“Don’t put garlic in your nose”: The dangers of sinusitis misinformation on TikTok

A new study published in the journal Otolaryngology-Head and Neck Surgery sheds light on the quality of sinusitis-related videos on TikTok. Researchers found that nearly half of these videos contain misleading or inaccurate content, primarily propagated by non-medical influencers. This alarming trend highlights the potential risks associated with sourcing health advice from unverified content on social media.

Sinusitis, an inflammation of the sinuses, affects about one in seven adults in the United States, leading to an annual medical cost of approximately $5.8 billion. The condition can be triggered by various factors, including infections and allergies, and can severely impact the quality of life, causing symptoms like nasal congestion and facial pain. Despite its prevalence, many people opt for self-treatment, guided by information sourced online.

Previously, platforms like Twitter have been scrutinized for the spread of health misinformation. With TikTok’s user base rapidly growing—it’s expected to reach 2.2 billion by 2027—its influence is undeniable. The platform’s engaging format of short, catchy videos makes it a fertile ground for the spread of both useful knowledge and harmful misinformation. This has prompted researchers to systematically evaluate the quality of sinusitis-related information shared on TikTok.

“Every type of ‘Tok’ exists – that’s just how the internet works,” said Rose Dimitroyannis, a third-year medical student at the University of Chicago Pritzker School of Medicine. “Little tiny segments of the population find one another and make waves.”

“There is high-quality and factual information out there on social media platforms such as TikTok, but it may be very difficult to distinguish this from information disseminated by influencers that can actually be harmful,” added Christopher Roxbury, a surgeon and rhinology expert at UChicago Medicine.

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The researchers conducted a comprehensive search using popular hashtags like #sinus, #sinusitis, and #sinusinfection on TikTok, from January 29 to 30, 2023. They aimed to capture a broad spectrum of content, filtering videos that provided sinusitis-related information in English. Out of 465 videos initially found, 220 met the inclusion criteria after duplicates and irrelevant content were removed.

The content of these videos was then categorized into types such as medical advice, comedy, marketing, and lifestyle, and evaluated for educational value and factual accuracy. The researchers used several tools to assess video quality for understandability and actionability, and the Journal of the American Medical Association (JAMA) criteria for reliability and accuracy.

Only 55.5% of all videos were categorized as factual, meaning that nearly half contained inaccuracies or misleading content. Videos from medical professionals had the highest proportion of factual content at an impressive 84.4%, significantly higher than other groups. In contrast, only 45.3% of videos posted by non-medical influencers and 53.6% from lay individuals contained factual information. This significant disparity underscores the risk associated with non-expert health advice prevalent on social media platforms.

Furthermore, the study utilized the Global Quality Scale (GQS) to rate the overall quality of the videos, with scores ranging from 1 to 5. Videos from medical professionals averaged a GQS score of 3.76, indicating “good quality,” whereas videos from non-medical influencers and lay individuals scored lower, at 2.47 and 2.38, respectively. These scores suggest that content from medical professionals not only tends to be more accurate but is also of higher quality in terms of presentation and utility.

In addition, videos with higher views tended to have lower quality scores, suggesting that popularity on TikTok does not necessarily correlate with informational quality.

The spread of inaccurate medical videos on social media can have serious consequences. Not only can such misinformation lead to confusion, but it can also promote harmful “treatments” that pose real dangers to individuals’ health. Individuals might also forego necessary medical treatment in favor of ineffective alternatives touted online.

“I frequently have patients in the clinic asking me questions about things they saw online or on social media, and I have found that many times the information has steered patients in the wrong direction,” said Roxbury, the study’s senior author. “In some cases, I see patients who have already sought out and undergone such treatment without any benefit; in rarer cases, they’ve been harmed.”

During the study period, researchers noted a trend where individuals were inserting whole cloves of garlic into their noses to alleviate congestion, a practice popularized on TikTok. While this method may initially appear to clear mucus when blowing the nose, it is actually counterproductive. The garlic irritates the nasal lining, leading to increased mucus production rather than genuine relief. This practice poses significant risks, including potential damage to nasal tissues and the danger of inhaling garlic deep into the nasal passages.

“Just to put it out there — don’t put garlic in your nose,” Dimitroyannis said. “It wasn’t coming from a bad place, but as many trends do, it tended to become quite unsafe.”

Looking forward, the study emphasizes the need for medical professionals to play a more active role in content creation on platforms like TikTok to counteract misinformation effectively. The findings suggest that when medical professionals engage in social media, they have the potential to deliver high-quality, factual information that can compete with and correct misleading content.

“If you’re a healthcare expert with any interest in content creation, you could make a difference,” Dimitroyannis said. “Someone could see your video and get the health information they need instead of seeing something that could hurt them.”

The study, “A Social Media Quality Review of Popular Sinusitis Videos on TikTok,” was authored by Rose Dimitroyannis, David Fenton, Stella Cho, Rachel Nordgren, Jayant M. Pinto, and Christopher R. Roxbury.