Dermatologists say girls are getting rashes and worse from beauty products pitched by influencers and that it ‘needs to be addressed’

Dr. Elizabeth Houshmand remembers the day a nine-year-old appeared in her Dallas dermatology clinic with a rash on her face from a cleanser containing glycolic acid she had seen on TikTok and bought with her mom’s help to treat her skin problems. Glycolic acid, which is used as an acne and anti-aging serum, is approved for use by adults but is generally unsafe for kids because it can be too strong for their still developing skin.

The girl’s rash eventually went away without causing any permanent damage. But it shows the dangers lurking on services like TikTok, YouTube, and Instagram, which are rife with influencers hawking skincare products that are potentially dangerous to minors.

“You can use social media for such a greater good—educating on skin cancers, melanoma—but then I think this aspect of monetizing and targeting that [young] age demographic is something that needs to be addressed,” said Houshmand, who also chairs the American Society for Dermatologic Surgery’s social media committee.

She and another dermatologist told Fortune that young girls—from nine to 14-years old—routinely visit their clinics with skin damage after using products they bought after seeing influencers post about them on social media. Many of those impacted are looking to mimic their favorite influencers and gain cool girl status for owning and using viral products.

In some cases, the influencers, not just on TikTok, but also on Instagram, YouTube, Amazon and other platforms, make money from pitching the skin products that can end up being harmful to young skin. They can earn commissions by directly linking to skincare products that can be purchased online.

Whatever the case, it feeds into the internet version of the phenomenon known as “Sephora kids,” young girls frequenting beauty chain Sephora to sample and buy skincare products. When shopping online, kids may be unaware of the dangers of certain ingredients to their skin and can be susceptible to buying fake and scam products that could also be dangerous.

Social media's skincare obsession

The skin obsession on social media largely started in the last few years with popular influencers posting “get ready with me” videos, which often go by the acronym GRWM across social media. The clips are characterized by the stars talking through makeup and skincare routines, selfie-style in intimate settings like bedrooms and bathrooms. The videos have led millions of girls and women to post their own clips showing them washing their faces and applying makeup—taking viewers through their often-complicated preparations for dates, school, church, and many other occasions.

In turn, personal care brands, as well as TikTok, YouTube, Instagram, Amazon, and the influencers themselves, have turned these GRWM videos into a lucrative corner of the creator economy as they seamlessly connect product endorsements and glamorous online personalities.

The videos have enjoyed a symbiotic relationship with TikTok Shop, the platform’s ecommerce offering that debuted in September. TikTok hopes ecommerce will become a growth engine that supplements its core advertising business. Influencers who sign up for TikTok Shop can tag TikTok Shop products—ranging from bags of chips to skin moisturizers—in their videos so that users can buy those products within the app. The influencers who work with the brands on TikTok Shop take a cut of everything sold through the links.

TikTok has implemented a number of guardrails to prevent harm to kids. Users must be 18 or older to view, sell, and purchase items through TikTok Shop. But many young users lie about their age when they sign up for the service.

Some of the most popular brands among kids, like Drunk Elephant, have no official TikTok Shop presence and say they don’t sell through third parties. Yet some merchants on the platform still claim to sell their products, often with discounts from retail prices—a telltale sign that they may be fake and therefore more likely to be manufactured with risky ingredients, or come with inflated shipping costs.

Fortune found eight different sellers on TikTok Shop claiming to sell Drunk Elephant products without permission. One of the merchants selling the company’s products was Hudson-Litchfield Youth Football & Cheer. Fortune asked the organization why the New Hampshire youth football and cheer league was selling Drunk Elephant on TikTok Shop, but did not get a response. To become a TikTok Shop seller, users need only upload a government issued ID to the platform and link their bank and TikTok accounts.

A Drunk Elephant spokesperson told Fortune that since the company doesn’t sell products on TikTok Shop, it “cannot verify the authenticity or quality of any Drunk Elephant products appearing there.”

Drunk Elephant does have a TikTok account that it uses to market itself, at times to children. In one video, founder and chief creative officer Tiffany Masterson spoke positively about kids buying the company’s products. She said that the company has “something that’s appropriate for every age" and went on to say that girls buying Drunk Elephant products is “great” because they’re learning to take care of their skin. “My guess is their skin is going to look a lot better than other people’s skin because they’re learning all of this on TikTok,” Masterson said.

Children say they're careful

TikTok declined to comment on record to Fortune about children buying beauty products through its platform. Facilitating sales of the beauty and skincare products to children isn’t illegal and neither the Food and Drug Administration nor TikTok requires companies to attach warning labels to products that may be harmful to children.

TikTok prohibits counterfeit products on Shop. Using automation, it detects and removes 93% of products that violate intellectual property rules before the products are ever publicly listed, the company said.

TikTok also encourages users and brands to report counterfeits. Users who have posted videos of themselves buying fake products on TikTok report that the company removed those products from Shop shortly after.

