An Analysis of Skin of Color Dermatology Related Content on Instagram

July 2020 | Volume 19 | Issue 7 | Original Article | 746 | Copyright © July 2020


Published online June 12, 2020

doi:10.36849/JDD.2020.5142

Taylor M. Wells BS,a Chandler W. Rundle MD,b* Mindy D. Szeto BS,c* Colby Presley,d Robert P. Dellavalle MD PhD MSPHb,e

aSchool of Medicine, Meharry Medical College, Nashville, TN bDepartment of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, CO cDivision of Biomedical Informatics and Personalized Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO dRocky Vista University College of Osteopathic Medicine, Parker, CO eRocky Mountain VA Health Care System, Department of Dermatology, Aurora, CO *authors provided equal contribution

Abstract
Importance: Social media is making information about skin of color more readily available to those unfamiliar with ethnic skin and hair. Objectives: To answer: 1) what skin of color-related dermatology content is being posted on Instagram? And 2) who is producing this content?
Design: Cross-sectional epidemiologic study analyzing the content of posts associated with 31 Instagram skin of color dermatology-related topics (hashtags).
Setting: Population-based
Participants: The Instagram accounts linked with the top 9 posts as generated by the Instagram algorithm associated with each search term.
Exposures: Instagram account holders.
Main Outcomes and Measures: [1] The number of posts associated with each skin of color dermatology hashtag search term. [2] Classification of posts as either educational or promotional. [3] Classification of posts as a photo or video. [4] Classification of Instagram accounts that produced the posts (American board-certified dermatologists, dermatology residents, foreign dermatologists, patients, medical interest groups, or other). [5] Quantification of the number of post likes and comments. [6] Comparison of number of educational and promotional posts between board-certified dermatologists and other Instagram users.
Results: The 31 sampled hashtags were associated with a total of 9,087,589 posts as of January 16, 2020. 219 of the 288 top posts generated from these queries met inclusion criteria. Board-certified dermatologists (26 posts) only generated 12% of top posts, whereas individuals not certified in dermatology produced 88% of top content. Of this group, social media influencers were the largest subcategory (37 posts). A majority of the top posts were promotional (135 posts, 61.6%) and formatted as photos (181 posts, 82.6%). While there was a significant difference in the number of likes for content posted by board-certified dermatologists vs non-dermatologists (P=0.027), these differences became non-significant after stratifying by the intention of the post (promotional P=0.13, educational P=0.17).
Conclusions and Relevance: Board-certified dermatologists are underrepresented among people generating top skin of color dermatology-related content on Instagram. Board-certified dermatologists should establish a more prominent presence on social media platforms so that patients have greater access to accurate, evidenced-based educational resources regarding dermatologic conditions, treatment options, and treatment risks from reliable sources.

J Drugs Dermatol. 2020;19(7): doi:10.36849/JDD.2020.5142

BACKGROUND

The population of the United States is becoming increasingly more diverse. The most recent US census showed that while non-Hispanic whites currently make up the majority of the population at 198 million, they remain the only segment of the US population in which deaths outpace the number of births. At the same time, other racial and ethnic groups are experiencing population growth.1 In fact, it is projected that by 2050, over half the US population will be individuals of color.

While this rise in diversity has been reflected in many realms of society (eg, television, movies, and print media), there are
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