Scientific Smuggling: The Dark Side of Instagram's Evidence-Free 'Expert' Health Science Courses

This study aimed to investigate the prevalence and characteristics of health-related courses promoted on Instagram that advertise unvalidated or scientifically unsupported clinical and surgical techniques, specifically targeting courses taught by self-identified healthcare professionals on the Instagram platform.

Metadata regarding user credentials, engagement metrics, course format, claimed outcomes, and references to scientific evidence were extracted. An unvalidated technique was defined as any procedural claim made in a course promotion lacking citation to peer-reviewed literature, documented pre-clinical or clinical trials, or formal recognition by a relevant professional regulatory body. Scientific validity was assessed based on the presence or absence of these predefined criteria: (1) citation of peer-reviewed studies, (2) evidence of prior regulatory approval (e.g., from a professional council), and (3) documentation of clinical trial data. Statistical analyses were performed in RStudio using Pearson's correlation and Kruskal-Wallis tests (p < 0.05).

A total of 612 accounts promoting 1120 courses were screened, with 77 eligible accounts included in the final analysis. The instructors had an average of 11.6 years since graduation, though some had only months of professional experience. Only 17 specialists were trained in the relevant field, and advanced degrees were rare. Seventy-six distinct unvalidated techniques were identified, 17 of which were surgical, and 11 explicitly prohibited by professional councils. Most instructors lacked formal academic affiliation, and 35 falsely self-identified as specialists. Notably, only 14.5% of unvalidated techniques faced regulatory prohibition, leaving the majority unmonitored.

The findings reveal alarming trends in the commercialisation of unvalidated aesthetic practices through Instagram-based courses, often taught by underqualified professionals. Urgent regulatory reforms are needed to address the role of social media in promoting harmful health practices.