Dr. Elaine Kung never sought to be “TikTok famous.” Instead, the board-certified dermatologist’s foray into social media began when a patient came to her with an itchy scalp ― a simple enough complaint. Because the patient was a regular, Kung knew her common skin concerns. But that day, something wasn’t normal. The woman’s entire scalp and hair were oily, and pimples covered her face.
“I looked at her, and I’m like, ‘What’s going on?’” Kung said.
The patient told Kung about a recent change to her skin care routine. She’d heard that washing her hair every day wasn’t good for the scalp or hair, and that instead, she should use olive oil. She’d gotten the advice from a TikTok influencer.
“I said, ‘That’s why you’re itching,’” Kung recalled. “You’re not washing sweat, hair grease and air pollutants away. You’re trapping all of that in with olive oil. And the olive oil is getting on your face, and you’re getting pimples.”
Kung’s medical assistant asked the patient about the influencer. Who was this person? What did they base these claims upon? Did they have any medical background? Any experience in the skin care industry?
“And the young woman said, ‘No ... but she has a million followers on TikTok!’”
Scenarios like this are becoming more and more common. Patients are taking skin care advice not from professionals or people with expertise, but from popular social media creators on their screens.
How social media encourages influencers to set a bad example
Some content creators are able to generate a full-time income from their love of skin care, showing off different products, educating viewers about common ingredients and promoting various brands through sponsorship deals.
“They don’t know the consequences ... They are doing things because they need to go viral. That’s their goal.”
But the boom in skin care information on platforms like Instagram, YouTube and TikTok has proven a double-edged sword for professionals.
“From a medical standpoint, it is great to have patients who have researched treatments and conditions,” said Dr. Beth Goldstein, a board-certified dermatologist and president of the Central Dermatology Center in North Carolina. “But it can take a bit of time to rectify misinformation.” (Below, for example, is a TikTok in which Goldstein debunks the myth that sunscreen causes cancer.)
Sometimes misinformation is unintentionally communicated to users because of the visual nature of video.
“When you look at these influencers, and they are demonstrating product use, they’re pumping and pumping and pumping, so you see big globs of cream or big globs of cleanser,” Kung explained. “Your face is just like the size of your hand ... You don’t have to pump so much.”
But a tiny amount of moisturizer doesn’t show up as well on camera, which is bad for influencers. Their main objective is to make their videos as visually pleasing as possible to capture viewers’ attention.
The vast number of products showcased and sponsored on influencers’ channels, reels and pages can also encourage viewers to buy more products than they truly need.
“I’ve had some people tell me that they had never used so many skin products in their life, but their skin is not getting better,” Kung said.
She recalls one patient who had six steps in both her morning and nightly skin care routines in an effort to use up all the products she’d bought on the recommendation of influencers. “So now she has a bunch of stuff that she feels obligated to use and not waste. She even astutely recognized that ‘sometimes if I skip a step, it doesn’t mean that my skin got any worse.’”
However, other times, misinformation can take the form of dangerous fads ― like “SPF contouring” and self-administered injectable trends.
“These influencers, they don’t have a medical background,” said Mina-Jacqueline Au, an esthetician and founder and CEO of Vivre SkinLabs. “They don’t know the consequences ... They are doing things because they need to go viral. That’s their goal.”
‘How do you teach in two to four seconds?’
To combat misinformation, many skin care professionals have had to hire social media managers to broadcast the facts on their own accounts. And that’s not exactly the best use of their time.
“It is a call for us to continue to be on social media platforms in inefficient ways and in significant numbers to educate, help dispel myths and misinformation,” Goldstein said. (Below is a video where Kung talks about at-home microneedling rollers and why they’re a bad idea.)
Many skin care professionals find themselves in an uphill battle. Even social media influencers struggle to learn the platforms’ ever-changing algorithms and get attention from followers, and that’s their full-time job. So for dermatologists and estheticians, particularly those in smaller practices who cannot afford social media managers, combating misinformation online isn’t something they have time for.
“Any 15- to 30-second video I do is actually two hours of work,” Kung said. “Not only to record and edit ― I have to caption [the videos] and post on three platforms.”
“Sometimes it’s kind of sad,” she said. “I do all this work, but I only have, like, 2,000-something followers on Instagram and 8,000-something followers on TikTok. That is so small compared to having a reach of 1 million people. The problem is, we’re not professional entertainers or info-tainers. Most of the people who watch my videos don’t watch for more than two to four seconds. So how do you teach in two to four seconds?”
Question everything you see on TikTok
With entertaining visuals, an inviting “best friend” personality and accessibility from the comfort of your phone, it’s easy to see why social media influencers have such an outsize voice when it comes to skin care. Platform algorithms can curate feeds that reinforce the same information repeatedly, leading to the spread of even more misinformation.
“I encourage people to look also at information from multiple sources that don’t necessarily come across your social media platform of choice,” Goldstein said. “Look as best you can for credibility in the source of any information.”
Skin care experts also urge people to use their critical thinking skills. Evaluate who is making the claim, and what their intentions may be. When in doubt, check in with a specialist.
“We are the people that not only know more about skin, but also the consequences of not doing the right thing,” Au said. ”At the end of the day, we always ask ourselves, what is the end goal? And none of these [influencers’] end goals are for the health of your skin.”