There's room for more derms on TikTok
Less than one-quarter of educational videos on Black skin come from board-certified dermatologists (1,400 words, 7 minutes)
The public is turning to social media for health information. Still, according to a recent study, less than 25% of the posts on TikTok related to Black skin were likely created by board-certified dermatologists.
These findings were published in the Journal of Drugs in Dermatology.
“The role of social media in patient education cannot be overlooked; 80 per cent of internet users in the United States have searched online for health information,” the authors write. A recent study by dermatologist Dr. Camila Villa-Ruiz of Harvard Medical School and co-authors found that educational videos dominate the content of top dermatologic videos on TikTok.
The Villa-Ruiz study also found that most of the videos were posted by patients—almost twice as many as by board-certified dermatologists.
The authors of the new study sought to examine if these results on TikTok content would differ when the search is adjusted to hashtags specific to Black skin.
“Additionally, such results would provide board-certified dermatologists with insight into the specific skin concerns for which Black patients seek educational content on social media.”
On Oct. 12, 2021, a researcher searched TikTok using the hashtags #BlackSkinCare, #BlackSkinTreatment, #BlackSkinAdvice, and #BlackSkinCareTips.
“#SkinOfColor was not searched as this term is used almost exclusively by dermatologists and could skew the results,” the authors write.
Two hundred videos were obtained and classified regarding their content, and the skin concern and creator were recorded.
Among their findings:
Most of the videos were of educational content (57.1%)
The second-most common topic was personal experiences (23.2%)
Clinical demonstrations/live procedures were third-most common (9.6%)
54.5% of posts were about general skin care
22.7% of posts addressed dark spots
12.1% were related to acne
54% of videos were posted by vloggers or personal accounts
Board-certified dermatologists posted 18.7%
Estheticians posted 16.2%
8.6% were from business or industry
“These findings suggest that there is an opportunity for dermatologists to increase educational content relating to Black skin on TikTok,” they conclude.
Bottom line: The public is searching for health information, including on dermatology in skin of colour, on TikTok. Much of the information on the site on these topics is not provided by dermatologists, suggesting an opportunity for public education.
From the literature on skin of colour education and social media
Skin of colour dermatology representation in American College of Mohs Surgery educational cases on Instagram: Content analysis
The authors of this paper note that the American College of Mohs Surgery (ACMS) provides educational information for patients, students, and dermatologic surgeons through its Instagram page @mohs.college.
This study assessed the representation of skin of colour (SOC) in the “Flap Friday” content on the Instagram page.
The researchers used a four-tone skin scale to categorize photos, rather than the Fitzpatrick scale, as the latter scale is used primarily to measure sun sensitivity rather than pigmentary phenotypic appearance.
For the study, investigators analyzed 93 “Flap Friday” cases out of 114 weeks (July 2020 to Sept. 2022).
They found that 83.9% (78/93) were considered to be of light skin tones, and 16.1% (15/93) were considered fair. None of the cases depicted medium or dark skin tones, although the proportions of fair (darker) skin tones were observed to increase every year to 25.9% (7/27) in 2022 from 14.3% (3/21) in 2020.
Using a medical student app to promote a better representation of skin of colour in undergraduate education
This paper discusses the history of the British Association of Dermatologists’ medical student app and some of the identified limitations of medical education related to dermatology in skin of colour.
The authors note the under-representation of skin of colour in primary medical texts will lead to students connecting diagnosis with a one-dimensional presentation and, in turn, hesitation in diagnosing skin diseases in darker skin tones.
Also detailed are updates that have been made to the app to include a more significant proportion of images of darker skin tones and contrasting images to assist in illustrating cutaneous diseases that present significantly differently in lighter and darker skin tones.
Exploration of skin of colour dermatology content on YouTube
Researchers worked to identify and analyze skin of colour-related dermatology content found on YouTube, characterizing the content creators and comparing content from board-certified dermatologists to content created by other YouTubers.
The investigators searched YouTube using 23 dermatology terms and analyzed the top nine relevant videos for each search term. Each video was also labelled as being promotional or educational.
