Social media posts need to be planned carefully, thoughtfully and transparently, as, if not, they could negatively influence impressionable viewers
It is estimated that there are now 48 million active users of social media in the UK today, which accounts for 67% of the UK population (Zivkovic, 2021). Of this 48 million, 39 million scroll through social media on their mobile devices, accessing apps from anywhere at any time for an estimated 110 minutes per day. Of these estimated 110 minutes, Avocado Social (2021) approximates that over half of social media users will research a brand or business on social platforms first, as what they see influences their purchasing decisions. Last year, social media usage grew at the fastest rate in over 3 years as a direct result of the pandemic and countrywide lockdowns (Avocado Social, 2021). Therefore, for those who are not advertising on social media yet, these statistics suggest that now is as good a time as any to start. However, along with this substantial growth in use, so, too, have cases of mental health conditions relating to appearance and body image thanks to posed photos, skin-perfecting filters and airbrushing, as well as the prevalence of online ‘trolls’ and where likes and followers equate to feelings of acceptance and popularity.
Before the 2020 UK lockdown, an estimated 2% of the UK population struggled with body dysmorphic disorder (BDD) (Phillips, 2007), a mental health condition that is characterised by an individual's obsession and focus on one or more aspects of their appearance. This statistic is likely to have risen considerably since, perhaps due to prolonged periods online. In an industry that works with patients and their body and skin concerns, any promotion on social media, although seemingly essential today, needs to be conducted carefully, thoughtfully and transparently. If not conducted in this way, such posts could negatively influence impressionable viewers, which ultimately negates the reason for promoting and advertising services via social media in the first place. Yet, it is not just adults struggling with their body image who could be affected by a poorly published post. The Advertising Standards Agency (ASA) has become increasingly concerned about the types of advertisements that children may be exposed to on social media and the effect this has on them. Through ongoing sweeps of children's online media, the ASA has pledged to tackle age-restricted advertisements (alcohol, gambling and any aesthetic treatment) that have been irresponsibly placed. Therefore, the question is not a case of ‘to post, or not to post?’, but, rather, what to post?
What not to post
Medical aesthetics businesses and brands have always had to tread carefully when advertising, especially concerning prescription-only medications (POM) such as botulinum toxin. Social media promotion should be no different. However, it appears to be easier to slip into pitfalls that can usually avoided in other modes of advertising, such as posters and clinic literature. Perhaps the reason lies with the ease with which an image or video that is taken in real time using a handheld device can reach hundreds and thousands of people in minutes. Alternatively, maybe it is the familiarity of different social media platforms as a result of personal use and the compulsion to add filters in one's own pictures. Regardless, given how an online post can easily be seen by the wrong eyes, let alone the potentially negative impact on mental health, it is essential that every post is carefully curated. The ASA is quick to take action if a post is misleading or an image does not fall within certain criteria and has no problem reporting those who have failed to comply with their rulings. Therefore, one wrong post could not only make a negative impression on a vulnerable person or a potential patient intent on getting a specific treatment, but the name of a clinic owner or the name of the practice (designed this way to appear in search engine results whenever a consumer searches for a business) could be posted on the ASA website, detailing the problem with the advert. At the very least, a social media post could be removed, which can still be costly if a whole media campaign has been planned around the imagery or wording. At the worst, the ASA could report you to trading standards, posing problems for future advertising campaigns and business promotion. In accordance with ASA rules, below are things that should be avoided in regard to wording and images posted on social media:
- Images: imagery should not infer that one body type is better than another or that a post-treatment picture is the ‘ideal’, as this could exploit those with particular body insecurities or mental health issues such as BDD. Similarly, the images used should not be posed or taken from an angle that accentuate a feature, promote surgical enhancement or slim down another, as these can be seen to glamourise and, again trivialise, underweight bodies. The use of before and after images that have been digitally enhanced and do not portray a true reflection of the use of a particular product and course of treatments. The ASA has worked hard to ensure that social media influencers must declare when they are being paid to promote a product or service. The use of filters to enhance the effects of a treatment or product, for example, could well go the same way
- Wording: avoid unsubstantiated claims, such as ‘100% removal’ or ‘results guaranteed’, just as if a patient was being consulted in person. Similarly, try not to infer that a post-treatment image is more attractive than the before, as, again, this could imply that a particular look or body is preferable to another or that you are only considered beautiful if you have had a particular treatment done. Be careful not to trivialise any serious surgical or non-surgical procedures, as they are not decisions that should be entertained lightly or can be decided over a social media post with limited characters that cannot fully explain the pre- and post-procedure information or contraindications and risks.
