Acne Misinformation Prevalent Across Social Media and Health Blogs

Cathal O’Connor, PhD

A new investigation into misinformation regarding acne vulgarisidentified key themes including diet and other “causes” of acne, non-conventional “cures”, and a distrust of conventional acne treatments.

Investigators suggested that dermatologists should be aware of the distress caused by acne as well as the surplus of misinformation about the condition to prepare themselves in combatting false information through evidence-based practices.

Young patients affected by acne often seek help online via social media and “influencers”. This practice can leave patients vulnerable to misinformation, a global challenge that has only worsened in recent years.

As such, investigators led by Cathal O’Connor, PhD, Department of Dermatology, South Infirmary at Victoria University Hospital, assessed misinformation regarding acne available online.

O’Connor and colleagues utilized PubMed to conduct a literature search using terms including “acne”, “misinformation”, “disinformation”, and “conspiracy theory”.

The team identified 1024 abstracts that were reviewed for inclusion. Among them, 5 were deemed appropriate for inclusion.

A Google search was also conducted using the same terms from the PubMed search, and additional targeted searches of social media outlets including TikTok, Twitter, Facebook, and Instagram were done.

Key themes found among these searches included the influence of diet on acne and other “causes”, non-conventional “cures” and skepticism regarding conventional treatments.

Regarding diet, common alleged caused of cane included various foods, poor hygiene, systemic infections, and fluoridated water.

Dairy products were often cited as “causes” of acne. Despite a “modest increased risk of acne” from higher milk intake, investigators noted that there was no evidence that it caused acne.

The strongest associated between diet and acne, however, was a high glycemic load diet – or high sugar foods- which is believed to increase IGF-1 levels resulting in increased acne flares.

Notably, investigators observed several “miracle cures”- or “cures” with insufficient evidence- including veganism, nutritional supplements, and branded creams. These practices claimed to “rapidly eradicate severe acne refractory to standard therapy”.

Additionally, several conventional therapies such as antibiotics and oral isotretinoin were associated with negative opinions.

On select blogs, systemic infections were considered to cause acne, and more “extreme” blogs stated that a hidden cause of acne was fluoridated water, a claim that investigators noted was lacking any plausible scientific basis.

Furthermore, several veganism support groups claimed that veganism rapidly cleared acne, yet there is no supportive evidence for that claim.

Perhaps most concerningly, “wonder” treatments such as toothpaste, lemon juice, and garlic were said to treat pimples on various blogs, an investigators noted that antibiotic treatments were defined as “pollutants” and “health-ruining”.

A controversial link between depression and treatments such as isotretinoin were also observed, with investigators adding that the development or worsening of depression being very rare.

In their concluding remarks, O’Connor and colleagues suggested that the psychosocial impact of acne on teenagers could result in them being exposed to the misinformation detailed in the study, adding that dermatologists should be more aware of the need for more evidence-based resources.

“Dermatologists should be aware of the large amount of misinformation around acne available online and be prepared to refute and rebut misleading health information,” the team wrote.

The study, "Spotting fake news: a qualitative review of misinformation and conspiracy theories in acne vulgaris," was published online in Clinical and Experimental Dermatology.