How Dermatologists Can Ethically Disseminate Skincare Information On Social Media

In 2018, the American Academy of Dermatology Association (AAD), a professional organization of dermatologists with over 20,500 members, issued a position statement on medical professionalism in the use of social media that emphasized dermatologists should maintain patient privacy, suggest reliable sources of information and disclose financial relationships with products or services.

An internal working group at AAD is currently reevaluating the 2018 statement to update it for today’s social media and the roles dermatologists play in it. Asked by Beauty Independent about a social media code of ethics for dermatologists, the AAD responded with the following:

“With more and more patients turning to social media for health care information, it’s become increasingly important for dermatologists to establish a social media presence so they can combat misinformation shared by non-dermatologist influencers and provide a reliable and credible source of information. We encourage members to include their credentials in their social media bio…In addition, we advise discretion when recommending products and accepting paid partnerships with brands. Above all, the AAD aims to empower its members to effectively use their voice on social media as the leading experts in the skin, hair, and nails.”

Dermatology content is full of misinformation. According to a cross-sectional study published in 2021 in the International Journal of Dermatology of 385 pieces of dermatology content shared on social media networks such as Facebook, Pinterest, Twitter and Reddit with key words like “acne,” “skin cancer,” “melanoma” and “rosacea” rated 44.7% as imprecise, 20% as confusing and 35.3% as precise. A study of 100 YouTube videos on psoriasis published in the Journal of Medical Internet Research in 2017 showed 52% were misleading, 11% were dangerous and 20% had evidence-based information.

A 2021 review of the available research to offer medical professional guidance in Current Dermatology Reports instructed, “Dermatologists commonly engage with an online audience through social media marketing or being an influencer to improve business and extend their reach to clients; however, this warrants formal training and the need to monitor their own online presence to prevent legal consequences.”

It continues, “Having a social media presence must be exercised with care, purpose, and transparency to maximize benefits and minimize harmful consequences. This is especially important when inappropriate social media posts by physicians can be scrutinized for breaching patient confidentiality, violating privacy, financial conflicts of interest, and possibly disseminating incorrect information.”

Given the changing landscape of social media, notably the rise of TikTok, where an analysis last year in JMIR Dermatology revealed 40.4% of 94 dermatologists with profiles had sponsored posts, and the continued necessity of dermatologists to act with care, purpose and transparency amid the changes, we were wondering about the best ways for the AAD to revise its position statement on medical professionalism in the use of social media.

So, for the latest edition of our ongoing series posing questions relevant to indie beauty, we asked 15 dermatologists and cosmetic chemists the following question: What’s something a dermatologist code of social media ethics must contain to be relevant now?

Heather Rogers Dermatologist and Founder, Doctor Rogers

To make things clear for consumers, all sponsored posts, where the person, be it a dermatologist or other, is being paid to make a recommendation, not just gifting products because sampling is everywhere, needs to be clearly labeled #AD. All links like ShopMy or ITK need to highlight that payments are going to the influencer/doctor when you buy from their links. I think this form of compensation is here to stay, so we just need it to be transparent about it.

Then, to help with the growing misinformation on social media, Meta needs to support public service announcements labeled as such providing accurate information to their consumers be it about the importance of wearing a helmet, seatbelt or sunscreen.

As you know, endorsements have been around for a long time—the Austin Martin driven in the James Bond movies, the razor used by Tiger Woods. But now it has moved past movie stars and athletes on TV and in magazines to the vast, unregulated world of social media. Over the past 10 years, influencers have been able to make a nice livelihood from pushing products.

I understand why dermatologists as some of the best trained to make skin recommendations want to be compensated for doing the same thing. Doing these ads also provides power through creating a large audience by putting you in front of more people. Yet, as physicians, we are viewed as an objective source of information, something that is becoming far less common on social media than in person.

In any setting when a doctor speaks on behalf of a brand, the fact he or she is being compensated needs to be declared clearly.  According to the AMA, the primary objective of the medical profession is to render service to humanity. Reward or financial gain is a subordinate consideration. Under no circumstances may physicians place their own financial interests above the welfare of their patients.

I am one (and maybe the only) dermatologist on social media with over 50,000 followers who refuses to do ads despite being asked to do so by brands every week. I have grown this following by providing accurate, unbiased information, which seems to be much appreciated by at least some on social media.  Yet, it is a much harder and less lucrative path, which is maybe why I am on it alone.

