Emojis and Emoticons in Healthcare and Dermatology Communication: A Narrative Review (Preprint)

BACKGROUND Emoticons and emojis have become staple additions to modern day communication. These graphical icons are now imbedded into daily society through the various forms of popular social media and through users’ personal electronic conversations. With ever increasing use and inclusivity, exploration of the possible healthcare and dermatology applications of these tools is imperative. OBJECTIVE The goal of this narrative review is to provide and evaluate an up-to-date literature survey examining the utility of emoticons and emojis in medicine. Special attention will be drawn to existing and potential usage in the field of dermatology, especially during the COVID-19 pandemic. METHODS A PubMed search of peer-reviewed publications was performed in mid-2021 to collect articles with emoticon or emoji keywords in combination with other healthcare or dermatology-relevant keywords. Screening of publications and described studies was performed by authors with education and research experience in healthcare, dermatology, social media, and electronic communication trends. Selected articles were grouped by common subjects to be qualitatively analyzed and presented for in-depth discussion. RESULTS From this extensive search, researchers were able to identify a wide variety of publications detailing the use of emoticons and emojis within general healthcare, pediatric healthcare, public health, and dermatology. Key subject areas that emerged from the investigation included the ability of emoticons or emojis to improve communication within pediatric healthcare, enhance mood and psychological assessment or mental health screening in adults, develop interventions to improve patient medication adherence, complement novel means of public health and COVID-19 surveillance, and bolster dermatology-specific applications. CONCLUSIONS This review illuminated the repurposing of emojis or emoticons for a myriad of advantageous functions in the healthcare and public health, with applications studied in many populations and situations. Dermatology-specific uses were relatively sparse in the literature, which highlights a potential opportunity for growth in future studies and practices. The importance of diversity and inclusivity has extended to emojis, with the recent introduction of Skin of Color customization and new emojis better representing the comprehensive spectrum of users’ experiences. A continuously evolving and technology-driven population creates a unique niche for emoticons and emojis to ease worldwide communication and understanding, transcending barriers of age, language, and background. We encourage future studies and innovation to further understand and expand their utility.