Dermatology consultant Nicola Ralph dedicates around half of her workday to diagnosing and removing skin cancers. She and her fellow expert Prof Caitriona Ryan find the impact of social media on their patients’ perceptions of body image increasingly concerning. The mass consumption of damaging online beauty trends, particularly on platforms like TikTok, has them particularly worried. One such trend is “sunscreen contouring”, which encouraged selective application of sunblock to achieve a coveted “sun-kissed” look, leaving parts of the skin unprotected and prone to damage.
With Ireland witnessing over 13,000 skin cancer cases annually, the trend raises alarm. Prof Ralph is particularly concerned that such advice promotes deliberate sunburn and potential skin damage, increasing the risk of skin cancer. The professor, also a clinical assistant at University College Dublin, points out that the internet is rife with dubious beauty information, from snail secretion claims for skin hydration to injecting salmon sperm-derived DNA below the eyes.
Nicola Ralph and Caitriona Ryan, co-founders of the Institute of Dermatologists and residing at the Blackrock Clinic, find some of these trends more disconcerting than others. During the lockdowns of 2020, Prof Ralph noted the rise of ‘sunscreen contouring’. This period also saw an increase in cosmetic procedures such as dermal fillers and botox, fuelled by dissatisfaction with appearances during video calls – a phenomenon known in the beauty sector as “the zoom boom”.
Online platforms, primarily TikTok, are now seen as the primary source of skincare and beauty education, particularly among the younger demographic. Prof Ryan reported that even older patients, in their 60s and 70s, watch TikTok and discuss these latest trends. As dermatologists, they find it impossible to ignore these alarming practices. One of the weirdest trends, according to Prof Ralph, is “freckling”, which involves using, often unsterilised, home sewing needles to apply a semi-permanent tattoo pigment to imitate freckles across the cheeks and nose.
The effects have been scarring and infections. The dye is regularly procured off online marketplaces such as eBay, regarding which the consumers often lack knowledge about its composition and origin, she commented. Even though she hasn’t encountered any client at her clinic undergoing this procedure, numerous videos on freckle tattooing are popular on TikTok, puzzling younger individuals who’ve experienced significant frustration over their natural freckles in previous times. “Those who once mocked me for having freckles are currently tattooing them for aesthetics,” wrote one user.
Another trendy internet activity denounced by Prof Ryan involves DIY chemical peels. In these, the audience is guided on how to formulate their unique blends and peel their skin using strong concentrations of acid and other ingredients. The immense potential of things going terribly wrong cannot even begin to be exaggerated, according to her words, echoing the serious risk that these at-home peels might inflict burns and cause scarring.
Other social media influencers advocate the topical application of ice to alleviate facial bloating and decrease inflammation. But ice can induce a cold burn since it numbs the area, leading to reduced sensation of any associated pain, Prof Ryan warns. Her advice is to shun direct ice exposure and instead, envelop it in a fabric.
Selene Daly, a practicing advanced nurse and life adviser based in Sligo, likens social media outlets such as TikTok to a lawless land and laments that these pervasive platforms often drown out the counsel of conscientious professionals and parents alike.
Devoting the better half of her career to Dermatology, Daly shares the dismay over the negative influence wielded by these platforms and influencers—particularly upon younger audiences—regarding beauty therapies and cosmetic operations.
She recounts an instance last Christmas when parents purchased an overly pricey brand of “non-age appropriate” essences, aggressively promoted online, containing retinol for their children. Retinol serves to slough off dead skin cells, which she uses, being 45-years-old. The irony lies in fact that these younger individuals are marketed an anti-ageing product, which they, being less than 18, have no tangible use for, rendering it entirely absurd, especially taking into account the crucial role of the skin’s outermost layer in protection against sun damage.
One of the other elements of this predicament is the concept of self-value and the emotional perceptiveness of young individuals regarding their appearance. Body image distortion is rampant, and yet there is a lack of effort to safeguard these impressionable young females.
In the span of six years since Professor Ryan appealed to the Health Minister, Simon Harris during his tenure to prohibit those lacking medical training from administering dermal fillers on people’s faces. Despite this call to action, the practice remains prolific, especially in beauty parlours throughout the nation.
Dermal fillers, which are laced with injectable hyaluronic acid, serve the purpose of facial augmentation, focusing on areas such as the cheekbones, jawline, and lips including fine lines. Professor Ryan, alongside colleague Rosemary Coleman, alarmed the Minister about this practice and its potential hazards. They argued that accidental injection of a filler into a facial artery could lead to catastrophic consequences such as blindness or facial tissue necrosis. The only solution when things go awry is an immediate hyaluronidase injection, a controlled prescription (potentially resulting in anaphylaxis in individuals allergic to bee stings) that should only be administered by a licensed physician.
Nonetheless, in spite of the fact that only medically trained doctors and dentists are allowed to dispense Botox, categorised as a “medicine”, fillers are labelled as a device. Consequently, it is permissible for anyone to administer them, not merely in Ireland but all over the European Union, as stated by Professor Ryan.
She voiced her concerns about the distinct potential of procuring fillers from platforms like eBay and injecting them into the faces of acquaintances, with no legal repercussions. But her worries are primarily geared toward the susceptibility of younger females who might not be financially capable of visiting reputable clinics, and instead frequent beauty parlours or even invite someone over to their residences. There are instances where injection of fillers take place within the privacy of homes.
Professor Ryan, an affiliate clinical professor at University College, Dublin, has identified a surge in the ‘filler-face’ phenomenon, which she believes has become a widespread issue in Ireland in recent years.
She remarks, “Over the past four to five years, I have observed a significant rise in this ‘overfilled’ trend, predominantly among women aged between 40 to 60 years in Ireland, which often leads to distortion of natural elegance and, in my view, tends to age many of these women.”
In recent times, it has been observed that people are moving away from fillers towards natural looks and are selecting firming treatments that activate their natural collagen, as stated by an individual. Daly also opined that influencers are targeting both young males and females, with males being influenced towards muscle building, certain look, and teeth whitening.
Statistics unveiled by the Health Products Regulatory Authority (HPRA) recently claimed that nearly 30 per cent of the illegal drugs they intercepted in 2023 were anabolic steroids, and over a quarter million units were held back.
Grainne Power, who heads the compliance unit of the HPRA, said some purchasers seemed eager to take the risk of procuring counterfeit drugs and unauthorised substances for aesthetic and body image improvement. She also pointed out a 20% increase in the confiscation of illegal anabolic steroids, and highlighted concerns about young men acquiring these for body improvement without realising the significant health risks they are potentially subjecting themselves to. These dangers include severe health problems like cardiac failure, liver problems, damage to kidneys, and infertility.
In relation to dermal filler regulations, the HPRA declared that they do not regulate the usage or users of these fillers. Following the rules brought into force last June about medical devices, the organization mentioned that dermal fillers are to be labelled as not suitable for under 18s and should be given by adequately trained medical personnel.
Additionally, the HPRA iterated that discussions are ongoing with the Department of Health regarding regulation, and a policy document has been submitted already. A representative from the department revealed that they currently consider regulating dermal fillers in Ireland and have discussed it with various stakeholders, including the HPRA.
TikTok asserted that it does not permit any content showcasing or endorsing dangerous challenges or activities. Also, it doesn’t allow misleading information, particularly health-related, which could potentially harm anyone’s health.