Dear Editor:
Social media platforms allow physicians and laypeople alike to disseminate information quickly and effectively. Over 80 percent of people seek medical information online and 90 percent of Gen Zs often turn to social media for medical advice.1,2 TikTok is the world’s fastest-growing social media platform with over one billion active users. The application allows users to create short videos that range up to one minute in length. Users that generate video content on the platform are known as creators, and they can respond directly to videos, questions, and comments from other users. TikTok uses an artificial intelligence algorithm that provides a personalized feed called the “For You” page. This individualization prompts users to spend more time consuming content on the platform.3 Some users may view more medical advice-related videos than others. Previous studies have analyzed sponsored content among dermatologists on TikTok and one study in 2020 analyzed top dermatology-related posts on TikTok.4,5 In this study, we sought to understand the credentials, aims, and promotions of creators of the top skincare-related TikTok videos in 2022.
The keywords “skincare” and “black skincare” were queried on TikTok in August 2022. The top 50 posts for each search term and the profiles of the creators of these posts were analyzed. Non-English posts were excluded. Data on the topic and purpose of each post were recorded, as well as the creator’s profession, the number of followers, likes, total posts (between May-July 2022), and sponsored posts. Brand names of each promoted product were also recorded. The Federal Trade Commission guidelines were used to define sponsored posts.6
Three posts were excluded as they contained non-English videos, leaving 97 posts in our analysis. Most of these posts were educational (34%) or opinion-based (20.6%), but only 5 out of 97 videos (5.2%) were posted by board-certified dermatologists. Nearly 63 percent of top videos were posted by bloggers. Bloggers’ posts had 2.4 times more likes than those of board-certified dermatologists (31,113,226 vs. 811,641), in addition to having 1.5 times more followers (12,800,000 vs. 555,540) on average (Table 1). Although these differences were not statistically significant, they are sizable and result in varying levels of engagement. and audience size. Furthermore, only 34 percent of creators in our search listed products as paid promotions, while 74.2 percent unofficially promoted products without naming sponsorship.
TABLE 1.
Characteristics of the top skincare-related posts on TikTok.
| ACCOUNT CHARACTERISTICS | TOTAL (97) | PERCENT | MEAN # TOTAL FOLLOWERS | P-VALUE | MEAN # TOTAL LIKES | P-VALUE |
|---|---|---|---|---|---|---|
| Credentials | – | – | – | 0.85 | – | 0.71 |
| Board-Certified Dermatologist | 5 | 5.2% | 555,540 | – | 12,800,000 | – |
| Physician/Nurse/HCP | 4 | 4.1% | 55,487 | – | 1,236,275 | – |
| Blogger | 61 | 62.9% | 811,641 | – | 31,113,226 | – |
| Esthetician | 12 | 12.4% | 213,672 | – | 2,108,254 | – |
| Entrepreneur | 8 | 8.6% | 329,573 | – | 9,417,262 | – |
| Stylist/Artist | 4 | 4.1% | 262,615 | – | 5,017,750 | – |
| Other | 3 | 3.1% | 66,249 | – | 1,938,400 | – |
| Account Type | – | – | – | 0.56 | – | 0.42 |
| Educational/Demo/Skincare Routine | 33 | 34.0% | 368,614 | – | 8,214,586 | – |
| Marketing | 12 | 12.4% | 1,167,342 | – | 71,324,958 | – |
| Education/Marketing | 15 | 15.5% | 748,421 | – | 20,774,813 | – |
| Patient Story/Testimony | 14 | 14.4% | 108,682 | – | 2,981,071 | – |
| Opinion | 20 | 20.6% | 802,945 | – | 51,337,240 | – |
| Other | 3 | 3.1% | 1,333,127 | – | 32,797,867 | – |
| Promotional Content | – | – | – | 0.65 | – | 0.54 |
| Paid Promotion | 33 | 34.0% | 879,162 | – | 42,054,836 | – |
| Unofficial Promotion | 72 | 74.2% | 509,905 | – | 30,817,291 | – |
| Self-Promotion | 10 | 10.3% | 406,980 | – | 10,109,210 | – |
| None | 14 | 14.4% | 958,582 | – | 10,506,043 | – |
The results of our study coincide with those of a 2020 study by Ngugen, et al. that sought to inform dermatologists to be aware of skincare trends that patients are exposed to online. However, two years later, misinformation and a lack of accredited information on social media are more present than ever. We hope that the results of our study serve to increase patients’ awareness in healthcare decision-making and highlights the need for dermatologists to promote high-quality evidence-based information for skincare on TikTok and other social media platforms. Like it or not, social media is a central place where patients obtain health information, and it is here to stay.
With regard,
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