Managing Gen Z patients
Answers in Practice
By Emily Margosian, Assistant Editor, March 1, 2023
DermWorld talks to Brittany Craiglow, MD, FAAD, from Yale School of Medicine, about tips for managing Gen Z patients — individuals born after 1996.
DermWorld: Tell us about your practice.
DermWorld: In your experience, how does Gen Z approach health care differently than previous generations?
Dr. Craiglow: As a whole, I think Gen Z is interested in wellness and self-care in a way that previous generations haven’t been. Many of these patients are frequently going online for health information before seeing a doctor. Importantly, it’s more often to TikTok or Instagram rather than a place like the AAD website. While some of the information may be accurate, unfortunately much of it isn’t. Personal anecdotes appear to be especially compelling among this group, but as we know those are often the least reliable sources. When those opinions or stories win out over our medical expertise, it can be especially frustrating.
DermWorld: Gen Z-ers have been referred to as “digital natives.” How does that affect the doctor-patient relationship?
Dr. Craiglow: In some ways, it can be quite useful. There was a rise in popularity of “skinfluencers” during the pandemic as skin care became trendy as a form of self-care. That kind of content is popular with Gen Z, and as a result we see more patients coming in who are paying more attention to their skin. In some cases, they may also be absorbing some positive messaging, for example, that sunscreen is an important part of their skin care routine. We also have colleagues who are devoting a lot of time to educating on a variety of social media platforms, which is enormously helpful.
On the flip side, some patients may feel that they’re suddenly an expert because they’re accessing all this information and come in having diagnosed themselves already. When they’re right, it’s great, but when they aren’t it can be tricky. Dermatologists need to strike a balance between, “I know you saw that online, but you don’t actually have ‘fungal acne,’” with an understanding of where people may be coming from. I try my best to stay up to date on the latest trends because if we’re more “hip,” so to speak, to what’s being discussed online then they’re more apt to trust our expert opinion. Sometimes I’ll say, “Oh, did you learn that from TikTok?” My patients will chuckle, but when they recognize that I get it, I think they may be more inclined to follow my instructions or believe what I have to say.
Your Dermatologist Knows
Learn more about how the AAD is engaging the public on questions about their health and wellness, while putting dermatologists in the foreground at staging.aad.org/your-dermatologist-knows.
DermWorld: Do you have other examples of how you might adjust your communication style when working with Gen Z patients, particularly when discussing online misinformation?
Dr. Craiglow: I think it’s super important not to alienate the patient. While it can be difficult, we need to try to avoid saying things like, “That’s ridiculous,” or “That’s garbage,” or using other condescending language. If it’s something they really believe in, then they’re not going to trust anything else you have to say. Ultimately, our job is to help patients, so we need to meet them where they are and then go from there.
One thing I discuss with my patients is knowing your sources. Where are you getting this information? Who is this person? Do they have medical training or a medical degree? We often see patients with certain disease states spending time in online support groups. They may hear, for instance, that going gluten free cured someone’s condition. It’s important to reiterate that they should take these personal anecdotes with a grain of salt. I try to emphasize to my patients that you can find anything you want on the internet — if you have a belief, you can find someone else to reinforce it, but that doesn’t necessarily mean that it’s real.
DermWorld: What are some common misconceptions about dermatologic care among Gen Z?
Dr. Craiglow: The conversation around isotretinoin is a good example. Patients will often have preconceived notions and immediately say they’ll never take it. Ultimately, it’s their body and their decision; however, I think it’s important to address their concerns with a thorough discussion and emphasize that we’re making recommendations based on our years of medical training and experience.
There’s also a lot of focus on diet and how it may affect different skin diseases. In general, diet isn’t playing much of a role, if any, in most of the things we see. Not that it’s wrong to have a healthy diet, but I think people get fixated on the idea of food as a ‘trigger.’ There’s often this desire to blame skin disease on some environmental exposure when most of these conditions arise largely because of a genetic predisposition. It’s an interesting thing about skin and hair — because we can see it, there’s this feeling that it must be something we’re interacting with that’s causing the problem. I think a lot of patients get hung up on diet because they’re looking for a sense of control, and one thing we can fairly easily control is what we eat. Social media and marketing also really prey upon these beliefs and the desire for a quick fix.
Another common theme is the assumption that “natural” or “organic” is always better. I’ll tell my patients, “Poison ivy is natural, but that doesn’t mean it belongs on your skin.” I see this particularly among my patients with atopic dermatitis — they’re fed the idea that they need to be “all natural” to resolve their skin disease and often end up using things that are actually more harmful than helpful.
Paging Dr. Google
Read about the consequences of self-practiced medicine and what dermatologists can do to educate patients.
DermWorld: What are Gen Z’s perceptions of sun safety? How do you discuss sun protection with your Gen Z patients?
Dr. Craiglow: There are a lot of patients in that age group who don’t understand the dangers of UV exposure and feel a bit like they’re invincible still. They’re living in the moment more than thinking about the long-term. When you’re 20, it can be hard to imagine yourself getting wrinkles or melanoma as a 40- or 50-year-old. This is an area where we need to help patients better understand that their behavior now is affecting their future. One way we can do that is by normalizing sun protection and presenting it as part of a routine, almost like a type of self-care. That framing can be persuasive to Gen Z patients. Along those “wellness” lines, I emphasize to patients that this is an important part of taking care of yourself and your health. This is a place where personal stories can be especially powerful. I personally have had melanoma and have a giant scar on my arm — now that really catches patients’ attention, like “Oh wow, that happened to her, maybe it could happen to me.”
DermWorld: What do you enjoy about working with Gen Z patients?
Dr. Craiglow: On the whole, they’re engaged and interested in taking an active role in their health. Sometimes we have patients who come in and don’t know the names of medications or products they have tried or how they’re meant to be using a particular treatment; however, Gen Z patients are often more up to speed and proactive about their care. That kind of engagement from a patient is really useful. I also think that in general they tend to be a bit more open to new ideas versus someone who’s a bit older and maybe more set in their ways. As long as we’re able to effectively engage them, treating Gen Z-ers tends to be really fun and rewarding.
Brittany Craiglow, MD, FAAD, is in private practice in Fairfield, Connecticut, and serves as adjunct associate professor of dermatology at Yale School of Medicine.
