est interest in New Jersey, New York, Florida, Maryland, and Delaware, with 45 out of the 50 states having an RSV greater than 70 (Figure 3).
Related queries to the keyword vitiligo are presented in Figure 4, with the most popular searches being “vitiligo skin,” “Michael Jackson/Michael Jackson vitiligo,” and “vitiligo treatment.” Top rising queries included “what is vitiligo,” “vitiligo model/Winnie Harlow,” and “treatment for vitiligo” as the search phrases that are most rapidly increasing in search frequency. The five top related queries and five top rising related queries, defined as searches with the biggest increase in search frequency in the defined time-period, for each individual year from 2005-2018 were recorded. (Table 1) Related queries for year 2004 were not available. “Vitiligo treatment” and “Michael Jackson/vitiligo Michael Jackson” were included in the top five related queries for 11/14 years of available data; “vitiligo cure” was the next most common, appearing in the top five related queries for 5/14.
A search of the hashtag “#Vitiligo” on Instagram revealed over 350,000 vitiligo-related posts. Figure 1 displays a breakdown of the content and sources of the top 300 posts. 61% of posts contained personal content posted by people living with vitiligo, many of which encouraged embracing diversity and loving the skin you are in. 12% of the content of posts advertised treatments and services available to patients with vitiligo, including light treatment, vitiligo cures, make-up and associated tutorials to either celebrate or cover spots, and skin tattooing to cover spots. Only 3% of post content provided educational information about the pathophysiology and disease progression of vitiligo. A mere 1% of posts came from organizations promoting vitiligo awareness, the two most common of which were Vitiligo Society and Unite for Vitiligo. Furthermore, only 3% of posts came from a dermatologist.
DISCUSSION
Aligned with published studies on other dermatologic conditions, we found that both Google Trends and social media platforms provided insights into population interests about vitiligo. Google Trends provided us the ability to analyze big data to investigate population interests over time and, with the rising related queries feature, a means of predicting future trends. Social media platforms, like Instagram, on the other hand, allowed us to explore a more individualized perspective about how issues related to vitiligo are shared among on-line communities.
The Google Trends analysis of the search keyword vitiligo revealed that the number of web searches for vitiligo over time has remained relatively stable with a seasonal sine pattern for web searches, with high RSVs seen during summer months and lower RSVs in winter months. This is not surprising as a condition characterized by depigmentation for most will be more noticeable during the summer months, as darker tans provide greater contrast to the affected areas.It is also important to note the significant impact celebrities have on perceptions of vitiligo. The RSVs for vitiligo for the months of May and June in 2009 were 64 and 100, respectively. Undoubtedly, the death of Michael Jackson directly contributed to this surge of interest in vitiligo. An analysis of the top rising related queries for the year of 2009 revealed breakout growths, defined as a >5,000% increase, for queries such as “Michael Jackson vitiligo pictures†and “did Michael Jackson have vitiligo.â€1 A smaller but still significant increase in searches occurred in the summer of 2014, with the emergence of Chantelle Brown- Young, better known as supermodel Winnie Harlow, on the television show America’s Next Top Model. Winnie Harlow captured America’s interest with her unique beauty and confidence despite her history of being bullied for vitiligo, sparking numerous diversity and inclusion campaigns centered on embracing one’s skin. Since her breakout in the fashion industry, vitiligo has received an abundance of positive media attention, generating a significant and steadily increasing RSV for vitiligo since that year. Because of positive media coverage and vitiligo champions like Winnie Harlow, there has been a significant push for self-acceptance and embracing the beauty of skin diversity.
While the search “vitiligo treatment†is consistently a top related query, treatment options have only been featured once. Specifically, tacrolimus ointment was featured as a breakout rising related query in 2015. The paucity of treatment-specific searches may represent a lack of widespread discussion about medications for vitiligo but may also reflect the shortage of new treatment options for the condition. With clinical trials now focusing on use of immunosuppressant medications as treatments for vitiligo, the rising related query feature of Google Trends may be an effective tool in tracking the use and perceived value of these new treatment options.
The main limitation of examining Google Trends to explore the internet presence of vitiligo is inherently linked to its usefulness; it can only provide population-level analyses of trends and interest and disregards individual variation. However, when
The Google Trends analysis of the search keyword vitiligo revealed that the number of web searches for vitiligo over time has remained relatively stable with a seasonal sine pattern for web searches, with high RSVs seen during summer months and lower RSVs in winter months. This is not surprising as a condition characterized by depigmentation for most will be more noticeable during the summer months, as darker tans provide greater contrast to the affected areas.It is also important to note the significant impact celebrities have on perceptions of vitiligo. The RSVs for vitiligo for the months of May and June in 2009 were 64 and 100, respectively. Undoubtedly, the death of Michael Jackson directly contributed to this surge of interest in vitiligo. An analysis of the top rising related queries for the year of 2009 revealed breakout growths, defined as a >5,000% increase, for queries such as “Michael Jackson vitiligo pictures†and “did Michael Jackson have vitiligo.â€1 A smaller but still significant increase in searches occurred in the summer of 2014, with the emergence of Chantelle Brown- Young, better known as supermodel Winnie Harlow, on the television show America’s Next Top Model. Winnie Harlow captured America’s interest with her unique beauty and confidence despite her history of being bullied for vitiligo, sparking numerous diversity and inclusion campaigns centered on embracing one’s skin. Since her breakout in the fashion industry, vitiligo has received an abundance of positive media attention, generating a significant and steadily increasing RSV for vitiligo since that year. Because of positive media coverage and vitiligo champions like Winnie Harlow, there has been a significant push for self-acceptance and embracing the beauty of skin diversity.
While the search “vitiligo treatment†is consistently a top related query, treatment options have only been featured once. Specifically, tacrolimus ointment was featured as a breakout rising related query in 2015. The paucity of treatment-specific searches may represent a lack of widespread discussion about medications for vitiligo but may also reflect the shortage of new treatment options for the condition. With clinical trials now focusing on use of immunosuppressant medications as treatments for vitiligo, the rising related query feature of Google Trends may be an effective tool in tracking the use and perceived value of these new treatment options.
The main limitation of examining Google Trends to explore the internet presence of vitiligo is inherently linked to its usefulness; it can only provide population-level analyses of trends and interest and disregards individual variation. However, when
