# Severe nodulocystic acne requiring corticosteroids after social media-induced delay: a two-patient case series

## TL;DR

Two teenagers with severe acne required corticosteroids after delaying proper treatment by following TikTok skincare advice.

## Contribution

Reports two cases where social media misinformation led to severe acne requiring corticosteroids before isotretinoin.

## Key findings

- Two adolescents with nodulocystic acne required systemic corticosteroids after delaying treatment via social media advice.
- Both patients showed clinical improvement after corticosteroid bridging therapy followed by isotretinoin.
- The cases emphasize the risks of unverified skincare advice and the importance of early dermatology care.

## Abstract

Delayed by TikTok advice, two adolescents with nodulocystic acne required systemic steroids before isotretinoin, underscoring a modern challenge in acne management.

Social media platforms, particularly TikTok, are increasingly used by adolescents for skincare advice. However, much of the content lacks medical accuracy and may delay appropriate treatment. We report two adolescent boys with severe nodulocystic acne who postponed dermatology care while following influencer-promoted routines. In both cases, the disease progressed to a highly inflammatory state, prompting the use of systemic corticosteroids before starting isotretinoin. The first patient, aged 16 years, presented with painful nodules after months of self-treatment; a short course of oral prednisone and antibiotics was followed by isotretinoin, with a good response. The second patient, aged 15 years, experienced similar progression and was also pretreated with oral steroids before isotretinoin initiation. Both achieved clinical improvement. These cases highlight the therapeutic consequences of digital misinformation and the role of corticosteroids as effective bridging therapy. They underscore the importance of early dermatology intervention and the need for evidence-based communication in online health spaces.