To this day, I have not figured out how to recommend products that I love and be paid to do so. In May, I did posts for Coolibar, Kinship and Dermaquest because I find their products helpful and wanted to draw attention to them, but declined compensation. Then, to really make it a riddle, I have a skincare company that I made to better the welfare of my patients, but, when they use it, I have a financial benefit.

Dhaval G. Bhanusali Dermatologist and Founder, Hudson Dermatology & Laser Surgery and Skin Medicinals

I think this is a challenging question only because there is no real precedent. It’s not unreasonable to say that information can change and so what’s accurate today may shift over the coming years. In general, it’s important to create a community based on education. If working with a brand, it should be something that is clearly represented.

While some are against brand partnerships (and I do not currently do any), I rather see a colleague work with a brand than an influencer with no medical background. My hope is that colleagues and the general public take these as opportunities to educate on the “why” and allow for a platform where the science takes center stage.

Richard Bottiglione Dermatologist and Founder, Dermatologist’s Choice Skincare

The first thing dermatologists need to do is give the scientific answer of what is true from their studies. Too many are becoming a "celebrity" and forgetting they're a dermatologist. The dermatologist should only recommend the treatments that are known to work over the last 50 years. They should stay faithful to scientific studies.

Unfortunately, many people give skin recommendations. Most are not doctors and the information they give is mostly to sell a product. If there is a question, ask your dermatologist and look up the facts on the AAD site with scientific studies to understand the truth about skin, hair and nails. I stay with the scientific facts and my 50 years of experience.

Naana Boakye Dermatologist and Founder, Bergen Dermatology

I think it would be great if dermatologists share content that is scientifically backed with the latest research and cite the references in the caption to help foster a community of evidence-based content. Audiences often make decisions about their skin health based on the educational content circulated by dermatologists, so it’s important to ensure the spread of high-quality information and minimize the risk of misinformation.

Laura Lam-Phaure Cosmetic Chemist and Founder, Lam Phaure Beauty

It is highly frustrating to see dermatologists on social media discussing topics where they lack full expertise. Due to their status as practicing doctors, people tend to believe whatever they say. I often come across dermatologists talking about the ingredients in formulas, claiming that certain ingredients are more effective, less effective, toxic or not worth using. They delve into the chemistry of a formula but fail to address the nuanced nature of ingredient selection and formulation.

Some ingredients are only effective at specific concentrations or when stabilized at a certain pH or in combination with another ingredient. As a chemist, it is disheartening to see fellow scientists demonizing products and ingredients without presenting the full story.

Just as I would never diagnose a person with a skin condition or disease—even if I felt confident about it—I believe social media dermatologists should, at a minimum, consult with a cosmetic chemist to ensure the accuracy of their statements. Reading numerous scholarly articles is valuable, but it does not substitute for the hands-on experience of a bench chemist who formulates skincare products daily.

With all this in mind, I believe that dermatologists who wish to discuss product chemistry and ingredients with the general public should consider pursuing higher education or certification in cosmetic science. Numerous programs have emerged in recent years, making it an opportune time to invest the effort to understand how products are made.

Just as cosmetic chemists study skin conditions to formulate effective products, dermatologists should learn about the product formulation. It is unethical for dermatologists to speak on topics they are not well-versed in, especially in the realm of social media where viral content can easily spread misinformation. This undermines the efforts of those working to debunk false information online.

Shereene Idriss Dermatologist and Founder, Dr. Idriss

As a board-certified dermatologist who’s been on social media since 2018, before derms on social were honestly even a thing, I think the most important thing to be added to a dermatologist code of social media ethics is transparency with paid partnerships.

There are many layers to this onion! Beyond just one-off sponsorships with brands, I think it’s crucial for derms, and all professionals in the beauty industry for that matter, to not only disclose one-off relationships, but ongoing financial relationships with brands, and even managers who have financial affiliations with brands that are never spoken about. Pay to play is a real thing, and it’s not talked about enough.

Geeta Yadav Dermatologist and Founder, Facet Dermatology

Misinformation absolutely runs rampant on social media, but it is my optimistic belief that it doesn't come from dermatologists, but rather from self-proclaimed “experts,” with the biggest offenders being influencers. Those who have no formal medical training should not position themselves as experts when it comes to medical conditions like acne, eczema and psoriasis.

But to speak specifically to dermatologists and a social media code of ethics, remember that physicians take the Hippocratic oath upon graduating medical school. While the oath goes back to at least 5 BCE, the principles within it are still relevant and can be applied to concepts as modern as social media.

