Dermatologists in the digital age: Combating cosmeceutical misinformation through social media

INTRODUCTION

In an era where skincare knowledge is increasingly driven by social media trends, many young dermatologists face a pressing dilemma: Whether or not to actively engage on social media platforms such as Instagram, YouTube, and TikTok through scientifically grounded, bite sized videos to counteract misinformation on cosmeceuticals?^[1]

The average urban patient today has already consulted social media before visiting a dermatology clinic. They arrive with screenshots of influencer-endorsed regimens, multi-step skincare routines involving Vitamin C, retinoids, niacinamide, or peptides, and often, with significant cutaneous damage. While cosmeceuticals have great therapeutic potential, their improper and unsupervised use frequently leads to irritant reactions, barrier dysfunction, steroid acne, and paradoxical pigmentation.^[2] Many everyday consumers still believe that skincare follows a “one-size-fits-all” approach, assuming that any influencer-endorsed product will deliver results regardless of individual skin type or specific dermatological needs.

REVIEW OF LITERATURE

The overwhelming dominance of non-medical personnel in the skin health conversation raises a deeper concern. Influencers, many of whom lack any formal training, often promote products based on sponsorship deals or personal experience rather than evidence. Its primary goal is to generate income for influencers rather than educating the everyday viewers.^[3]

Unfortunately, dermatologists, being the most qualified professionals dealing with skin, are underrepresented in these digital ecosystems.

The COVID-19 pandemic saw a marked increase in social media usage, which initially served as a means of communication and entertainment but gradually evolved into a habitual engagement for many individuals and ultimately took the form of digital marketing.^[4] A significant proportion of the population, particularly adolescents and young adults, started relying on short video reels as their primary source of skincare advice.^[5] These videos are quick, visually engaging, and algorithmically boosted with millions of views. In contrast, our clinical knowledge remains confined to academic journals and the walls of our clinic, largely inaccessible to the general public. The mismatch between what the public consumes and what we as dermatologists communicate has created a vacuum, and in this vacuum, misinformation thrives.^[6]

Almudimeegh et al., conducted a study involving 1,056 participants in Saudi Arabia to assess the influence of social media on public attitudes and behaviors toward cosmetic dermatologic procedures and skincare practices.^[7] The findings revealed that 28.9% of men and 54.4% of women relied on social media for dermatological advice. In addition, 9.4% of men and 19.5% of women sought guidance specifically from beauty influencers or advertisements on social media for skincare and cosmetic dermatology-related information.^[7]

In a separate study by Alamer, et al., involving 1,174 female participants in Saudi Arabia, 51% reported becoming familiar with skincare products through social media platforms.^[8] When asked about their sources of information, 33.2% cited dermatologists, while 20.1% identified social media influencers. Notably, 95.4% of participants expressed trust in the information obtained from these sources, and 91.3% indicated that the visual presentation of cosmetic and skincare products significantly influenced their confidence in the information presented.^[8]

This presents a compelling case for dermatologists to reassess their role and presence on social media. While the idea of physicians creating reels may appear juvenile and incompatible with medical professionalism at first glance, it is not the medium that matters, but the message. Bhutani et al., reported that in a cross-sectional study among 265 adults, although 66% of individuals believed that physicians held the greatest authority in making skincare recommendations, there was a notable discrepancy in actual behavior.^[9] Only 35% of respondents stated that they consulted healthcare professionals for skincare advice, while 28% indicated that the media was their primary source of information.^[9] Therefore, effectively communicating the benefits and limitations of cosmeceutical ingredients on such platforms is essential to ensure that the public gains a basic understanding of what to use, when to use it, and how to use it safely.^[6,10] It is of paramount importance to clarify which molecules are appropriate for over-the-counter use versus which ones warrant professional supervision.^[11] An emphasis on the variability in individual skin types highlights the importance of a tailored regimen guided by an expert. Hence, when a dermatologist condenses evidence-based information on the safe and effective use of cosmeceuticals into a 1-minute video, it should not be viewed as a dilution of scientific integrity, but a strategic translation of knowledge. The target should always be patient education and combating misinformation, and not to replace an in-person consultation with a qualified dermatologist.

DISCUSSION

The perception that cosmeceuticals are inherently safe often leads to their unsupervised use, despite the potential for significant adverse effects. Common active ingredients such as retinoids, alpha-hydroxy acids (e.g., glycolic acid and lactic acid), and Vitamin C derivatives can induce irritant or allergic contact dermatitis, photosensitivity, and exacerbation of pre-existing dermatoses when used without appropriate guidance.^[12-14] The need for gradual initiation, photoprotection, buffering strategies, and compatibility with other topical agents is unknown to the daily consumers. The growing trend of incorporating nanoparticles, low pH acids, and unregulated actives into cosmetic formulations raises additional concerns regarding long-term skin barrier integrity.^[15]

There are some agents, such as retinoids, which are contraindicated during pregnancy and lactation due to their potential teratogenicity and systemic absorption.^[16] This information is usually missed on the product labels, with minimal disclosure regarding the concentration of the molecule, pH, safety profile, or suitability in special populations. Some common cosmeceuticals and their risks when misused are shown in Table 1.

Thus, patient counseling in a traditional manner is no longer sufficient in an age where a single scroll on the screen can change consumer behavior overnight. There are, of course, legitimate concerns. The medical community worries that such engagement may result in professional branding and erode professional boundaries. While social media offers an opportunity for dermatologists to educate the public, it is important to note that sharing detailed treatment regimens and naming prescription-only medications in the videos may lead to self-diagnosis, inappropriate use of potent drugs, and neglect of individualized clinical evaluation. This not only raises ethical and medico-legal concerns but also blurs the line between public health education and unauthorized medical advice.^[17] These concerns highlight the need for well-defined ethical standards and a commitment to academic integrity when dermatologists engage with social media platforms.

Not every dermatologist does not specializes in everything; some have expertise in lasers or dermatosurgery, others are more fluent in clinical dermatology. Similarly, there is a need for a cohort that specializes in digital dermatology advocacy, professionals who are trained not only in clinical science but also in effective science communication. The curriculum followed in the institutions or perhaps the dermatology societies can support this by providing media training, communication toolkits, and encouraging ethically responsible content creation.

It is important to understand that the primary focus is solely on the responsible dissemination of cosmeceutical-related information through social media and does not extend to the promotion or discussion of prescription-based therapies. The burden of misinformation is disproportionately higher, and dermatologists must actively participate in shaping public understanding of skin health, or we risk ceding this space entirely to non-experts.

CONCLUSION

The question is no longer whether dermatologists should be on social media, but how we can do so effectively, ethically, and impactfully because digital engagement is not a vanity project; it is an urgent extension of our professional duty. Just as the field adapted to teledermatology during the COVID-19 pandemic, embracing digital platforms may represent the next evolution in patient-centered dermatologic care.