In dermatology, as in other medical specialties, social media has become a platform for patient education, public outreach, and professional development and networking.
A review article published in Dermalogica Sinica sets out to investigate the use of popular social media platforms within dermatology along with the potential benefits and harms of these platforms when used by dermatology providers and their patients.
Dermatology and Facebook
Facebook remains the most popular social media platform worldwide, with over 1.8 billion monthly active users. In the health-care field, Facebook introduces many new opportunities for networking, professional education, and patient education.
In a 2012 study, [1] Amir et al. showed that almost 13% of dermatology journals were present on Facebook and that number has increased to almost 18% in 2017. Professional dermatology organizations have also increased their public and professional engagement through Facebook. Popular professional dermatology organizations with the most likes on Facebook include dermRounds, Dermatology, American Academy of Dermatology, and Associated Skin Care Professionals.
Facebook has also been used as an educational platform with the goal of helping providers to provide the highest-quality care to patients. Groups like DermLife and The Dermapaths, a group specifically for dermatopathologists, promote this goal. Another group, The Dermatologists, focuses on providers helping one another with particularly difficult cases.
The communication capabilities of Facebook are also used to improve medical education. In dermatology, reports describe the benefit of visually-oriented social media platforms, such as Facebook for use in medical student education.[2] Moreover, Facebook has found an avenue to enhance patient education and in some cases, patient care. There has been an increase in the number of dermatology journals and patient-centered groups that use Facebook to help educate the public. One study assessing public engagement using Facebook found online educational posts most effective.[3]
Dermatology and YouTube
YouTube is the second-most popular website in the world, hosting over 30 billion monthly users with an average viewing session of 40 min. The presence of dermatology on YouTube is increasing, with most of its content being educational or advocacy. One dermatologist, Dr. Sandra Lee (aka Dr. Pimple Popper), uses YouTube to post educational videos and interact with her audience of more than 5 million subscribers. This increase in availability of dermatologic information on YouTube demonstrates an opportunity for HCPs to inform the public about popular dermatologic topics.
Dermatology and Instagram
Instagram is a popular photo and video sharing media platform among teens and young adults. Instagram “hashtags” allow users to search for and identify content related to a specific topic. In one study, researchers showed that the top three dermatology-related “hashtags” included #acne, #alopecia, and #eczema.[4] Physicians of all medical specialties including dermatologists have created Instagram profiles that allow their followers to see before and after procedure photos, patient education material, and advertisements for cosmetic lines and in-office promotions. In the academic environment, Instagram is used to connect and inform students of events, announce services, and provide public education; however, this tool is underutilized in dermatology. One study found that 7% of dermatology departments have an Instagram profile.[5] A recent study found that 5% of dermatologic focused Instagram posts were made by a board-certified dermatologist.[6]
Dermatology and Twitter
In dermatology, Twitter has become a popular platform for users to communicate dermatologic concerns. One study shows that almost 85,000 tweets over a 1-year period communicated personal concerns with skin disease [7] while another study shows that the most common type of re-tweeted tweets (43.1%) are about acne.[8] Furthermore, medical schools have begun using Twitter to increase student engagement. For example, Northwest Ohio Medical University used twitter to post weekly dermatology quizzes and successfully increased student engagement from 23.8% to 55.9%.[9] The authors note, one of the biggest challenges facing Twitter is the dissemination of misperceptions related to dermatologic diseases. With such a large young adult population communicating information through Twitter, there is a significant amount of incorrect information, empirical data, and myths circulating that may influence a patient’s approach to dermatologic concerns.[10]
Dermatology and Reddit
Reddit is a website that allows users to join communities of people with similar interests to share and learn information. There are over 150,000 “subreddits” containing threads of comments pertaining to a particular topic where users are able to comment and communicate with one another. Dermatology has several subreddits with the most common being cosmetic advice, disease identification, and medications. The authors again point out that Reddit presents challenges as it allows members to post responses to medical questions, thus introducing the possibility for the dissemination of inaccurate or dangerous medical advice. But counter this by highlighting Reddit’s opportunity as an entry point for physicians to provide accurate information and dispel false information, promoting knowledge about common dermatologic topics as a public health measure.[11]
Dermatology and Pinterest
Pinterest started in 2009 as a platform designed to share images, GIFS, and videos. Users are able to upload images, “pin” images, and create “boards” (collections of pins). With respect to dermatology, studies show that informative pins, advocacy, and home remedies compose the majority of dermatology related “pins” and “boards.” However, it is important to note that only 24% of these “boards” were created by M.D.s or advocacy organizations.[12]
Dermatology and Snapchat
Snapchat, developed in 2011, is a social media application that allows users to share photos and videos with other users for twenty-four hours. Snapchat’s interface of quick 10-second stories captures the attention of the audience and the story features allow millions of people to view the same story posted by a particular user. For example, Dr. Michael Salzhauer (a plastic surgeon better known as Dr. Snapchat) posts his surgeries live and receives over 700,000 views/day. He uses Snapchat as a tool to educate the public as well as generate new clientele, as over 60% of new patients in his office come from Snapchat and other social media.[13] The potential benefit of social media, specifically Snapchat, is clear in healthcare, but the use of Snapchat in dermatology is lagging behind that of other healthcare fields.
