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English Version | Test Drive: Nonsense Issue

Notícias 15. 7. 2021

English Version | There's plenty of doctors in the sea

by Ana Saldanha

 

Talking about lipsticks on social media can lead to out-of-stock products and empty shelves. Unknowingly talking about diets and medical procedures can fill hospital beds. The scenario may seem dramatic, but it is a reality when DMs become doctor's offices. 

It all started with TikTok - being a Gen Z has some advantages and being able to talk freely about scrolling in TikTok is one of them - in a video where a woman talked about her miraculous anti-wrinkle treatment. This treatment was nothing more, nothing less than a tube of tretinoin cream, or retinoic acid, which in Portugal is known as Ketrel, a medicine sold only with a prescription. In the short video - which has since been removed but not before being scrutinized by SkinTok stars like Charlotte Palermino (@charlotteparler). This woman was talking about this cream as she applied it in absurd amounts over her red skin with some areas completely flaking off like she just had a chemical peel. Searching for the #tretinoin you can see hundreds of videos about personal experiences that show before and after images and advise you to use this medicine to eradicate acne, blemishes, wrinkles, you name it. However, it is difficult to find videos warning about the consequences of misuse of this product - which can range from dry and peeling skin to burns and scars, when those who use this product do not use adequate sun protection or, in the worst-case scenario, use it in the morning routine and then go out in the sun. The issue extends to other social media platforms (and that also happens because many content creators repost their content across many platforms, increasing the number of people reached by uninformed information) for those who blindly follow the advice of people who share information based on their personal experience or repeat what they read on the internet - without checking sources, without thinking that they are called influencers because they actually influence purchases, habits, and beliefs. In the world of skincare and on the accounts of those who speak about them knowingly, DM boxes often have questions about acne, dermatitis, rosacea, melasma, and the list goes on - conditions that need expert opinions and appointments with dermatologists, since if they go untreated or the treatments are given are not adequate, these skin conditions can worsen.

Questions reach these platforms because it is standard that we look for answers on them. If you share your opinion about a lipstick you will only influence the sales of that product, but talking about issues involving health - skin health, hair health, or even nutrition - is much more dangerous since we are dealing with issues that have real consequences for those who treat opinions as facts. Joana Álvares worked for several years in Pharmaceutical Marketing and in 2019 decided to use her knowledge of the Beauty industry to launch Beautyst (beautyst.pt). The site was born from the desire to create a credible information space with specialized medical support. To Vogue, Joana tells that her own experience with androgenetic alopecia - a hair disease that affects a large part of the population and although more common in men, affects 40% of women aged 40 - made her see lots of false information about the disease and about "miracle" treatments that promised incredible results without scientific evidence. “I felt, as a woman and as a professional in the field, that there was a lack of credible information in the digital world, but especially in social media, which ended up impacting so many people. This idea initially came about because I have a hair disease and this was a topic that led me to realize that many women were lost on the way to find a solution that would work. I felt that people had some difficulty in noticing the difference between a hair disease and any other hair situation that can be resolved in the hairdresser and me, having this knowledge, not only because I suffer from this pathology, but also because I launched numerous drugs in this area, knew what were solutions and false solutions” she tells us. On her platform, which has more than 19,000 followers on Instagram, Joana collaborates with 12 health professionals, including dermatologists, pharmacists, and plastic surgeons, which she considers a reference in their fields, to increase health literacy and equip her followers with the knowledge necessary to decode false claims and wrong information. "I think there is still a lot to be deconstructed, there is still a need to better explain some basic concepts of health, hair, and skin, for people to understand what are the answers in front of them, what are the promises and what are the false promises”, explains Joana, who does not shy from pointing a finger at brands and those who make their decisions about numbers and engagement social media networks. “I think there is still some work to be done in this area. I see many brands associate themselves with people who have completely contradictory opinions regarding what is the basis of scientific knowledge. If people see that a brand is associated with someone, we, without knowing it, end up trusting in what that person has to say and we don't even question that a brand can deceive us. And I also see content creators associating themselves with doctors and through a brief search on the website of the Ordem dos Médicos, we realized that they aren't even doctors." This idea of ​​shared guilt, in which the consumer is caught in a kind of loop of interests in which both brands and content creators benefit from the dubious information they publish on social media is also a reason of concern for Marisa André, dermatologist and one of the professionals participating in the Beautyst project. “I think it's a shared responsibility and I think it's also shared by those who believe and those who buy. Brands that want advertising, that want the numbers and that want to sell have a primary goal and we know that it is normal for that to happen and then the influencers who make a living from content creation end up having no alternative, because if they want to continue to have this income they have to enter in a certain rhythm of posting", explains the dermatologist, who also does not fail to mention that the active role of an informed consumer is also very valuable in decoding information disseminated on social media: "There is a third party, the one of those who follow the influencers and who can choose to believe or not believe what they are reading. Some people are a little more critical, but then there is also a market share that cannot do it”.

