Influencers, Not Dermatologists, Hold Court on TikTok Skin of Color Subjects

Robert P. Dellavalle, MD, PhD, MSPH

Increasingly popular photo- and video-based social media networks including TikTok have been targeted by dermatologists as an opportune medium to improve skin and hair health awareness and literacy—especially among the networks’ younger demographics.

But new data show it is estheticians and influencers, not board-certified dermatologists, who are leading discussion on matters including skin of color care on these channels.

A new study presented at the American Academy of Dermatology (AAD) 2022 Annual Meeting in Boston this weekend showed non-dermatologists are the primary source of dermatology content to include skin of color-associated hashtags on TikTok. While some dermatologists are active on TikTok, they generally lack the followership and traction seen by non-professionals discussing these subjects to sometimes millions of users.

Led by Robert P. Dellavalle, MD, PhD, MSPH, professor the department of dermatology at University of Colorado Anschutz Medical Campus and a social media editor for the Journal of the American Academy of Dermatology (JAAD), investigators sought to interpret the sources of the most popular skin of color dermatology posts on TikTok.

The team derived 61 skin of color-related TikTok hashtags from multiple sources including the Skin of Color Society, a list of common disorder terms and phrases, and focused social media research into popular skin of color topics. They then examined the popularity of each hashtag by total views on TikTok, along with the source, content and level of engagement accompanying each hashtag’s top-viewed post.

Content was defined as educational, promotional or personal, and engagement was measured by TikTok Likes and Comments. Investigators conducted the final assessment in Septemebr 2021.

The most popular skin of color-related hashtags on TikTok included #IngrownHair (approximately 2 billion views), #HairLoss (1.2 billion views), #Dandruff (875 million views), #Vitiligo (483 million views) and #Hyperpigmentation (251 million views). Adversely, 17 hashtags included no related posts.

The hashtags featured on the highest-viewed available posts included #HidradenitisSuppurativa (75 million views), which featured an esthetician source and personal content. #Follucilitis was featured on the post with the most Likes (722 million) and featured an esthetician source and educational content. #Dandruff featured on the post with the most comments (76,000) and featured an influencer source and personal content.

Just one-fourth (n = 12) of the observed top-view posts featuring the identified skin of color hashtags featured a board-certified dermatologist post; another 9% (n = 4) featured other health care providers. All of the latter posts were educational content.

More than half (53.3%) of all sources behind the top-viewed skin of color-related TikTok posts featured an influencer source. The investigators categorized each of the influencers’ posts as either promotional or personal—not one was defined as educational.

The team concluded that while search-term skin of color subjects regarding hair or pigmentary disorders are popularized on TikTok, many of the most-viewed posts are not strictly related to the clinical subjects of the field.

“Estheticians and bloggers are the source of most (skin of color) dermatology-related content on TikTok,” they wrote. “Herein lies opportunity for more board-certified dermatologists to share evidence-based information with online communities.”

The study, “Skin of Color Dermatology on TikTok: An Analysis of Popular Social Media Content and Sources,” was presented at AAD 2022.