Isotretinoin on TikTok™: misinformation getting under our skin.

Dear Editor, Patients are increasingly seeking health-related information on social media, including TikTok™, the world's fastest growing social media platform with over 2 billion downloads.1,2 TikTok™ users are generally young (63.5% of users worldwide are less than 24 years old), and accordingly, health issues such as acne are of particular concern in this demographic.1 However, misinformation can dissuade patients from pursuing treatment, particularly isotretinoin.2,3 In this cross-sectional study, we analysed the most popular TikTok™ videos under hashtags: #isotretinoin, #accutane and #roaccutane to determine their quality of medical information. After application of the inclusion criteria (video related to isotretinoin, in English and non-duplicate), 350 eligible videos were included in the final analysis (Figure 1). Descriptive characteristics of video content were categorised according to uploader type and content: previous treatments and/or history of acne, benefits of isotretinoin, adverse events, laboratory monitoring and dosing schedule (Table 1). Each video was given a quality rating of good, fair, poor or no health-related information (Table 2). A linear regression model assessed the association between number of likes (log transformed due to skewness) and video quality. Of the eligible videos, the majority (n=235, 67.1%) did not provide any medical information. 48(13.7%), 53(15.1%) and 14(4.0%) videos provided poor-quality, fair-quality and good-quality medical information respectively. Most videos categorised under 'no medical information' (n=211, 89.8%) were non-verbal montages of acne improvement. The benefits of isotretinoin were covered in 18 videos (5.1%). Cheilitis (n=39, 11.1%) was the most commonly reported adverse event, followed by xerosis (n=23, 6.6%), teratogenicity (n=18, 5.1%), mood lability (n=15, 4.3%) and arthralgias (n=7, 2.0%). Laboratory monitoring was mentioned in 12 videos (3.4%) and dosages were mentioned in 6 videos (1.7%).