Patients with pigmented skin often face underrepresentation in dermatologic literature, necessitating a concerted effort to bridge this gap. As the demographics of the United States change, it becomes imperative for dermatology clinicians to equip themselves with the knowledge and skills to effectively diagnose and treat patients with skin of color (SoC). A study conducted by Kurt Ashack, MD, board-certified dermatologist in Grand Rapids, Michigan, and 2 medical students at Michigan State University College of Human Medicine, delved into the representation of SoC in educational content on TikTok, a growing social media platform.1
This study involved a TikTok search conducted on July 27th, 2022, using the term #eczema. The initial 136 videos were assessed for inclusion, ultimately yielding 118 suitable for analysis. Two independent researchers utilized DISCERN criteria to rate the videos, achieving high inter-rater reliability (Pearson rho correlation value of 0.912, p<.01). Videos were also assessed for SoC representation based on Fitzpatrick skin types I-VI.
Out of the 118 videos analyzed, a majority (101) were created by non-physicians, while only 17 were produced by physicians, with 14 by dermatologists and 3 by non-dermatologists. Non-physician posts garnered an average DISCERN score of 1.26, while physician posts received a notably higher average score of 2.24 (p < .01). Among the non-physician posts, 30% featured images or videos of patients with SoC, compared to only 5.9% in physician-created content. Strikingly, none of the dermatologist-generated posts featured SoC.
Furthermore, non-physician posts accumulated more than 3 times the number of views compared to those created by physicians. Among physicians, dermatologists demonstrated higher average view counts compared to non-dermatologists (597,357 versus 105,033).
Social media platforms, particularly TikTok, present an opportunity to disseminate educational information and diminish health disparities among patients with SoC. With their accessibility, wide reach, and cost-effectiveness, these platforms are invaluable tools for raising disease awareness and sharing treatment options.
However, there is a clear need for an increase in both the quantity and quality of posts. Despite physician-generated content scoring significantly higher on the DISCERN scale, there remains room for improvement, particularly in categories related to "sources of information" and "areas of differing opinion." Addressing these gaps in educational content on platforms like TikTok can contribute to a more inclusive and informed dermatologic landscape.
1. Ashack K, Abdelnour A, Comeau N. A Cross-Sectional Study on Skin of Color Representation for Atopic Dermatitis Across TikTok.Poster presented at: 19th Annual Skin of Color Scientific Symposium; March 16, 2023; New Orleans, LA.