Analysis of TikTok Content on Hyperpigmentation in Skin of Color

Abstract

Postinflammatory hyperpigmentation, which is dark pigmentation that occurs after skin inflammation or injury, disproportionately affects individuals with skin of color (SOC), both more frequently and in severity [1, 2]. In recent years, the skincare industry has seen social media platforms like TikTok become influential hubs for dermatological advice, with users turning to online content creators for advice on managing hyperpigmentation [3]. This trend toward self-treatment is driven by the accessibility of over-the-counter products and the influence of online content creators, with one in five adults consulting TikTok for health solutions before seeing a doctor [4]. However, this rapid dissemination of information raises concerns about the quality, safety, and accuracy of online advice and self-administered treatments [5]. Therefore, in this study, we examine TikTok content related to managing hyperpigmentation in skin of color and assess the quality of this content using the DISCERN scale.

To assess the content landscape on TikTok regarding the management of hyperpigmentation in SOC, the mobile application TikTok was utilized to search for the top 50 videos tagged with “#hyperpigmentation” from March 28, 2024, to May 14, 2024. TikTok videos retrieved were screened by two independent reviewers (MS and LK) for inclusion and exclusion criteria. Videos selected for our study included those that addressed the management of hyperpigmentation in patients with skin of color, created by both health professionals and non-health professional content creators. Videos excluded from the study were those irrelevant to SOC or hyperpigmentation, created solely for entertainment purposes, in languages other than English, or duplicates. After reviewing the videos, demographic data such as creator type, content type, number of views, likes, comments, saves, and shares were collected. The two independent reviewers then assessed the top 50 videos using the DISCERN instrument, a validated questionnaire, consisting of 16 questions, distributed across three sections: reliability, quality, and overall score, to evaluate the quality of health information (Table 1) [6]. Scoring on the DISCERN scale ranges from 1 to 5, with higher scores indicating better quality information [6].

The top 50 TikTok videos tagged with “#hyperpigmentation” had an average DISCERN score of 2.83 (±0.74) and were predominantly produced by non-medical content creators, who accounted for 76% (38/50) of the videos, followed by physician dermatologists at 14% (7/50), and the remaining 10% (5/50) by other types of health professional creators (Table 2). Among the top 50 videos analyzed, 70% (35/50) of the videos were personal experiences from non-medical content creators who shared skincare routines they found effective in reducing hyperpigmentation. These routines featured over-the-counter and homemade facial soaps, moisturizers, and treatments such as hydroquinone, retinol, and niacinamide. Videos by non-medical content creators sharing personal experiences averaged a DISCERN score of 2.56 (±0.44) and received about 1,247,011 views and 1284 shares. In contrast, videos from physician dermatologists, offering expert advice, had an average DISCERN score of 4.02 (±1.02) and received approximately 295,957 views and 265 shares.

This study highlights that TikTok videos on hyperpigmentation management in SOC, made by non-medical creators with lower DISCERN scores, receive more engagement than those by medical professionals with videos with higher DISCERN scores. Although DISCERN is validated for assessing written health information, it is not designed for video content, and currently, there is no validated tool evaluating videos. Therefore, studies with larger sample sizes and alternative validated scoring systems are needed. Overall, the high engagement yet low DISCERN scores of non-medical content creators suggest a need for increased collaboration between medical experts and content creators. Additionally, the strong interest in hyperpigmentation management highlights the demand for treatment options for SOC patients with hyperpigmentation.

M.S., B.S. and L.K. contributed to the design and implementation of the research, analysis of the results and written manuscript. B.R. contributed to the design, implementation and supervision of the project.

The authors have nothing to report.

The authors declare no conflicts of interest.