For example, "I shall charge only for my professional services and shall not profit financially in any other way as a result of the advice and care I render my patients." You can apply this to sponsored content, which is a huge part of social media. Many of my colleagues and I create it, but it's critical to disclose that type of content.

I have heard of brands working with doctors to recommend their products in media outlets for profit with neither the brand nor doctor disclosing their professional partnership to the media. This is clearly unethical. I also know of medical professionals who have questionable business relationships with "aesthetic consultants.” Who is profiting here and how?

There's also the first line of the oath: “By all that I hold highest, I promise my patients competence, integrity, candor, personal commitment to their best interest, compassion, and absolute discretion, and confidentiality within the law.” "Commitment to their best interest" can include everything from disclosing paid relationships with brands when creating sponsored content to using consistent lighting and techniques—and no makeup or filters—when sharing before-and-after images of their patients, which, of course, should only be shared with the signed consent of those patients.

But the truth is that I'm not sure that creating a specific code of ethics for social media will make a difference. It's a horrible thing to say, but it's true. If providers are already eschewing the principles of the oath they swore to uphold upon graduating from medical school, then creating a new code of ethics isn't going to convince them otherwise. Using common sense and a finely tuned moral compass should be the standard, but it won't be for every provider.

Hannah Kopelman Dermatologist and Podcast Host, Derm Club

As a dermatologist actively engaged in both clinical practice and social media, I understand the importance of maintaining professionalism online. Given the evolving landscape of social media and its significant impact on patient perceptions and behavior, I believe a revised code of social media ethics for dermatologists should incorporate several key elements to remain relevant and effective today. These principles are not just for me, but for all dermatologists to follow:

Transparency and disclosure: It’s essential for me and my fellow dermatologists to disclose any financial relationships, partnerships or sponsorships when recommending products or services. This transparency builds trust with our followers and ensures that our advice is perceived as credible and unbiased.

Accuracy and evidence-based Information: We should all be committed to sharing information that is accurate, evidence-based and supported by current scientific research. By doing so, we can collectively combat the widespread misinformation often propagated by non-professional influencers and provide reliable guidance to the public.

Patient privacy and confidentiality: Safeguarding patient privacy is paramount. We must ensure that no identifiable patient information is shared without explicit consent. This includes being cautious with before-and-after photos and other patient-related content.

Professionalism and ethical behavior: Our online presence should reflect the same professionalism we exhibit in our clinical practice. This means avoiding any content that could be perceived as unprofessional or inappropriate and being mindful of the tone and language used in posts and interactions.

Educational purpose: The primary goal of our social media presence should be to educate and inform. By focusing on raising awareness about skin conditions, promoting preventative care and providing actionable skincare advice, we not only benefit the public but also reinforce our role as trusted medical experts.

Continuous learning and adaptation: Social media platforms and trends evolve rapidly. It’s important for us to stay informed about the latest developments and continuously adapt our social media strategies. This includes understanding platform-specific dynamics such as the brevity of TikTok videos or the visual emphasis of Instagram and tailoring content accordingly.

Engagement and interaction: Engaging with followers by answering questions, responding to comments and participating in discussions can enhance the educational impact of our content. However, this engagement should always be conducted respectfully and within the bounds of professional conduct.

By incorporating these elements into a revised code of social media ethics, the AAD can empower dermatologists like myself and my colleagues to navigate the digital landscape effectively, ensuring that our online presence upholds the highest standards of medical professionalism.

Kellie Reed Dermatologist, Westlake Dermatology

Patient privacy, transparency with brand partnerships, truthful info, evidence-based education and debunking myths and misinformation are essential components that comprise a dermatologist code of social media ethics.

If a dermatologist influencer chooses to stand behind a brand partnership, it’s advisable it is a company or product that the influencer believes in and can promote with integrity. It is essential to make it clear to followers it is a paid partnership.

Social media can be used to educate the masses from a true skin expert like a board-certified dermatologist to provide evidence-based information to combat misinformation.

Manuela Valenti Founder, CEO, Cosmetic Chemist and Head Formulator, By Valenti Organics

I would be inclined to say transparency. Given the evolving landscape of social media, it is crucial that the AAD revises its position statement on medical professionalism in social media to emphasize transparency more strongly.

Transparency should be a cornerstone of the code of ethics for dermatologists on social media. It is not enough to merely disclose financial relationships and affiliations. Dermatologists must go further to ensure that all recommendations are evidence-based and free from bias. This includes being upfront about any potential conflicts of interest and ensuring that their content is rooted in scientific research rather than marketing influence.

