PS24 Dermatology as narrative language: a cross-media analysis of skin, hair and nail representation in popular visual media

Abstract

Popular visual media likely plays a role in shaping public perceptions of skin health and disease. While dermatological features are frequently used as visual storytelling devices, there has been little systematic analysis of how these are represented across different media formats. We examined how dermatological features are represented across different media formats. A structured content analysis was conducted of top-ranked IMDb titles across four media formats: anime series, animated films, live-action films and television series (n = 400). Named characters were screened by paired independent reviewers for visible features affecting skin, hair and nails using predefined criteria. Extracted variables included condition type, congenital vs. acquired status, narrative role and moral alignment. Narrative framing and use of concealment devices were analysed thematically. Dermatological features were dominated by acquired skin damage, particularly scarring and burns, with limited representation of skin disease. For example, in anime characters, 95% of visible skin features were acquired rather than congenital. Scars were framed within distinct narrative contexts, functioning as symbols of resilience and heroism or markers of moral corruption or threats. Symmetrical or patterned scarring frequently appeared intentional or ideological, whereas asymmetrical scarring was commonly associated with trauma or conflict. Hair and nail features reinforced these portrayals, amplifying themes of power, menace, transformation or instability. Concealment of lesions through masks, bandages or cosmetic modification was a recurrent narrative device. Consistent quantitative patterns were observed across media formats. Mainstream media overwhelmingly portrays dermatology through damage, morality and concealment, and largely omits skin diseases. Skin is used as a narrative language rather than a reflection of real-world skin health. Visible dermatological disease is frequently associated with stigma. As mainstream media shapes and reinforces narrative frameworks that audiences readily accept, these findings suggest that media representations may influence public perceptions and could be leveraged to support improved understanding and destigmatization of skin disease.