Social Media Opportunities in Dermatology
The study authors believe “there is a great opportunity for health care providers to enhance communities and disseminate information at a greater, more efficient rate, through platform interoperability. Improved interoperability would also allow for greater patient recruitment and social media-based research.”
Each platform is designed to function independently; however, there is a degree of interoperability among platforms, of which there is incredible potential.
An additional opportunity for social media in dermatology is patient recruitment for clinical research.
Considering each clinical study has a target population, social media provides tremendous opportunity to gather a large volume of patients.
Finally, dermatologic based social media communication, research, and outreach has tremendous value from a public health perspective.
Social media is one of the fastest means for the dissemination of information, especially when content goes “viral.” In fact, the dissemination of public health knowledge through social media platforms has demonstrated a positive impact on health outcomes and patient behaviors.
Challenges of Social Media and Healthcare
Among the challenges presented by social media in a healthcare context, the authors point to biased demographics.
The majority of social media users are white women between the ages of 30–49. [14] Therefore, social media-based research must be cognizant of the inherent biases that may be present.
Not surprisingly the authors consider “the most concerning challenge of social media use in healthcare is the spread of unreliable and sometimes incorrect medical information.”
Most authors of medical information on social media platforms have unverified credentials and are generally underqualified. Furthermore, the information put forth on these platforms is often incomplete, unreferenced, and based on personal anecdotes.
While most medical literature is evidence-based, medical information through social media focuses on individual stories and experiences that may not be generalizable to the population at large.[15]
Furthermore, professionalism is an additional, ongoing concern with the increased use of social media platforms. Other challenges of social media use in healthcare are centered on patient privacy and violations between patient-provider interactions. Social media has brought forth new challenges in this respect, specifically HCPs using identifying patient information in public posts. In one study, it was found that 17% of blogs written by HCPs describing individual patients had enough information to identify the patient or the provider.[16]
Conclusion
The authors conclude, these risks aside, the opportunity to promote public health, patient education, and professional interactions is impactful and should not be missed.
With 80% of people searching the Internet for health information, there is an onus on HCPs to maintain a presence on social media wherever possible to dispel misinformation and circulate evidence-based knowledge.
Notes
This is an edited version of the original review which can be accessed in full here.
[1] Amir M, Sampson BP, Endly D, Tamai JM, Henley J, Brewer AC, et al. Social networking sites: Emerging and essential tools for communication in dermatology. JAMA Dermatol 2014;150:56-60.
[2] Enhancing dermatology education with social media platforms: Are we there yet? J Am Acad Dermatol 2018;79:AB129.
[3] Enhancing dermatology education with social media platforms: Are we there yet? J Am Acad Dermatol 2018;79:AB129. Back to cited text no. 12.
[4] Braunberger T, Mounessa J, Rudningen K, Dunnick CA, Dellavalle RP. Global skin diseases on instagram hashtags. Dermatol Online J 2017;23. pii: 13030/qt7sk410j3.
[5] St Claire KM, Rietcheck HR, Patel RR, Dellavalle RP. An assessment of social media usage by dermatology residency programs. Dermatol Online J 2019;25. pii: 13030/qt5v62b42z.
[6] Park JH, Christman MP, Linos E, Rieder EA. Dermatology on instagram: An analysis of hashtags. J Drugs Dermatol 2018;17:482-4.
[7] Sarker A, Magge A, Sharma A. Dermatologic concerns communicated through twitter. Int J Dermatol 2017;56:e162-3
[8] Shive M, Bhatt M, Cantino A, Kvedar J, Jethwani K. Perspectives on acne: What twitter can teach health care providers. JAMA Dermatol 2013;149:621-2.
[9] Kunzler E, Graham J, Mostow E. Motivating medical students by utilizing dermatology-oriented online quizzes. Dermatol Online J 2016;22. pii: 13030/qt0p31j0z8.
[10] DeBord LC, Patel V, Braun TL, Dao H Jr. Social media in dermatology: Clinical relevance, academic value, and trends across platforms. J Dermatolog Treat 2019;30:511-8.
[11] Buntinx-Krieg T, Caravaglio J, Domozych R, Dellavalle RP. Dermatology on reddit: Elucidating trends in dermatologic communications on the world wide web. Dermatol Online J 2017;23. pii: 13030/qt9dr1f7x6
[12] Whitsitt J, Mattis D, Hernandez M, Kollipara R, Dellavalle RP. Dermatology on pinterest. Dermatol Online J 2015;21. pii: 13030/qt7dj4267p
[13] Patel S, Bewley S, Hodson N. Snapchat is not for sharing. BMJ 352 (2016): i1543
[14] Sadah SA, Shahbazi M, Wiley MT, Hristidis V. A study of the demographics of web-based health-related social media users. J Med Internet Res 2015;17:e194.
[15] Pirraglia PA, Kravitz RL. Social media: New opportunities, new ethical concerns. J Gen Intern Med 2013;28:165-6.
[16] Chretien KC, Kind T. Social media and clinical care: Ethical, professional, and social implications. Circulation 2013;127:1413-21
Health Care Social Media 