Treatments for melasma: A cross-sectional study of YouTube videos including DISCERN scores

ABSTRACT

Background: Online searches have become a popular source of medical information, especially in the COVID-19 era. Methods: On February 13, 2021, we performed a YouTube search of “melasma treatment” with the “view count” filter on a private browser. The first 102 videos yielded were screened, and the top 30 videos meeting our inclusion criteria were independently evaluated by 2 reviewers using the DISCERN instrument. Results: The mean DISCERN score for the 30 videos was 41.4 points, categorizing them as “fair” in quality. The mean score for videos uploaded by dermatologists was similar at 46.3 points (“fair”) compared with 31.3 points (“poor”) by profit companies. It is concerning that only 53% of videos supported shared decision-making with a physician/dermatologist. Almost one-third of videos focused on natural home remedies, which generated the most views. A video using raw potato with 3.8 million views claimed to permanently “cure” melasma in weeks. Such false claims pose unrealistic expectations for viewers. Furthermore, only 17% of videos discussed melasma recurrence, and 60% mentioned treatment risks. Popular home ingredients (i.e., raw potato, lemon, etc.) that videos classified as “harmless” can certainly cause contact urticaria, anaphylaxis, or exacerbate melasma. Conclusions: The top 30 most-viewed videos with 15.5 million views contained mostly fair-quality medical information with a focus on home remedies without reliable sources of evidence. Dermatologists should be aware of common misconceptions propagated by these videos and thus underscore treatment risks, recurrence, and insufficient evidence in the literature on the efficacy of home remedies for melasma.