Dermatology: Practical and Conceptual Review | Dermatol Pract Concept. 2023;13(4):e2023234 1 Combating Misinformation in Dermatology Emelie Elizabeth Nelson1, Troy Austin Black1, Morgan Ansley Rousseau1, Rashid Mohammed Rashid2 1 University of Texas Health Science Center at Houston John P. and Katherine G. McGovern Medical School, Houston, Texas, USA 2 Mosaic Dermatology, Houston, Texas, USA Citation: Nelson EE, Black TA, Rousseau MA, Rashid RM. Combating Misinformation in Dermatology. Dermatol Pract Concept. 2023;13(4):e2023234. DOI: https://doi.org/10.5826/dpc.1304a234 Accepted: April 5, 2023; Published: October 2023 Copyright: ©2023 Nelson et al. This is an open-access article distributed under the terms of the Creative Commons Attribution- NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited. Funding: None. Competing Interests: None. Authorship: All authors have contributed significantly to this publication. Corresponding Author: Rashid M. Rashid, MD PhD, Mosaic Dermatology, 2211 Norfolk St #405, Houston, TX 77098. Email: rashidmdphd@gmail.com Freedom of speech is one of the foundations of democracy. With the advent of modern technology, we now have the access to seemingly-limitless information at our fingertips. However, with increased accessibility to information comes susceptibility to misinformation, a phenomenon that poses vast implications for the scientific community and general population. Misinformation, described in politics as a threat to de- mocracy, is pervasive throughout medicine and can hinder the delivery of healthcare [1]. Dermatology, in particular, has recently been the center of many instances of misinfor- mation. From assertions that “sunscreen causes cancer” to the false claims that tanning and the use of Melanotan are “safe”, it is imperative that all are aware of the misinforma- tion that exists as it has the potential to significantly impact one wellbeing [2]. Though the benefit of easily-accessible information is significant, not all information is “equal” in quality or ac- curacy. While physicians are formally trained to make use of databases like PubMed or Ovid, navigating these sites can pose a great challenge to the general public. As such, search engines like “Google” become a more appealing, user-friendly option. Additionally, with the recent surge in social media users, the opportunity for the spread of misin- formation is amplified. A 2021 systematic review examined this phenomenon by collecting healthcare-related social media misinformation rates from 69 studies. Within the studies examined, misinformation rates reached as high as 87% of the total content posted on social media [3]. While information is information, and free speech is a protected right, information can also be counterproductive, deceptive, and used to incite emotions, especially when it is viral and has algorithmic appeal. How do we handle this information overload and combat misinformation? We suggest creating a health rat- ing agency that provides a rating to publicized health in- formation, similar to the system employed by the Motion Pictures Association. Ultimately, this rating agency would serve to create a metric that individuals could use to bet- ter understand the quality of information they are accessing. Just as the movie industry uses movie ratings: G, PG, PG-13, and  R, healthcare-oriented information could be reviewed and “rated” for accuracy (Table 1). We propose that physicians spearhead rating efforts within their respective fields. While this represents a labori- ous task, we believe that physicians could be incentivized to participate in review efforts by offering Continuing Medical Education credits for their time. After content (articles/ social media accounts/ influencer accounts) has been “rated,” a seal or emblem from each specialty governing body (American 2 Commentary | Dermatol Pract Concept. 2023;13(4):e2023234 Academy of Dermatology for Dermatology) could be ap- plied to the content, indicating that the content has been subject to expert review and quality control. The simplicity of this rating system would enable its implementation across major search engines and social media platforms, ultimately serving to combat misinformation in the field of dermatology and medicine at large. References 1. Roozenbeek J, Schneider CR, Dryhurst S. Susceptibility to mis- information about COVID-19 around the world. R Soc Open Sci. 2020;7(10):201199. DOI: 10.1098/rsos.201199. PMID: 33204475. PMCID: PMC7657933. 2. O'Connor C, Rafferty S, Murphy M. A qualitative review of misinformation and conspiracy theories in skin cancer. Clin Exp Dermatol. 2022;47(10):1848-1852. DOI: 10.1111/ced.15249. PMID: 35514125. PMCID: PMC9796846. 3. Suarez-Lledo V, Alvarez-Galvez J. Prevalence of Health Misinfor- mation on Social Media: Systematic Review. J Med Internet Res. 2021;23(1):e17187. DOI: 10.2196/17187. PMID: 33470931. PMCID: PMC7857950. Table 1. Proposed rating system for medical literature. Rating Guideline E1 Content is backed by substantial evidence-based literature. E2 Content is supported by sparse evidence- based literature. N No supporting research. X Anecdotal information without supporting research.