Rachel Simon, third-year pediatric resident at Nemours/Alfred I. duPont Hospital for Children, also contributed to this article.
Teens’ use of TikTok, the social media app that allows users to watch, create, and share 15- to 30-second videos recorded on cellphones, has escalated during the pandemic. TikTok is now the second most popular downloaded app, after only Instagram.
If you ask teenagers what they like to do online, chances are it’s TikTok. Almost half of TikTok users are between ages 16 and 24, and 90% of users engage with the app every day.
The content varies widely and ranges from music, dance, exercise, and tutorial videos to humor and parodies. TikTok can get people moving, educated, and laughing. “It’s all good!” however, does not apply to all of TikTok.
Here are just a few of TikTok’s dangerous “challenges”:
- “The Benadryl Challenge” involves individuals taking high doses of diphenhydramine, an over-the-counter allergy medication, to induce hallucinations. Diphenhydramine overdose can lead to serious heart problems, seizures, coma, and death.
- “The Blackout Challenge” dares participants to choke themselves until they pass out for several seconds. In Italy, the challenge turned deadly when a 10-year-old girl tied a belt around her neck. Another variant of the challenge called “The Pass Out Challenge” involves people vigorously shaking their heads back and forth until they pass out.
- “The Boiling Water Challenge” involves people throwing hot water from a container into cold air. If the challenge is successful, the liquid instantly freezes into snowflakes. However, the hot water can splash, causing serious burns.
- “The ‘Cha-Cha Slide’ Challenge” involves participants listening to the song by DJ Casper while driving. When the lyrics say “slide to the left!” — the driver makes a corresponding steering-wheel swerve, even into the oncoming traffic lane.
- “The Concussion Challenge” starts with a group of individuals standing in a circle and bending forward to create a huddle. An object is then thrown into the area and no one is allowed to move, risking serious concussion.
- “The Nutmeg Challenge” involves participants rapidly drinking water that has a large amount of ground nutmeg, purportedly to get high. Nutmeg leads to nausea, dizziness, and hallucinations. Teens are dumping nutmeg straight from the bottle, often without measuring. Ten grams (two teaspoons) is enough to cause symptoms and 50 grams can be deadly.
- “The Penny Challenge” involves plugging a phone charger into an outlet partially, and then sliding a penny down the exposed prongs. This can result in sparks and fires.
- “The Skull Breaker Challenge” involves three people facing the same direction. The one in the middle jumps up while the two others kick the person’s legs from behind. This causes the middle person to fall backward, risking serious head and neck injury.
Deadly challenges are not the only problem. The videos on TikTok are short and stimulating, and as soon as one is done, the next captivating video is just a “swipe up” away. The nature of these videos triggers a dopamine release, similar to that experienced with substance abuse. Planning on spending a few minutes on TikTok but winding up spending hours watching video after video and unable to stop? That’s addiction.
Another problem: bullying. Individuals may deride others in comments and in disparaging videos.
Another problem: promoting weight loss, starvation, and purging, contributing to teens developing eating disorders.
Our advice to parents and caregivers:
- Let your children and teenagers know what you consider to be inappropriate content for them to be watching and encourage them to tap “not interested” on a video that is inappropriate.
- Enable “Restricted Mode” to limit inappropriate content.
- Enable “Screen Time Management” to set limits on time spent on TikTok.
- Follow their accounts so you can see the videos they are posting.
- Help them control the comment section on their videos. They have the option to restrict comments altogether, limit comments to just friends, or use comment filters.
This article originally published in the Philadelphia Inquirer.