Dandruff was the most popular search term, while the least popular search terms were dermatosis papulose nigra, eczema, and central centrifugal cicatricial alopecia.
Of the 207 videos analyzed, most video profiles consisted of medical interest groups (77, 37.2%), whereas most video subjects were board-certified dermatologists (50, 24.2%).
The least common video profiles belonged to patients (two, 1%), and the least common video subjects were news media (two, 1%). When comparing board-certified dermatologists to all other classifications of content creators, there was a significant difference in views, comments, and likes. There was a similar trend when comparing all physicians to all other content creators. Physicians were significantly less likely to include promotional content in their videos when compared to other content creators.
Colourism attitudes and use of skin-lightening agents in the United States
Researchers examined skin lightening habits, including general lightening and lightening for treating a skin condition, among skin of colour individuals in the United States and the role of colourism in motivating these behaviours.
A total of 455 participants completed a survey administered through ResearchMatch, an online U.S. national health registry.
Ninety-seven participants (21.3%) reported using skin-lightening agents: 73.2% (71/97) used skin-lightening agents for the treatment of a skin condition, and 26.8% (26/97) used the products for general skin lightening. Only 22.6% (22/97) of skin-lightening users consulted a medical provider before using the products. Forty-four participants (45.4%) were unaware of their skin-lightening product ingredients, and 35.1% (34/97) reported using hydroquinone-based products. Composite colourism scores were significantly higher in skin-lightening users than non-users (20.03 vs 18.20; p<0.001).
In the paper, the authors note these findings may be partly attributable to the colourism ideals that continue to be propagated in popular culture, social media, and institutions in the U.S.
VIDEO: Aesthetics for Skin of Colour
Fayetteville, N.C.-based physician Dr. Judith Borger speaks with Dr. Degha Fongod, founder of Delight Medical & Aesthetics in McLean, Va., about the best aesthetic treatments for skin of colour and how practices can be inclusive in their marketing and social media representation.
At the intersection of skin and society
The Ottawa Hospital has opened a dedicated skin of colour dermatology clinic to better serve the needs of patients with darker skin types, reports The Ottawa Citizen.
Quoted in the article, Dr. Reetesh Bose, a dermatologist at The Ottawa Hospital, said he founded the clinic to address some of the inequities he saw in the field of dermatology and provide better care for racialized patients.
“Throughout my medical training, it became clear that there was an underrepresentation of diverse skin types in dermatology, with very few images in textbooks showing conditions in dark skin,” he said.
“Skin conditions can present differently in darker skin types, and they can be tougher to diagnose. And so, what happens is there can be delays in diagnosis, and more severe disease when they’re finally seen by a dermatologist, and it can affect the outcomes of treatment.”
According to the news outlet, the hospital’s new specialty clinic features dermatologists trained in diagnosing and treating people with darker skin. It is also a research and professional development centre.
The article cites Canadian 2021 census data that shows roughly one-third of Ottawa’s population identify as visible minorities, up from 26% in 2016.
This new clinic operates one morning a week at The Ottawa Hospital’s Civic campus. Patients can be referred to the clinic by a physician or nurse practitioner, the Citizen reports.
This week
August is National Water Quality Month in the U.S.
Aug. 18 is Men’s Grooming Day in the U.S.
Aug. 19 is World Humanitarian Day
Something to think about in the week ahead. . .
Michael Korda, English novelist 1933-
Next week
Dermatologist Laura Ferris, M.D., Ph.D., professor of dermatology at the University of Pittsburgh School of Medicine in Pittsburgh, Pa., talks about research findings suggesting increased skin cancer screening in individuals with skin of colour is insufficient to address racial disparities in melanoma survival rates.
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An essay from Dr. Chaocheng (Harry) Liu (Vancouver) submitted to the 2022 Dermatology Industry Taskforce on Inclusion, Diversity and Equity (DiTiDE) short essay contest. Dr. Liu gave his perspective as a resident on dermatology education on skin of colour in Canada.
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