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

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.