When Ayva Pe?a got a phone at age 10, her interest in skin care skyrocketed.

At first, she bonded over it with her mother, Giselle Pe?a. Together, they would have spa days with face masks and take occasional shopping trips to try out new products. But when the Rhode Island mother found a $300 anti-aging face cream in Ayva?s medicine drawer, it gave her pause.

?I got very upset. ? She?s 15 years old,? Pe?a said. ?It says it makes your skin ageless, improves fine lines, wrinkles and firmness. I was like, ?This is not for you, girl.??

Pe?a is among a growing number of parents concerned about how content on social media platforms is influencing children and teens into trying out elaborate, often age-inappropriate skin care products. Now, a study published Monday in the journal Pediatrics may confirm those parents? worries.

After analyzing beauty routines from 100 TikTok videos by content creators ages 7 through 18, researchers found an average of 11 potentially irritating active ingredients among their regimens, many of which carry a risk of developing skin allergies and increased sun sensitivity. Only a quarter of the lengthy product lists contained sunscreens, however.

?The majority of (children) featured in these videos didn?t have any visible acne. They had perfect, clear skin,? said Dr. Molly Hales, the first study author and a board-certified dermatologist in the department of dermatology at Northwestern University?s Feinberg School of Medicine. ?For many of them, the harms probably outweigh any potential benefits.?

Between the dozens of daily serums, moisturizers, toners and cleansers featured in the videos, the average routine was six steps long, costing about $168 ? with some more than $500 ? for one month?s worth of product, according to the study.

?When you have kids waking up at 5:30 in the morning on a school day to have enough time to layer on these complicated regimens, I think it becomes less about health and more (about) pursuing an idea of beauty that is unrealistic and problematic,? said Hales, who is also a postdoctoral research fellow at Feinberg. The findings raise serious ethical questions about how social media content influences young people in their everyday lives, she added

A TikTok spokesperson, noting that this type of content is ?common across all media,? said the platform is only for users ages 13 and older, and any creators suspected to be under 13 are removed. Additionally, they said that TikTok works with third-party doctors and experts in adolescent development to implement safeguarding policies.

Red flags in teen skin care

Most of the studied skin care routines lacked a form of sunscreen but contained products that could increase sun sensitivity and risk of skin cancer, the authors found.

Common active ingredients found in recommended skin products were alpha hydroxy acids or AHAs, mild chemical exfoliants that help remove top layers of skin cells, Hales said. While they have the intended effect of evening skin tone and creating a more youthful appearance, they are known to make the skin more vulnerable to the sun?s ultraviolet rays.

?I would recommend daily sunscreen use for all ages and regimens, but especially for those using these (AHAs),? Hales said. ?It?s a necessary step to prevent permanent skin damage.?

Those AHAs, as well as vitamin-based ingredients such as niacinamide, are also considered potential irritants, carrying side effects such as redness and dryness, especially with overuse.

?In many cases, the girls may not have realized they were applying the same active ingredient again and again, which just increases the risk of irritation,? said Dr. Tara Lagu, senior study author and adjunct lecturer of medicine and medical social sciences at Feinberg.

More than half the products contained fragrance ? a common cause of allergic contact dermatitis ? and 20 other inactive ingredients that are known allergens, according to the study.

?Misinformation is a big issue on social media, but especially for these content creators younger than 18,? said Dr. Sonal Shah, a board-certified dermatologist in Cleveland and director of pediatric dermatology at University Hospitals Rainbow Babies & Children?s Hospital. Shah was not involved in the study.

?These are sources that perhaps don?t have a scientific background and are not well read in the science behind a lot of these products, how they work, or what risks they carry,? Shah said, adding that there are board-certified dermatologists on TikTok that could offer more credible advice.

Other concerning trends Shah has seen in her practice, but were not mentioned in the study, include mechanical exfoliants, such as scrubbing wands or cleansers containing plastic microbeads, which are often too rough for facial skin.

The study also noted that many of the creators were offering tips relevant to those with lighter complexions, which may exclude the unique skin care considerations of darker complexions while perpetuating harmful ideals of ?brighter? skin associated with whiteness.

What skin care should teens use?

Both Shah and Hales recommend children under 18 who are not dealing with acne use a gentle cleanser with no active ingredients, paired with a fragrance-free moisturizer and a daily mineral sunscreen.

In general, children will not benefit from anti-aging products that promise to boost skin elasticity or eliminate fine lines, Shah said. In these young ages, collagen production is at the highest it will ever be.

As children reach puberty, however, they may produce more acne-causing hormones. In those cases, Shah recommends adding an over-the-counter product with salicylic acid or a low percentage of benzoyl peroxide.

?Their skin care does not have to be complicated and does not have to be very expensive,? Shah said. Parents ?can talk to a board-certified dermatologist or pediatric dermatologist if there are skin concerns that are significant or don?t respond to over-the-counter treatment.?

The bigger picture

Ultimately, if parents are concerned about their child?s skin care regimen, they should talk about it, said Jennifer Harriger, a professor of psychology at Pepperdine University who studies childhood development, in a statement.

?I think that it is always best to have open conversations with children about the messages they see on social media as well as their own intentions behind purchasing particular skincare products,? said Harriger, who was not involved in the study.

It?s also important to keep an open mind, understanding the social dimension of youth beauty and wellness content, Hales said.

?These videos show a kind of playful self-expression that?s very appealing to this age group,? Hales said. ?These are girls who are just starting to develop their own sense of independent identity, how they present (themselves) in the world, their gender identity, and in many cases what it means to be a girl in our society.? (CNN)

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