Social media dermatologic advice: Dermatology without dermatologists

Social media has become a source of dermatologic and treatment information for many laypeople.¹ Apart from regulations on disclosing sponsored content and posting identifiable patient health information, there are minimal regulations on health-related posts on social media.¹ Particularly worrisome, social media influencers can recommend treatments or procedures that are not evidence based, lack efficacy, and may cause harm. Who comprises these dermatology social media influencers? A 2020 study found that health care professionals comprise only 38% of Instagram accounts with popular dermatology content, and board-certified dermatologists account for just 4%.¹ Of these health care professionals, credentials were missing for 27%.¹ Thus, many self-proclaimed social media “skin-care experts” or “skinfluencers” lack qualifications, and the majority of dermatologic advice on social media is provided by nondermatologists.²

Dermatologic advice on social media is prone to misinformation and false claims and often features promotional or advertised content.² Sponsored content may create conflicts of interest, potentially misleading patients.² However, the problem of promotional content is not limited to those outside the health care setting; 87% of health care professionals posting dermatology content on social media featured self-promotional content.¹

Patient health may be compromised because of dermatologic advice received from social media. A study of 199 YouTube videos on topical psoriasis therapies found that the majority discussed natural treatments (55.3%), and only 28.1% discussed therapies with grade A recommendations by the American Academy of Dermatology.³ The popular TikTok social media beauty trend deemed “slugging,” which involves slathering a petrolatum-based ointment on the skin, creates risks of acne, milia, and increased potency of topical medications when layered.⁴

Although the availability of both over-the-counter and prescription treatment regimens for dermatologic conditions creates more options for patients, this may also create confusion. For example, both pharmacies and beauty/cosmetic stores sell acne treatment regimens. Patients may be unaware that dermatologic conditions such as acne are medical conditions with potential consequences (such as scarring, depression, etc) that are treatable in the medical setting. This lack of understanding may encourage patients to turn to nondermatologists for dermatologic advice.

Dermatologic medical advice on social media should come from reliable sources, ie, dermatologists. Social media can be used to quickly disseminate information to a large audience, posing a unique opportunity for dermatologists and dermatology organizations to provide high-quality, evidence-based education to the public and counter misinformation. Dermatologists should be encouraged to use social media platforms for these purposes. However, there are potential ethical concerns of social media marketing by dermatologists; therefore, dermatologists should avoid promoting products on social media in return for compensation.⁵ Because health-related posts on social media can cause potential harm, we advocate for more regulations and oversight.

As social media can be employed to monitor new trends in public health, we also advocate familiarity with social media dermatologic trends so that we can combat misinformation and improve patient health outcomes. If dermatologists are aware that patients may be using social media for dermatologic treatment decisions, we can inquire what social media sites are being employed and recommend reliable, evidence-based online educational sources to patients.

Conflicts of interest

Dr Grant-Kels is a scientific advisory board member at DermaSensor and an investor and Chief Medical Officer at VeraDermics. Neither company has been discussed in this submission. Author Trepanowski has no conflicts of interest to declare.