PracticalDermatology

Social media is rapidly becoming a major avenue of health information for the public, reaching millions of people around the world.¹ Over 34 million Instagram posts currently use the hashtag “skin”, and 72% of adults report using at least one social media platform, averaging 2 hours of daily usage.² The majority of skincare influencers lack dermatologic training and can spread misinformation about non-evidence-based skincare trends, a risky setup for followers trying trends without knowing the potential impact on their skin.^3,4 Dermatology providers should be aware of social media skincare trends to address misinformation in the clinic and online, improve patient communication, and provide qualified advice.

The hashtags “skincare”, “skincare tips”, and “skin” were queried on TikTok and Instagram. The first 100 posts in English for each hashtag were analyzed. Duplicates, sponsored posts/advertisements, and posts unrelated to dermatology were excluded. Trends were defined as recently emerging over-the-counter products or procedures distinct from established medical dermatologic recommendations. The most frequently mentioned trends were identified, researched in the literature, and reviewed by a board-certified dermatologist. Below are the top 5 trends.

LED light therapy masks

LED therapy includes red and blue light, with different colors of light stimulating different layers of the skin. Reported benefits include reversal of skin aging signs as well as improvement in skin texture.^5,6 Photobiomodulation therapy can potentially deliver positive results from home, though this comes with a costly price tag - up to $1000.

Double-board-certified dermatologist and pediatric dermatologist, Dr. Krystal Massey (@drkrystalmd on Instagram), notes that some studies show a benefit, but with real world use this is likely minimal. “The major caveat here is these are controlled studies where patients are monitored to actually use the device daily during the study,” Dr. Massey notes, “We know actual practice at home ends up being much less compliant.” Furthermore, devices such as these have minimal FDA oversight, raising concern for high variability in quality. Given this and the high cost, these devices are likely not worth the money. “Patients are much better off spending their money on proven, effective in office treatments with board certified dermatologists,” Dr. Massey states.

Pimple Patches

Pimple patches are targeted spot treatments that are easy to apply and are worn for extended periods of time to assist with healing active pimples. Hydrocolloid, the gel in pimple patches, is frequently used in wound care and absorbs exudate from existing pimples, but is ineffective on comedones or in preventing acne.⁷ Pimple patches also provide a moist healing environment protecting the pimple from further trauma such as picking. Dr. Massey encourages patients to use these, especially those who struggle with picking pimples and acne scars.

Facial Massaging

Facial manipulation techniques include Gua Sha, jade rolling, and ice rolling. Jade rolling and Gua Sha have shown potential to improve lymphatic drainage and vascular reactivity,^8,9 The long-term evidence for ice rolling is still unclear, though cold temperatures are known to increase vasoconstriction and reduce skin puffiness. Users should exercise caution, as prolonged ice contact can cause burns, and excessive use of force with devices can be traumatic and induce bruising.

“I don’t think this is something you do for ‘results’, I think you do it because it makes you feel good,” says Dr. Massey, “It can be relaxing and stimulating, and afterward can leave you feeling rejuvenated because you took the time to rest and take care of yourself.” As long as it doesn’t cause harm or stress, this practice can be part of a self-care routine.

Snail Mucin

Korean skincare is a growing global sensation, largely due to its use of less traditional natural ingredients. Snail mucin in particular is commonly used, and its origins are in fact centuries old.¹⁰ This substance contains ingredients such as growth factors, antioxidants, hyaluronic acid, lactic acid, and glycoproteins.¹¹ Studies suggest its ability to improve skin texture, histological signs of photoaging, and wound healing.¹² However, large scale clinical trials on snail mucin are currently lacking.

The texture may be off-putting to users; “I am not opposed and have used it myself… I couldn’t get past the slimy texture,” admitted Dr. Massey, “but there is decent data to support its effects in wound healing and radiation dermatitis in particular… It can be helpful for those with sensitive skin.”

Dermaplaning

Dermaplaning, or face shaving, involves shaving the upper epidermis with a sharp blade. Initially described in the 1970’s as an acne vulgaris treatment, theoretically it reduces the appearance of scars.¹³ However, there is a paucity of data regarding its efficacy. On social media, individuals self-perform this procedure, touting smoother skin, improved application of make-up, and enhanced permeation of skincare products. An in-vitro study demonstrated increased topical drug permeability with dermaplaning, however these results varied with user and hydrophilicity of the drug.¹⁴

“While there are many—including dermatologists—who love dermaplaning, personally, I am not a fan,” says Dr. Massey, “Physically removing the stratum corneum and all vellus hair from the face removes many good protective barrier qualities of your skin (think moisture barrier, protective barrier, etc).” Individuals should be counseled on risk of infection, scarring, and skin discoloration. “You would definitely want to avoid this practice if you have active acne, as bacteria and yeast can spread,” counsels Dr. Massey. “My alternative preference is gentle, medicated chemical exfoliation with acids and retinoids.” She notes that dermaplaning can also be very drying and irritating for those with eczema or sensitive skin, however, those with mature sun damaged skin or significant acne scarring could benefit from this practice.

