Acne-Related Social Media Content Lacking in Dermatologist Input

A recent investigation into acne information on the social media platform Instagram found that the vast amount of relevant content was heterogeneous in its message and quality. Additionally, dermatologists were only responsible for a small fraction of acne-related content.

Acne vulgaris is responsible for a significant number of dermatology visits, and though a myriad of effective, evidence-based treatments are available there exist various products for acne marketed on platforms such as Instagram that are either untested or show no benefit in treating the skin condition.

A previous study of YouTube content that videos on the acne-treating medication isotretinoin found that content was heterogeneous in terms of information quality, with most videos ranging from poor to fair.

This prompted investigators led by Suzanne C. Ward, MD, University of California, Irvine, to evaluate the current landscape of skin-related content available on Instagram.

The Methods

The team searched for top posts on the platforms using the hashtag #acne before analyzing them based on their source and content.

Posts were excluded if they did not relate to acne, not in English, or duplicates. By April 2020, a total of 900 posts were assessed and 439 were included.

From there, “like” and “follower” counts were compared with single factor ANOVA applied with the Microsoft Excel data analysis ToolPak.

The Findings

Investigators noted that many of the top acne posts were generated by “influencers”, while dermatologists were only responsible for 17 posts. This accounted for less than 4% of the included content.

Despite dermatologists having a comparable number of followers (P=0.58) to influencers, they had fewer average “likes” per photo, with 250 compared to 764 with a trend toward significance (P=.011).

Additionally, retailers had significantly more followers than other groups (P=0.02).

Additional “providers” observed in the study included Instagram users who used a professional credential to substantiate their recommendations, while the most common other providers offering advice under a professional pretext were aestheticians, nurses, pharmacists, dieticians, and dentists.

Among the posts featured in the study, 232 promoted a commercial product, 82 centered around acne awareness and acceptance, 48 advertised services from a medical or beauty-industry provider, 35 promoted home remedies for acne, 31 recommended behavioral interventions, and 11 addressed the underlying etiology of acne vulgaris.

Nearly half of all posts recommended at least 1 specific intervention, and 124 separate ingredients were proposed as potential acne treatments

Among posts that made a specific recommendation, only 11% referenced a treatment with grade A evidence based on American Academy of Dermatology guidelines. Additionally, most recommendations focused on over the counter treatments.

Ward and colleagues added that further research was needed to determine if patients judged content differently based on its source and if or how exposure to this content leads to changes in behavior or attitudes

“This study showed that the content is heterogeneous in message and quality, and dermatologists are responsible for a tiny fraction of it,” the team wrote. “Thus, there is a need for dermatologists to generate content and to support one another in promoting high-quality evidence-based treatments for acne on Instagram.”

The study, “Acne Information on Instagram: Quality of Content and the Role of Dermatologists on Social Media,” was published online in the Journal of Drugs in Dermatology.