Portal de Periódicos da CAPES

Keratosis pilaris on TikTok: A cross-sectional analysis of trending content

2022; Elsevier BV; Volume: 8; Linguagem: Inglês

10.1016/j.jdin.2022.06.015

2666-3287

Meghan R. Mansour, Yasmine Abushukur, Geoffrey Potts,

Health Literacy and Information Accessibility

To the Editor: In 2020, TikTok became the most downloaded app globally, reaching over one billion users.1Lyons K. TikTok says it has passed 1 billion users. The Verge. September 27, 2021. Accessed January 9, 2022. https://www.theverge.com/2021/9/27/22696281/tiktok-1-billion-usersGoogle Scholar While the credibility of educational content on TikTok may vary among videos, they can contain valuable information about common dermatologic conditions, including keratosis pilaris (KP), an underrecognized condition usually appearing in childhood and progressing into adolescence.2Pennycook KB, McCready TA In: StatPearls Publishing StatPearls., ed. Keratosis pilaris. July;26:2021.Google Scholar Our purpose was to examine the quality of popular KP content on TikTok and identify areas for improving the delivery of medical information on the app. On December 28, 2021, TikTok was searched for videos containing #keratosispilaris. After screening 132 videos, the top 100 videos generated based on viewership were included in this study, excluding non-English and repetitive videos. The content was assessed by 2 independent reviewers using the DISCERN 16-item questionnaire, previously validated to determine the quality of written health information regarding treatment options.2Pennycook KB, McCready TA In: StatPearls Publishing StatPearls., ed. Keratosis pilaris. July;26:2021.Google Scholar Reviewers evaluate the reliability of published content using a scale of 1 (poor) to 5 (excellent).3Charnock D. Shepperd S. Needham G. Gann R. DISCERN: an instrument for judging the quality of written consumer health information on treatment choices.J Epidemiol Community Health. 1999; 53: 105-111https://doi.org/10.1136/jech.53.2.105Crossref PubMed Scopus (1262) Google Scholar Content creators consisted of physicians (32%), nonphysicians (52%), and private companies (16%); the majority of physician creators were dermatologists (84%). Overall, the videos had a mean DISCERN score of 1.59, with high interrater reliability (Cohen's Kappa > 0.75). Physician creators' videos received the highest DISCERN scores, averaging 1.87; and when stratified by specialty, dermatologists received the highest scores, averaging 1.90. However, internists received the most likes and comments, 260,000 and 2455, respectively. Some creators referred to KP in colloquial terms, including "strawberry" or "chicken" skin (36%), and/or used hashtags containing variations of these phrases (28%) in their videos, although the majority did not (Table I).Table IKeratosis pilaris content on TikTok overviewNumber of videos (n = 100) (%)Mean number of likes (K)Mean number of commentsDISCERN SCOREContent creator Physician32 (32)16316941.87 Nonphysician52 (52)906291.47 Private company16 (16)664651.35Gender Male24 (24)201619961.80 Female59 (59)909441.55 N/A∗If the creator was a private company, gender may not be available.17 (17)5164551.34Physician specialty Dermatology27 (84)15416291.90 Internal medicine4 (13)26024551.88 Family medicine1 (3)264021.85Video type Personal experience9 (9)887941.15 Educational content34 (34)14415431.86 Home remedies28 (28)1177151.51 Treatment advertisement23 (23)745531.43Other6 (6)493361.34#chickenskin #strawberryskin #strawberrylegs #strawberryarms #strawberrybumps Hashtag used28 (28)847791.59 No hashtag used72 (72)120841.57Verbal or written reference to chicken or strawberry skin in video Reference used36 (36)11310261.63 No Reference used64 (64)10268971.55∗ If the creator was a private company, gender may not be available. Open table in a new tab The elevated DISCERN score of physician creators highlights the importance of physician-created educational content to reduce the spread of misinformation on TikTok. To reach a wider audience, popular creators referenced the terms "strawberry" or "chicken" skin in their videos and included hashtags with these colloquial terms. According to the literature, patient education materials are less effective when patients lack adequate health literacy.4Vallabhaneni A. Eskander P.N. Martin K. Eisenstein K. Dyer J. Assessing and optimizing readability of dermatology patient education materials (PEMs).Pediatr Dermatol. 2022; 39: 382-384https://doi.org/10.1111/pde.14901Crossref PubMed Scopus (2) Google Scholar Videos including colloquial hashtags had approximately 9.3 times more comments than videos without them, suggesting that content with these hashtags may appear more approachable and encourage interaction from users. Although videos that did not include these hashtags had a 1.4 times higher average number of likes, this difference was marginal when compared with the difference in the number of comments. Increased engagement indicates that simplified terminology may be used as a tool by physicians to reach a broad audience by improving comprehension. Study limitations include the lack of reproducibility because of its cross-sectional nature, the generalizability of TikTok users to the general population, and the inability to fully encompass self-identified gender expression in a categorical manner. Additionally, the DISCERN score was conceived to assess the quality of writing, not video or educational content.5Gorrepati P.L. Smith G.P. DISCERN scores of YouTube information on eczema treatments.J Am Acad Dermatol. 2021; 85: 1354-1355https://doi.org/10.1016/j.jaad.2020.11.007Abstract Full Text Full Text PDF PubMed Scopus (18) Google Scholar Our data demonstrated elevated engagement with videos including colloquial terms. Hence, we advocate the use of simplified language when promoting educational content on apps such as TikTok. With patient education materials expanding to easily accessible apps, it is important to increase physician awareness of what users are learning and methods to increase the visibility of reliable health videos. None disclosed.