Spending too much time on social media and having the Internet as your main source of information about anything and everything can be a symptom of the Dunning–Kruger Effect (also known as “wisdom of the idiots”). This behavioral phenomenon causes a person to overestimate their knowledge on a given topic, finding themselves capable of discussing, disassembling, and evaluating it. It was researchers Justin Kruger and David Dunning who, in 1999, proved this effect by submitting their psychology students to self-evaluations, asking them to estimate their skill level against the other participants. The results obtained revealed that the more competent group had an inferior or correct perception about their skill level, while the more incompetent group believed to have much more knowledge than it was revealed. This study also found that Dunning-Kruger sufferers are driven to make bad choices based on their arrogance and they achieve unsatisfactory results because they believe in their false wisdom. Spending too much time researching skincare, for example, can lead us to believe that we really understand what we're talking about and are have enough knowledge to make the right decisions (and the same can happen in matters about nutrition, for example), diminishing the actual expertise and scientific knowledge of competent health professionals in different areas. “I think there is a total renouncement of what a medical act is and what medical procedures are, and I think this is cultural, in Portugal it is cultural. If you see in a magazine that tretinoin cream is the most effective and cheapest anti-aging product on the market and if this information comes out in August, people will use it in August. Because they think there's nothing more to it. There is disbelief of Beauty as part of Health”, says Marisa.

But this isn’t only about uninformed Beauty remarks on social networks. On July 2, Pinterest banned all paid content that promotes diets and slimming products, being the first social network to completely ban this type of publication. In 2019, Facebook and Instagram restricted, for all users under the age of 18, publications that advertise products for weight loss and cosmetic surgery. This decision came after complaints from several celebrities such as actress Jameela Jamil who criticized the Kardashian clan and artists such as Cardi B for their publications promoting laxative teas and meal substitutes. Ana Goios (@anagoios_nutrition) is a nutritionist and created a platform on Instagram to share recipes and deconstruct myths and beliefs in the field of nutrition. When asked about the dangers associated with misinformation in the area of ​​nutrition, she reveals that “if it is true that, in some cases, this misinformation ends up not having serious consequences (apart from spending money), in other situations, consequences can be far more serious. I refer, for example, to the prescription of dietary plans that are completely unbalanced from a nutritional point of view – the famous 'detox' plans –, the improper supplementation with excessive doses of vitamins and minerals, and the encouragement of the use of 'natural products, that can easily reach toxicity levels and/or interact with some drugs. It is logical that, in these cases, the risk will be greater the longer you keep the diet”. Just like it happens with skin and hair care, as mentioned, it is an almost desperate search for results that often leads us to be naive towards the promises made in posts that swear that product will give you amazing results, but Ana Goios also mentions the power of the words we associate with nutrition and how they can be damaging when it comes to having a healthy attitude towards eating. “This misinformation has contributed to the existence of a negative and highly emasculating attitude towards food. Every day we are “bombed” with expressions such as “good foods/ bad foods”, “detox”, “guilt-free”, “cheat meal”, “cheat day”, etc. This type of opposing approach (between "good" and "evil" foods) are empty of scientific evidence", explains the nutritionist, who considers that when it comes to the subject of food, it is very difficult to filter out credible information and unfounded statements. “In nutrition and food sciences, this issue of 'pseudoscience' seems to be even more predominant, because everyone eats. And since everyone eats, everyone has an opinion and feels they can share it, without any training in the area. Furthermore, never before have so many scientific studies in this area been published, making it increasingly difficult to 'filter' so much information. Today, there is at least one scientific study that supports any argument we want, however, we cannot look at just one study. Nor can we just look at the last study. The last is only the most recent, it does not mean that it is enough to cancel all the others previously published. As contradictory as it may seem, in my opinion, disinformation is fought with information. Credible information based on scientific evidence. I believe that we, as health professionals, have a responsibility to contribute in this regard”. In addition to the active role of health professionals and those who want to partner with them and lend their platform to provide further information based on scientific evidence, legislation is also making some moves to protect the consumer. “There was, in 2019, a first approach by the Direção Geral do Consumidor to show on social media which are paid and sponsored posts and which have gifted products. In other words, there has already been a first approach to protect the consumer from what is honest information or sponsored information, what is advertising, and what is not. But I feel that there is a lot to do about medical treatments and which medical treatments are spoken about on social media. There is currently no legislation office that is checking what is happening on social media in the medical field, supplements, and cosmetic products and they should have a much more active role, that goes beyond the concern about what happens in the traditional media. This is very important, of course, but nowadays it is much more important to legislate what goes on in the digital field because it is absolute anarchy”, says Joana Álvares, and Marisa André adds: “This part is the most complicated. It can be controlled, but then what? How can anyone who sees it know that that page or that account is not to be trusted?”. We circle back to digital literacy, health literacy, and shared responsibility. The consumer is an interested party and can be more critical about the content they consume, but the ones who create content can’t post whatever they feel like posting, even if the intention is not to deceive anyone, but especially when we are speaking on matters of health. “I am not, in any way, going to give any kind of opinion about pathologies. People who do this type of counseling don't have the ability [to do it] because they are not doctors, even if they read and study the topic. But they have a hard time assuming that it isn’t their place to talk about such matters. And this happens a lot, we see professionals from different areas trying to do another type of work for which they are not competent. The desire to help people cannot make any content creator say whatever he or she wants on social media. You can’t just be giving out tips and hacks”, concludes Joana.

Translated from the original article from Vogue Portugal's Nonsense Issue, published July 2020.
Full credits and story on the print issue.