skincare.
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Mumbai’s celebrity dermatologist, Rashmi Shetty, was among the first to get back to work after the 2020 lockdown. In May last year, she reopened her clinic with sanitisation protocols in place, announcing it on social media. “Our protocols and surface sanitisations were that of a hospital or a nursing home.” Since everyone’s biggest fear was sanitation, they came because they felt safe, she says.
“The clinics that were purely aesthetic couldn’t reopen but dermatologists who were doctors could open immediately. When I re-started, it felt like I was starting my practice from scratch as people trickled in slowly, one at a time,” she recalls. Early clients included those frustrated at home and who wanted to socialise on Zoom or look good without make-up.
Today, she sees greater demand for laser treatments that require a longer recovery period, platelet-rich plasma, thread lifts, peels, laser hair removal and micro-needling. But since the second surge in covid-19 cases, the pendulum has swung again—from an average of 30-40 patients a day, she is down to 10-15 patients a day, four-five of them online.
“Dermatology consultation is not just about looking through the camera. I need to touch and feel the lesion, see the shade of the pigmentation to understand exactly what the problem is,” she says, explaining that online consultations are limited to emergencies.
In Delhi, Isya Aesthetics founder Kiran Kaur Sethi staggers appointments. Every room is sterilised, with a 15-minute break between sessions. Popular treatments at her clinic include PRP facials, fraxel to remove acne scars, thread lifts to sculpt and tighten the skin, and body pigmentation lasers such as Picosure. “This means less volume and more expense but at least we are safe,” she says. Sethi too would see about 40 patients a day before the first lockdown. This came down by 30%. Now, they are only doing online consultations.
At the Render Skin and Hair Clinic in Chennai, Renita Rajan uses a strategy seen in the dentist’s office. “Instead of the patients coming into one room to see the doctor, doctors visit patients who are seated in different rooms,” says Dr Rajan.
Like Dr Gupta, she too had moved into a bigger clinic, on 18 March last year, just days before the nationwide lockdown. “But even though the financial implications of the move were heavy, in retrospect it worked out because we could devise this new system,” says Dr Rajan. They have continued to see 50-60 patients a day through the pandemic. At present, all consultations have moved online. “I am still coming in to work every day, predominantly for online consultations, which are about 40 a day.”
Let’s get social
Before dermatologists devised safety protocols, they had to become comfortable with online content and consultations. “I used to hate the digital format but thankfully we already had an online system in place for follow-ups,” says Dr Rajan.
Dr Shetty, who used to travel for dermatology conferences, now participates in online events. Recently, she took part in an Australian conference: While she did a live practical demonstration of fillers online from her Mumbai office, Greg Goodman from Australia lectured on the aesthetics of fillers and Woffles Wu from Singapore taught facial anatomy.
Dr Sethi collaborates with international experts, such as functional medicine practitioner Will Cole and facialist Joanna Vargas, via Instagram Lives. “With these conversations, I wanted to understand how we could go beyond allopathy, and apply those learnings to my practice,” she says.
What’s propelling the change is the fact that customers have spent the pandemic months educating themselves online about beauty and skincare. “This has led to a huge shift in attitude—now they are happy to get blood tests and take supplements because they understand the effect of nutrition, stress and hormones on the skin,” says Dr Shetty, who launched her own range of supplements last year. “When patients came back after the lockdown, even their expectations were more refined, like I want my profile to look nicer, or chin a bit sharper,” says Dr Sethi.
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Last year, a young Hyderabad resident flew to Mumbai to visit Dr Shetty for a “barely-there make-up look”, a cosmetic trend that is becoming popular. “I come from a traditional family who only believed in DIYs but since I was getting married last year, I wanted something to enhance my profile,” she says. “With a bit of filler and Botox, I looked perfect in wedding photographs and my family couldn’t figure out that I got anything done.”
Even men want to look good online now, adds Dr Rajan. Revanth Gururaj, a 23-year-old medical coder in Hyderabad, is one of Dr Rajan’s regular patients, lockdown or not. “Earlier, I used to do laser resurfacing for my skin and Botox to increase hair density at her clinic,” he says. Over the past year, he has been able to maintain the results of his treatment with the help of at-home kits and online tutorials. “I have learnt how to do a salicylic peel with the help of Dr Rajan’s videos.”
Patients are now more willing to try new procedures. Dr Shetty says this also holds true for celebrities, who got a much needed break from shoots and events. “During this time, they could work on their face with therapies that required more downtime. Additionally, people are wearing masks and not wearing make-up—both conducive to healing after an invasive procedure” says Dr Sethi.
Khushbu Sharma, 22, who divides her time between Delhi and Jaipur, was in touch with Dr Sethi through the 2020 lockdown—she wanted to look good online. “Towards the end of August, I tried Botox and fillers for jawline enhancement, a gold plasma facial for rejuvenation and pixel perfect for acne scars.”
Such was the increase in demand for fillers that Dr Rajan, a “laser person”, started offering “injectable procedures. We started doing more skin hydration with fillers, because one needs a touch-up once in nine months instead of multiple sessions,” she says, adding that the pandemic has made it essential to pivot.
Dr Gupta is now more comfortable with the new, informed customer and their demands. “Whether the client numbers go up or not, we have to move with the times, even if it means more expenses.”
Vasudha Rai is a beauty journalist and author of Glow: Indian Foods, Recipes And Rituals For Beauty, Inside & Out.