Overall, those perusing social media for skincare advice should be cognizant of the quality of their sources and seek reliable advice from dermatologists online or in clinic. Certain trends may be relatively harmless, but others can cause significant health risks if undertaken without background knowledge. Literacy in skincare trends on social media is recommended for dermatologists to be aware of what the public is exposed to online and provide evidence-based recommendations to patients.

The authors report no relevant financial relationships.

Fabiola M. Moreno Echevarria, BS, is a medical student at Northwestern University Feinberg School of Medicine.  Andrea Cespedes Zablah, BA, is a medical student at the University of Illinois College of Medicine. Andrea M. Rustad, MD, is a dermatologist at the University of Wisconsin School of Medicine and Public Health.

References

1. Ranpariya V., Chu B., Fathy R., Lipoff J.B. Dermatology without dermatologists? Analyzing Instagram influencers with dermatology-related hashtags. J Am Acad Dermatol. 2020;83(6):1840–1842. doi: 10.1016/j.jaad.2020.05.039.

2. de Vere Hunt I, Linos E. Social Media for Public Health: Framework for Social Media-Based Public Health Campaigns. J Med Internet Res. 2022 Dec 14;24(12):e42179. doi: 10.2196/42179. PMID: 36515995; PMCID: PMC9798262.

3. Szeto M.D., Mamo A., Afrin A., Militello M., Barber C. Social media in dermatology and an overview of popular social media platforms. Curr Dermatol Rep. 2021;10(4):97–104. doi: 10.1007/s13671-021-00343-4.

4. Trepanowski N, Grant-Kels JM. Social media dermatologic advice: Dermatology without dermatologists. JAAD Int. 2023 May 26;12:101-102. doi: 10.1016/j.jdin.2023.05.004. PMID: 37404249; PMCID: PMC10315776.

5. Couturaud, V., Le Fur, M., Pelletier, M., & Granotier, F. (2023). Reverse skin aging signs by red light photobiomodulation. Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging (ISSI), 29(7), e13391. https://doi.org/10.1111/srt.13391

6. Mineroff, J., Austin, E., Feit, E., Ho, A., Lowe, B., Marson, J., Mojeski, J., Wechter, T., Nguyen, J. K., & Jagdeo, J. (2023). Male facial rejuvenation using a combination 633, 830, and 1072 nm LED face mask. Archives of dermatological research, 315(9), 2605–2611. https://doi.org/10.1007/s00403-023-02663-w

7. Cleveland Clinic. (2024, April 30). Do pimple patches actually work? https://health.clevelandclinic.org/how-do-pimple-patches-work

8. Miyaji, A., Sugimori, K., & Hayashi, N. (2018). Short- and long-term effects of using a facial massage roller on facial skin blood flow and vascular reactivity. Complementary therapies in medicine, 41, 271–276. https://doi.org/10.1016/j.ctim.2018.09.009

9. Hamp, A., Anderson, J., Laughter, M. R., Anderson, J. B., Presley, C. L., Rundle, C. W., & Dellavalle, R. P. (2023). Gua-sha, Jade Roller, and Facial Massage: Are there benefits within dermatology?. Journal of cosmetic dermatology, 22(2), 700–703. https://doi.org/10.1111/jocd.15421

10. Liu L, Sood A, Steinweg S. Snails and Skin Care—An Uncovered Combination. JAMA Dermatol. 2017;153(7):650. doi:10.1001/jamadermatol.2017.1383

11. Singh N, Brown AN, Gold MH. Snail extract for skin: A review of uses, projections,         and limitations. J Cosmet Dermatol. 2024 Apr;23(4):1113-1121. doi: 10.1111/jocd.16269. Epub 2024 Mar 1. PMID: 38429932.

12. Nguyen JK, Masub N, Jagdeo J. Bioactive ingredients in Korean cosmeceuticals: Trends and research evidence. J Cosmet Dermatol. 2020 Jul;19(7):1555-1569. doi: 10.1111/jocd.13344. Epub 2020 Feb 26. PMID: 32100931.

13.Pryor L, Gordon CR, Swanson EW, Reish RG, Horton-Beeman K, Cohen SR. Dermaplaning, topical oxygen, and photodynamic therapy: a systematic review of the literature. Aesthetic Plast Surg. 2011 Dec;35(6):1151-9. doi: 10.1007/s00266-011-9730-z. Epub 2011 May 2. PMID: 21533984.

14. Tijani AO, Frempong D, Kaur J, Sergent S, Shaw K, Lessaint R, Al Shawi M, Verana G, Puri A. Dermaplaning for Transdermal Drug Permeation Enhancement: A Qualitative and Quantitative Assessment. AAPS PharmSciTech. 2023 Feb 1;24(2):54. doi: 10.1208/s12249-023-02505-y. PMID: 36725790.