In light of studies highlighting the prevalence of misinformation in dermatology content on social media, dermatologists have a responsibility to act as gatekeepers of accurate and reliable information. I have personally disagreed with several dermatologists and even cosmetic chemists in my line of work on both Instagram and TikTok for spreading misinformation, only to discover that their actions were motivated by financial ties to particular brands.

The AAD should encourage its members to thoroughly vet the information they share and to correct any inaccuracies promptly. This commitment to accuracy not only builds trust with the public, but also differentiates credible professionals from influencers who may prioritize engagement and paid partnerships over education.

Additionally, given the rise of sponsored content, the AAD should provide clear guidelines on how to ethically engage in partnerships. This includes advising dermatologists to prioritize patient welfare over commercial interests and to ensure that any endorsed products are clinically proven and safe for use. Transparency in these partnerships can prevent the spread of misinformation and maintain the integrity of the dermatological community.

I believe the code of ethics should include provisions for ongoing education and training in social media use. Dermatologists should be equipped with the skills to navigate the complexities of digital communication, including understanding the legal implications of their online presence and the potential impact on their professional reputation.

Helen M. Torok Dermatologist, Medical Director and Co-Founder, Trillium Creek Dermatology and HH Science

First, it is imperative today for dermatologists to be board certified by the AAD. After this, it is all about transparency. It is important that skincare professionals are open to reporting if they are paid by the company whose products they are promoting and advertising. And they should be transparent about whether they have personal experience and/or research in the products or topics they are promoting.

The average person often relies on what they see and read in their social media feeds. As a result, it is our duty to supply information that is based by fact not just personal opinion, being open about paid endorsements or if the topic or trend discussed is out of the realm of our normal area of expertise.

Courtney Rubin Dermatologist and Co-Founder, Fig.1

I think it's wonderful that dermatologists are using social media as a platform to educate about skin and skincare and debunk misinformation. Outside of major metropolitan cities, few people have access to a dermatologist, so social media can be a great way to expand the reach of experts.

From an ethical standpoint, I think it's important to continue to protect the privacy and dignity of patients, especially in the context of telling stories and sharing photos online, even in the name of education. I think it's also crucial that experts disclose financial relationships so that it is obvious to patients and consumers when something they are seeing is an advertisement.

Blair Rose Dermatologist and Founder, Laser & Skin Surgery Center of New York and Skincare Junkie

A dermatologist code of social media ethics must contain several key principles to be relevant in today's digital age.

Patient confidentiality is paramount. Just as we adhere to the  Health Insurance Portability and Accountability Act (HIPAA), we must ensure that everything posted on social media adheres to HIPAA as well. Patient information should be kept confidential and never shared without explicit written consent, including avoiding identifiable information or images without permission.

It is equally important that we provide accurate, evidence-based information and avoid spreading misinformation or unsupported claims. Social media should be a tool for patient education, offering valuable and relevant insights about skin health and treatments. Misleading information must be strictly prohibited.

To that end, transparency in endorsements is crucial. All sponsorships, affiliations, or endorsements with products and companies must be clearly disclosed. Integrity is the cornerstone of our profession, and it must be upheld always.

Those companies or products a dermatologist chooses to associate with must be very thoughtfully considered. We must strive to ensure that our professional judgment is not influenced by any personal or financial relationships. We must be vigilant about avoiding conflicts of interest and any potential conflicts should be disclosed.

Ethical marketing practices are essential. We must avoid making exaggerated claims about the benefits of treatments. Professionalism and respect in our online presence are vital to maintaining the high standards of our profession.

Ava Shamban Dermatologist and Founder, Althaea Skin

With the increasing importance of social media, it’s important to follow standards of communication that physicians utilize when presenting at medical conferences and contributing to scientific journals. Conflict of interest must always be disclosed so that the viewer knows there may be bias in any information presented or product recommendation.

Erica Suppa Founder, Cosmetic Chemist and Formulator, Fresh Faced Skin Care

Something that a dermatologist code of social media ethics must contain to be relevant now is to ensure that the code of social media ethics aligns with the AAD ethics pledge, specifically, “I will put my patients’ welfare above all other interests.”

The existing dermatology social media presence leverages their credibility to receive compensation from product manufacturers in exchange for promoting products. This needs to stop.

If you have a question you’d like Beauty Independent to ask dermatologists and cosmetic chemists, please send it to editor@beautyindependent.com.