Representation of Skin of Color in Social Media Discussions on Melasma, Keloids, and Vitiligo

July 2024 | Volume 23 | Issue 7 | 510 | Copyright © July 2024


Published online June 18, 2024

doi:10.36849/JDD.7716

Rithi J. Chandy a, Isabella J. Tan b, Michael G. Buontempo b,c, Kristen I. Lo Sicco c, Steven R. Feldman a,d,e,f

aCenter for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC
bHackensack Meridian School of Medicine, Department of Dermatology, Nutley, NJ
cThe Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, NY
dDepartment of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC 
eDepartment of Social Sciences & Health Policy, Wake Forest University School of Medicine, Winston Salem, NC 
fDepartment of Dermatology, University of Southern Denmark, Odense, Denmark 

Abstract
Background: The prevalence of social media as a source of medical information has grown substantially in recent years, especially for skin conditions disproportionately affecting individuals with skin of color, such as melasma, keloids, and vitiligo.
Objective: This study aims to evaluate the nature of content related to these conditions on social media platforms, Instagram and TikTok.
Methods: In March 2023, the top five hashtags for melasma, keloid, and vitiligo were identified on both platforms. For each hashtag, the 10 most popular posts were selected, based on Instagram and TikTok algorithms. A content analysis was conducted, categorizing posts as Educational, Promotional, or Inspirational. Posts were further classified by content creator type.
Results: For the top 50 posts related to melasma on Instagram, the majority were promotional (58%), with the most common source being non-dermatologist social media influencers (50%). Dermatologists were the primary content creators for specific hashtags, such as #Melasma on TikTok, where the content was predominantly educational.
Conclusion: Considering the high prevalence of dermatologist-creator content on TikTok, it is crucial to continue this shift toward dermatologist-driven educational content, as social media platforms continue to grow. These platforms are valuable channels for dermatologists to educate a broader audience, facilitating the dissemination of accurate medical information.

J Drugs Dermatol. 2024;23(7):510-514. doi:10.36849/JDD.7716

INTRODUCTION

Social media is an important source of medical information. Along with the progression of social media, interest in diseases that predominantly affect those with skin of color (SOC), including melasma, keloids, and vitiligo, has also grown. Social media content is produced by authors with different backgrounds and professional expertise.1 Although some of this content is authored by board-certified dermatologists, the vast majority is created by non-physicians, which can have implications on the quality, accuracy, and potential bias of the content.2 This phenomenon can result in the dissemination of false or misleading medical information, which can negatively impact health outcomes.2 As of March 5, 2023, melasma, keloid, and vitiligo content have a combined average of 3.4 million posts on Instagram and 1.1 million likes on TikTok, which reflects a potential susceptibility to the dissemination of inaccurate medical information.3,4

The characteristics of popular melasma, keloid, and vitiligo content on social media platforms, including Instagram and TikTok were evaluated. 

MATERIALS AND METHODS

The 5 most popular melasma, keloid, and vitiligo hashtags on TikTok and Instagram were identified in March 2023. For each hashtag, the top 10 posts were identified; Instagram posts were selected according to the Instagram algorithm and TikTok posts were selected based on view count. Posts that were not in English, unrelated to the diseases of interest, or duplicate posts were excluded. Posts were assigned classifications based on the creator: board-certified dermatologist (D), non-dermatologist physician (ND), non-dermatologist social media influencer (SI), or company (C). A content analysis for each post was conducted by two independent reviewers. Posts were categorized as educational (intended for educational purposes), promotional (promoting a service, brand, or product), or inspirational (posts that were not classified as educational or promotional).

RESULTS

On Instagram, the hashtag #melasma had the highest number of posts with 2.2 million, while the hashtag #vitiligo had the highest average likes at 4,330. On TikTok, #vitiligo had the highest average likes at 655,988, followed by #keloid
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