Evaluating Population Interest in Vitiligo Through an Analysis of Google Trends and Social Media

June 2020 | Volume 19 | Issue 6 | Features | 10 | Copyright © June 2020

Published online May 20, 2020

Simone Nicole Boeckmann Montgomery BA and Nada Elbuluk MD MSc

Department of Dermatology, Keck School of Medicine at the University of Southern California, Los Angeles, CA

Abstract

INTRODUCTION

Vitiligo is an autoimmune pigmentary condition with a complex, multifactorial pathogenesis resulting in depigmentation of skin. It affects between 0.4-2% of the population worldwide.1 In recent years, vitiligo has seen a significant increase in attention in both mainstream media and on social media. Prior to the emergence of body positivity campaigns and supermodel Winnie Harlow, representation of vitiligo in the media was sparse, focusing mostly on the skin lightening transformation of artists like Michael Jackson and Sinbad. In contrast, today, there are numerous advertising campaigns and platforms from makeup and clothing companies to patient-organized support groups encouraging representation of vitiligo and positive awareness about the condition.

Nearly 90% of Americans use the internet, which has transformed the way information is provided and accessed.2 The domain of health-related information is no exception. More than 72% of Americans report having used the internet for health-related questions, including exploring the potential diagnosis for symptoms, a diagnosis given to them, disease progression information, and symptom management.3 Furthermore, it has been reported that the internet, has become the first, and sometimes only, source of health information for patients.4 Google holds 88.5% of the market share of search engines, with over 3.5 billion daily queries – 7% of which are reported to be health-related.5,6

Google trends is a search tool which tracks and reports the search volume of a specific query over time and/or within a specific region. Recognizing the power of having access to the over 3.5 billion daily queries, the field of medicine has begun to adopt Google trends and the use of big data as a powerful epidemiological tool to track population trends and interests over time. In dermatology, studies using Google Trends have been used to elucidate population interest in several conditions including skin cancer, psoriasis, and Botox.7,8,9 In addition to patients’ using Google to obtain background information and explore health issues on varies websites, social media has also evolved from a personal sharing space to a marketplace of information, services, and products. Instagram, a photo-sharing app, has become the most popular social media platform, servicing over 110 million users in the United States and over 800 million users worldwide.10 Indeed in 2018, forty-two percent of Americans reported use of social media platforms, such as Instagram, to search for health-related information.11

Vitiligo has seen a significant increase in attention in mainstream media, ranging from campaigns to ‘embrace the skin you are in’ to supermodels with vitiligo being featured as the face of major retailers. To date there has been only one peer-reviewed study using Google Trends to examine interest in vitiligo. However, our study is the first to use both Google Trends and a social media platform to elucidate public knowledge patterns about vitiligo and general interest in vitiligo. The goal of this study is to 1) apply Google Trends to track and elucidate the temporal and geographical trends, related interests, and top searches about vitiligo and 2) to summarize the content of vitiligo related treatments and topics on Instagram and document its growing presence.

METHODS

The keyword of vitiligo was entered (August 15, 2019) in Google search and we recorded the number of results and the content of the top page of results. Next, Google trends was used to explore temporal and geographical population interest related to vitiligo. Searches were limited to those performed in the United States from January 1, 2004, the earliest year with recorded Google trends data, through December 31, 2018. Google Trends presents temporal and geographical trends as relative search volumes (RSV) on a scale of 1-100, which allows for normalization of geographic and population sizes. Interest over time (temporal) was recorded as RSV per month, and subsequently, annual RSV was estimated by calculating the mean of each monthly RSV per year. Interest by subregion was also recorded as RSV for each state. The subcategory of “Related Queries” was then explored. This subcategory is also provided in the Google Trends analysis and identifies the most frequent subsequent searches by users who initially searched for vitiligo.

We also searched the keyword of vitiligo as a hashtag on Instagram and recorded the number of total posts, with Instagram providing a “Top Posts” page with a continuous list of images. A sample of 300 top posts were recorded and categorized based on content and source (Figure 1a and 1b).