To the Editor: We read with great interest the recent research letter by Ranpariya et al, ''Dermatology without dermatologists? Analyzing Instagram influencers with dermatology related hashtags.'' 1 The authors show that board-certified dermatologists compose a minor fraction of popular dermatology content shared by influencers on Instagram. In a similar study, Park et al 2 found as few as 5% of all dermatology content on Instagram was created by board-certified dermatologists, regardless of influencer status or post engagement. If Raniparyia's parameters requiring [40,000 followers are used, it is unsurprising that only 6 of 146 of the top influencers were board-certified dermatologists (0 of 70 of the top trending content came from dermatologists). The recent findings by Sierro et al 3 show that of all board-certified dermatologists on Instagram, only 8 had [40,000 followers.Understanding the impact of influencers in dermatology necessarily requires defining an influencer. We assert that defining an influencer strictly based on follower count can lead to pitfalls because fake followers are for sale for as little as $13 per 1000 followers. Although this practice is against its community guidelines, Instagram does not always successfully ''purge'' these followers. The most basic definition of an influencer would include accounts with [10,000 followers, because this is the threshold at which most apps offer exclusive marketing functionality. The Advertising Standards Authority, a United Kingdom-based advertising watchdog, recently ruled that individuals with [30,000 followers are considered a celebrity and are therefore