Forget artificial intelligence: the technology that’s really shaping the future of dermatology is capturing billions of eyeballs and is generating a tidal wave of misinformation.
TikTok’s influence hung in the background of several sessions at the Australasian College of Dermatologists 58th annual scientific meeting in Melbourne this month.
Whether it’s Kim Kardashian sharing details of her psoriasis journey or famed internet ‘DermDoctor’ Dr Muneeb Shah promoting his skincare brand through US Target stores, patients are consuming thousands of reels of dermatology content prior to setting foot in the consulting room.
They may have also spent hours scrolling through communities dedicated to their individual skin condition, potentially forming opinions about treatment options from the advice of skinfluencers and patient testimonies instead of solid clinical evidence.
It’s an environment which puts the onus on dermatologists to step up and attempt to provide evidence-based information in a sea of emotive images.
“This is where our patients are getting their information, and if we’re not there trying to dilute the misinformation, then we’ve missed the boat,” Mater Hospital Associate Professor Lisa Byrom, who shares evidence-based content online, told the meeting.
Two recently completed Australian analyses have dived deep into the worlds of psoriasis and eczema TikTok, drawing out the major themes and unique personalities of each skin condition in cyberspace.
A review of 100 psoriasis videos with a combined 914 million views found awareness for the condition, its mental health impact and dietary modification.
While the vast majority of content was created by patients and focused on understanding their individual journeys, the group of reels focused on diet and anti-inflammatory claims contained significant misinformation.
This included “this notion that psoriasis stems from the gut, it comes through food and is triggered by stress or panic disorder,” Dr Laxmi Iyengar told the meeting.
“And that spending all day in the sun and swimming all day cures psoriasis, whereas medically endorsed-treatments, such as narrowband UVB therapy, are actually harmful to the skin.”
A similar review of eczema content on TikTok found videos focused on education and catharsis for patients, but also contained a significant volume of incorrect information.
“We took all the videos that purported to give objective information, we analysed them and found almost half of them had misinformation,” Dr Milan van Ammers said when presenting the eczema analysis.
“There’s a lot of focus on alternative therapies, distrust about dermatologists, and we see the topic of topical steroid withdrawal quite frequently.”
Clarifying misinformation with empathy
But there are signs that patients are open to having misinformation corrected, provided it’s done in a specific way.
Managing director of Eczema Support Australia, Melanie Funk, said patients are often frazzled by the volume of information online and can be confused about where to turn.
“Families, as you know, often arrive at your clinics frightened, overwhelmed, sleep deprived and influenced by information that can undermine trust in care,” she said.
Funk presented a retrospective review of content in the Eczema Support Australia closed Facebook group, including 101 posts which were seeking advice about treatment decisions.
The analysis found explicit misinformation about eczema was actually only present in a minority of posts, but what was more prevalent was confusion and or concerns stemming from information consumed elsewhere online.
Two-thirds of the posts required moderator intervention, often including evidence-based information and linking patients to educational resources.
“Once accurate information was introduced, key responses frequently reinforced it,” Ms Funk said.
“What was particularly interesting was that corrective information was also accompanied by empathy, reassurance, and shared lived experience.”
This suggested that correcting patient misconceptions alone was not what mattered, but how the information was delivered in an “emotionally safe environment,” she said.
The challenge for dermatologists, perhaps, is the amount of work that goes into providing these clarifications.
Ms Funk noted the Eczema Support Australia Facebook group did not emerge organically, but required the presence of experienced moderators to communicate directly with patients.
“Much of the work involved preventing misinformation and unsafe advice from gaining traction in the first place. This work is largely unseen, but it’s also essential to maintain safety and accuracy and trust.”