Ming Yi Wang, Yi-Jing Jin, Feng Xu
Background: Social media platforms like TikTok significantly influence health behaviors, yet the quality of scar management content remains under-evaluated. This study analyzes the quality, reliability, and actionability of scar management information on TikTok and examines the relationship between content quality and user engagement. Methods: A cross-sectional analysis of the 100 most-liked scar management videos was conducted. Two independent raters evaluated videos using mDISCERN, JAMA benchmark criteria, PEMAT-A/V, and the Global Quality Score (GQS). Creators were categorized as healthcare professionals (HCPs), content creators, or general users. Results: < 0.001) with significantly better reliability and actionability. However, an "engagement paradox" was observed: lower-quality videos from non-professionals garnered significantly higher engagement (likes, shares) than evidence-based professional content. Misinformation was prevalent in 46.2% of content creator videos. Conclusion: A structural disconnect exists on TikTok where accurate medical advice is overshadowed by algorithmically favored, visually stimulating, but often misleading content. Addressing this public health risk requires platform-level algorithmic adjustments and enhanced digital strategies from medical professionals to compete in the attention economy.