Analysis of Reddit Reveals Atopic Dermatitis Patient Questions

June 2021 | Volume 20 | Issue 6 | Original Article | 653 | Copyright © June 2021


Published online May 21, 2021

Alana Kurtti BS,a,b Jared Jagdeo MD MSb,c

aRutgers Robert Wood Johnson Medical School, Piscataway, NJ
bDermatology Service, VA New York Harbor Healthcare System, Brooklyn, NY
cDepartment of Dermatology, SUNY Downstate Medical Center, Brooklyn, NY

Abstract
Background: Reddit, the seventh most visited website in the United States, has become an exceedingly popular platform for patients to source medical information and discuss chronic conditions.
Objective: To uncover patient questions regarding atopic dermatitis, as physicians can use this knowledge to better address patient concerns and more comprehensively educate patients.
Methods: The authors analyzed 1,000 questions posted on the “Hot” section of the “eczema” subreddit. Each question was then separated into categories and subcategories for analysis.
Results: 1,000 questions from 881 posts were analyzed. The highest proportion of questions (29.5%) were non-pharmacologic management focused, with patients inquiring about diet, over the counter skincare products, personal hygiene practices, clothing, and supplements. Non-specific management (19.1%), uncertainty about symptoms (14.6%), medications (14.3%), cause and triggers (10.3%), and mental health (6.9%) were common categories as well.
Limitations: The questions of the eczema subreddit subscribers may not reflect the questions of all atopic dermatitis patients.
Conclusion: This analysis demonstrates that atopic dermatitis patients require greater management guidance, especially non-pharmacologic strategies, and more comprehensive discussions regarding the range of symptoms, trigger avoidance, and mental health resources. Addressing these gaps in knowledge may lead to improved outcomes and more informed, empowered patients.

J Drugs Dermatol. 2021;20(6):653-658. doi:10.36849/JDD.5734

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INTRODUCTION

Atopic dermatitis (AD) is a chronic relapsing inflammatory skin condition characterized by acute flare-ups of widespread rashes and pruritic lesions.1 Since the 1970s, the incidence of AD has increased 2- to 3- fold in industrialized nations, with the disease currently affecting approximately 15% to 20% of children and 1% to 3% of adults worldwide.2,3 In the US, it is estimated that there are 16.5 million adults suffering from AD, with 6.6 million reporting moderate-to-severe symptoms.4 Beyond its prevalence, AD has a tremendous impact on patient quality of life, with over 50% of adults with AD indicating that it limits their lifestyle.5 Additionally, AD presents a profound economic burden in the US as an estimated $5.3 billion, including direct medical costs, indirect costs from lost productivity, and quality of life impacts, is spent annually.6

Given the chronic and relapsing nature of AD, patients are often left frustrated and unsatisfied with their disease management. A recent study of adults with moderate to severe AD found that 60.5% reported severe or unbearable itch in the past two weeks, 85.8% reported daily itch, and 62.8% reported itching at least 12 hours per day.7 In addition, greater than half of adults with moderate-to-severe AD have insufficient disease control.8,9 As a result, patients frequently turn to social media, given its accessibility and convenience, to seek guidance and obtain additional health information.

Reddit, the seventh most visited website in the US with approximately 430 million monthly active users, has become a popular platform for patients to source medical information and discuss diseases, especially chronic conditions.10,11 The website is organized into a collection of millions of forums, or “subreddits,” dedicated to discussing specific topics. AD patients in particular have created a highly engaged and active community, titled the “eczema” subreddit. This forum has proven to be popular among patients, as the number of subscribers to the “eczema” subreddit has increased from 2,205 users in 2015 to 32,463 as of October 2020 and continues to rise.12

While Reddit has become commonplace for patients, it remains a relatively unstudied social media platform. Reviewing the