Merchants who violate the rules risk being kicked off TikTok Shop.

Children interviewed by Fortune have mixed opinions about the dangers of beauty products on TikTok. Some were scared of the risk of counterfeits, while others were unphased.

Fourteen-year-old influencer Chelsea Lascher, who has 3.3 million TikTok followers, told Fortune she has never bought products from TikTok Shop. But she notes that all her friends have, including one who bought lip tint for around $2, only to pay around $20 for shipping. She notes her friend was not harmed by the product. “TikTok Shop may be a little unsafe, because there could be products that aren’t using what they should be—that's why it's so cheap,” Lascher says. “Things that are $3 to $2, I think are fake and could be bad for the skin.”

Meanwhile, Naziyah, a 13-year-old influencer whose mom agreed that Fortune could interview her daughter, but only use her first name, said that neither she nor her friends had seen scams or fake skincare products on TikTok Shop or Amazon. “Everything from [TikTok Shop] seems to be authentic,” she says.

Francesca, a 14-year-old influencer whose mother said only her daughter’s first name could be used, said she tries to “do research” before buying products on TikTok Shop. To be safe, she says she prefers to buy from “blue check” sellers—ones whose identity has been validated by TikTok. Although she thinks TikTok Shop is “really cool,” she prefers to shop on Amazon for skincare products because she believes the products sold there are more reliable. “I trust buying on Amazon,” she said.

Amazon's big role in the influencer economy

Many influencers across social media use Amazon’s Storefronts to earn commissions from sales of the products they endorse. Anyone with an Instagram, TikTok, YouTube or Facebook account can apply to join Amazon’s Influencer Program, choose which Amazon products to promote, and link to their Amazon Storefronts across the internet. Some of the biggest influencers say Amazon pays them more than $10,000 monthly in commissions.

But critics have said Amazon is filled with fake products. Sally Olivia Kim, an influencer who sells two varieties of her collagen supplement brand Crushed Tonic on Amazon, worries minors lack the sophistication to identify fake products and may deliberately seek out discounted ones that are more likely to be counterfeit. “Dupe culture has enabled young girls to buy knockoffs,” she says, using a slang term for counterfeits, adding ”people don't understand how bad that really can be.”

Prudence Millsap, a founder of skincare brand Beauty by Earth, which sells its products through sites including Amazon, Target, and Walmart, says one change Amazon could make so that users are better informed is to require that sellers make their products’ country of origin more visible to shoppers. She notes that her company pays a premium to manufacture its products within FDA guidelines, and that competitor brands manufactured in places like China, and sold on Amazon at discounted prices, generally don’t meet the same standards. She thinks this is a safety issue for all consumers, especially young ones.

When it comes to teen skincare, an Amazon spokesperson told Fortune, “We are proud to offer a vast selection of skincare products suitable for a variety of ages and skincare needs, but products purchased for younger skin should always first be discussed with a dermatologist or skincare professional.” Amazon, however, does not appear to make such a public warning to its users in either its Help Center or on product pages for popular cosmetics with active ingredients that dermatologists have flagged for their potential harm to children. The company did not respond to a request for comment about the topic.

Users under 18 are permitted to shop on Amazon only with a parent or guardian. However, children can get around the rule by having an adult’s credit card linked in their accounts.

In terms of sales, Amazon prohibits anyone under 18 from operating Amazon Storefronts. The company does let children host Storefronts as long as they are managed by a parent or agent, though it’s unclear how this policy is enforced. One 12-year-old girl YouTuber who goes by Noelle Kate with nearly 200,000 subscribers receives a commission when shoppers purchase her “skincare favs,” including a Drunk Elephant serum with glycolic acid, the same ingredient that dermatologist Houshmand says can give kids non-allergic rashes. It’s unclear how many of Kate’s customers are children. She did not respond to Fortune’s requests for comment.

A call for legislation

Amazon says it has a zero tolerance policy for counterfeits. It says it withholds commissions, dumps inventory, and bar sellers from the platform who are caught selling counterfeits. In 2023, Amazon invested more than $1.2 billion and employed over 15,000 people to protect the company from “counterfeit, fraud and other forms of abuse,” an Amazon spokesperson says.

And still, children continue to be harmed by skincare products. Critics argue that legislation is needed to rein in the sale of beauty products on Amazon, TikTok and on social media at-large. “The beauty, health and wellness industry is not being regulated at all,” says Sheilagh Maguiness, president of the Society for Pediatric Dermatology, who also notes that the European Union has banned hundreds of ingredients from personal care products while the U.S. has only banned eight. “Given the absence of regulation in health, wellness and beauty, if companies are seeing an uptick in sales among younger patients with more sensitive skin, there really should be a call for making sure the product is appropriately labeled for its intended use.”

This story was originally featured on Fortune.com