What to post
The aforementioned information should not discourage the use of social media platforms to promote the work of medical aesthetic practitioners and their business, as they are still a very effective marketing tool. There are numerous ways that the powers of social media can be harnessed safely and ethically to the benefit of businesses and to those who see them. Consulting the ASA's advertising guidelines is a good place to start, as they have a specific section dedicated to cosmetic procedures and health and beauty. They are particularly useful, as they give examples of how best to employ certain advertising tools, such as testimonials and patient endorsements. Below are the kinds of images and wording that the ASA rulings accept being posted on social media:
- Images: use natural lighting and make sure you state that no filters have been used, as this is not always obvious, or a given on certain platforms. Before and after shots can be posted, but be honest about the timeframe of results and anything else that the patient was doing to achieve the results and supplement their treatment. Use real people showcasing real results. Use an array of different sized models across ethnicities to demonstrate diversity, inclusion and that not one type of body or person is preferable over another.
- Wording: keep it short, as many users will scroll past a lengthy post. A consultation is a good call to action (CTA) to further discuss skin and body concerns or procedures. Avoid getting into too much depth in the comments, private messaging is a safer space for one-on-one discussion. Avoid obvious exaggeration—if you cannot substantiate what you are writing and back it up with evidenced results, then do not write it (see Table 1, with some suggested phrases for further clarification).
Table 1. Suggested phrasing
| Avoid | Use |
|---|---|
| Any reference to a prescription-only medicine (POM): ‘beutox’, ‘btx’, botulinum toxin, ‘toxed’, etc | ‘Anti-wrinkle treatments’ and/or ‘anti-ageing skin treatments’, as this implies/shows that treatments other than botulinum toxin are performed |
| Discussing POMs in comments and public spaces | Discuss POMs in private messages |
| Visible pricing or special offers will be seen as coercing or promoting certain treatments that need professional consultation first. This is a definite no if only POMs are offered | Use blanket terms such ‘summer skin sale’ if doing a promotion, discuss the procedure for receiving treatments and express that consultations always happen first to determine suitability for treatment |
| Anything that cannot be substantiated: ‘permanent results’, ‘results guaranteed’, ‘revolutionary treatment’, ‘leading treatment’, ‘100% removal’, timeframes, etc | Anything that can be confirmed: a treatment/product leads to younger-looking, smoother or fresher-looking skin, or something that patients may see a reduction or increase in |
| When promoting skills or experience, do not say anything that cannot be substantiated: ‘specialist’, ‘leading doctor or nurse’, etc | The ASA provides guidance on the terminology that can be used regarding skills or experience. This is dependent on experience and qualifications |
| Anything that trivialises non-surgical treatments, surgery or the effects of invasive treatments and avoid slang | Posts should be honest, to the point and include information on how to book a consultation to discuss treatments in more depth |
| Common hashtags or trending hashtags that are affiliated with filtered images or other establishments not following Advertising Standards Agency (ASA) guidance | Hashtags that are in line with your brand messaging and promotion can be used. Dove have started a movement against the use of filters and airbrushing in images. #nodigitaldistortion can be tagged in unfiltered images, or a #movement of your own can be started |
» Even if a practitioner's output on social media is acceptable, patients can still pose a threat to the efficacy of a practice and the business's promotion by tagging them in an inappropriate post «
Plan, then post
It is advisable to make a media plan to organise what will be posted, when it will be posted and on what platform. There are plenty of safe and honest things that can be posted that will promote a business safely and effectively, but it takes planning to avoid a quick, unthoughtful post going out just to have some sort of online presence. Think about your CTA and what you want your post to achieve. What is your brand message, and how can this be portrayed visually and in a small number of characters on social media? Think about content that demonstrates your credibility as a medical practitioner and builds awareness of your practice and expertise. Helpful Q&As about a particular service, product or skin concern are one example of this, as are factsheets or posts that compare one treatment or product with another, as they open up a dialogue and educate viewers. Upon knowing what can and cannot be posted, it becomes easier to generate safe and clear content ideas. However, caution should still be exercised. Even if a practitioner's output on social media is acceptable, patients can still pose a threat to the efficacy of a practice and the business's promotion by tagging them in an inappropriate post. For example, being associated with a filtered image or unsubstantiated claim about a particular treatment that a practitioner has provided or a product that has been sold can be equally problematic, even though the practitioner had no control over it. Should this occur, the best course of action is to not engage with the post, which means no commenting or reposting, particularly from a patient that has had a POM. It would perhaps be beneficial to have clear guidelines for any collaborations with influencers, to ensure that anything they post surrounding the treatments they have are in line with the practitioner's output. It is also worth being mindful of who is chosen for such a collaboration, in case they have a particularly young demographic of followers.
Conclusion
Social media is a great way to promote a medical aesthetics practice, to demonstrate a practitioner's skills and educate and engage with patients, both old and new. It is certainly a tool that is worth using; however, using it is a decision that should not be entered into lightly. Although it can be frustrating to see other users not treading the same ethical road as you, it is not worth compromising your own standards to compete, as, whether it is through the ASA or an unsuitable patient with unrealistic expectations who visits you for treatments as a direct result of something that was posted, one way or another, you will reap the problematic effects of a misleading post.