Mounting evidence suggests that problematic adolescent social media use is associated with poor mental health. To respond to increased adolescent mental health concerns, health promoters increasingly rely on social media initiatives to promote their resources, programs, and services. This creates a paradoxical situation where social-media-linked adverse mental health outcomes are addressed using the same tools and platforms that can contribute to the development of such issues. It also highlights several areas of needed critical assessment in health promotion usage of social media platform features and products, such as addictive platform design, targeted marketing tools, data collection practices, impacts on underserved groups, and conflicts of interest. To advance subsequent action on these tensions, we offer three recommendations for health promoters that build upon existing scholarship and initiatives, including adapting ethical guidelines for health promoters using social media, adopting conflicts of interest policies, and promoting interdisciplinary scholarship.