This post is for a dermatology clinic, or the agency that runs its Instagram account, that has heard "Instagram is now searchable on Google" and wants to know where to put the words. A Reel carries text in at least four places: the caption, the alt text, the words burned into the video, and the spoken audio. Advice online treats them as one bucket called "keywords". They are not one bucket, and they are probably read by different systems.
The honest answer to "what does search actually read" is that Instagram has not published a field-by-field list. What exists is a public change in how professional accounts are exposed to search engines, Google's general documentation on how it reads images, and a lot of vendor speculation. This article separates what is documented from what must be tested, then gives a 50-query test you can run on your own account over two weeks.
It also keeps the examples inside the rules that now apply to Indian doctors. The clinical content in the examples is educational and illustrative; your dermatologist must review every real caption before it goes live.
What is documented, and what is not
In July 2025, Instagram began allowing public photos, videos and Reels from eligible professional accounts to appear in search engine results. PPC Land's report of the change describes it as applying to public business and creator accounts run by adults, switched on by default, with a privacy setting labelled "Allow public photos and videos to appear in search engine results" to turn it off. If your clinic account is personal, private or has that setting off, none of the rest of this article matters until you fix it.
That report does not say which fields a search engine reads. Treat anything more specific as a hypothesis. Three things are documented elsewhere:
- Instagram's own announcement of alternative text says it generates descriptions automatically with object recognition, lets you write your own, and that screen reader users hear it. Its stated purpose is accessibility.
- Google's image guidance calls alt text the most important attribute for giving an image metadata, says Google uses it alongside computer vision, and warns against stuffing it with keywords. It also says Google learns about an image from the text on the page around it.
- Neither source says that Google reads Instagram alt text, or that Instagram search ranks on spoken words. Those are the claims you will see repeated, and they are the ones to test.
The four text surfaces
Caption. The caption is visible text on the post page, so it is the field most likely to be crawled and quoted in a search snippet. Its first line behaves like a title: it is what a person sees before expanding the rest. Write it as a plain statement of the topic, not a teaser.
Alt text. Custom alt text is written for a person who cannot see the image. Its job is to describe what is in the frame. For a clinic, that is also the discipline that stops it being used as a hidden keyword field. If you do not write any, Instagram supplies an automatic description of objects, which for a dermatology diagram may be unhelpful.
On-screen text. Words burned into a Reel are pixels, not text, unless a system runs optical character recognition over frames. Some do. You should not rely on it, and you should never put on-screen text in a Reel that is not also in the caption.
Spoken audio. Platforms transcribe audio to generate automatic captions, and a transcript could in principle be used for retrieval. Whether Instagram search or Google uses it is exactly what a test should answer. Say the main term clearly early in the clip because it helps a viewer in any case.
Dermatology examples that stay NMC-safe
The Ethics and Medical Registration Board of the NMC issued guidelines on ethical advertising on 6 October 2026. Medical Dialogues' summary reports that they bar before-and-after photographs, advertising of surgical results, success rates and patient counts, guarantees, and unverifiable superlatives such as "best" or "No.1", and that using an agency or influencer does not move the responsibility away from the doctor. Read the notice itself on the NMC site before you finalise your own rules; our NMC compliance handbook and NMC guidelines page track the detail.
For skin content, that points towards education. Here is how one hypothetical post could be written across the four fields.
- Caption first line: "Sunscreen and darker Indian skin: what SPF and PA ratings mean."
- Caption body: Two or three plain sentences, an invitation to read the full guide on the clinic website, and a line saying the information is general and not a diagnosis.
- Alt text: "Infographic showing the difference between SPF, which relates to UVB, and the PA rating, which relates to UVA, with a sunscreen label annotated."
- On-screen text: The same two terms, short.
- Spoken line: "This is a short explainer on how to read a sunscreen label."
The clinical statements in that infographic need your dermatologist's review. Notice what is absent: no "results", no promise of clearer skin, no named brand claims, no "top skin clinic". Alt text for a diagram describes the diagram. It does not describe an outcome.
The same logic applies to a post on patch testing, on how long an eczema flare-up plan usually needs reviewing, or on what a mole check involves. Each has a topic term a patient might search, an educational purpose, and nothing that a regulator could read as inducement.
