Skincare Addiction on Reddit: Dermatology Enthusiasts Talk Skin

Introduction

In the current era, social media has become an important means of disseminating information. In relation to healthcare, 41% of consumers indicate that information found via social media would influence their choice of a specific doctor, 34% state that it would influence their likelihood of taking a certain medication, and almost 90% of individuals aged 18-24 report that they would trust health information found on social media.¹ This trend should be of interest in any medical field but is particularly pertinent to dermatology. In the dermatological literature, recent articles have explored social networking platforms including Twitter, Instagram, Facebook, Pinterest, and others.²

To date, no dermatology publications mention Reddit, a site advertised as “the front page of the internet.” In other fields, researchers have begun to explore the discussions on Reddit as an opportunity to learn about trends in public health, for example, investigating public perceptions of e-cigarette use.^3,4 Reddit is the 6^th most popular website in the US, surpassing Pinterest, Twitter, and Instagram.⁵ Although Reddit is less popular than Facebook, it averages more daily time spent per user, more daily page views, and a higher engagement score.⁵ In the US alone, there are 47 million unique visitors to the site per month.⁵ Compared to the average internet user, Reddit users are more likely to be young (18-34), male, and have “some college” or “college” education.⁵ Reddit is organized into pages called “subreddits” which represent various interest groups. Users create posts on these pages; anyone can become a user and all posts are public. The skincare enthusiast subreddit, r/skincareaddiction, has over 900,000 subscribers, and over 1,000 new posts per day, far more than other skin-related subreddits.

This study will describe a representative subset of posts on r/skincareaddiction to determine what topics in skin health are of greatest interest and whether physician care is being recommended by Reddit users. Understanding the discussions occurring on the internet will allow us to better understand our patients and the information they receive online. Reddit is an important potential source of information about, and possibly interactions with, the dermatologic patient population.

Methods

All posts on r/skincareaddiction are public. Archived posts from September 9-10, 2018 were accessed using the Reddit Pushshift API. Data are representative as of 12/27/2018; deleted or removed posts were not included in the analysis.

Each post on r/skincareaddiction must have one of a list of preset tags. Posts include informational links, advice, discussion prompts, and personal narratives. The texts of posts and their comments were analyzed for references to dermatologists or the medical profession through a keyword search. Any results that did not truly discuss medical skin treatment (e.g., where “derm” appeared but within a word besides dermatology/dermatologist) were excluded.

Results

There were 207 total posts in the time period (Figure 1). The most popular tags were “Routine Help” (59 posts), “Product Question” (43), “Skin Concerns” (33), and “Acne” (25). The tag for “Hair Removal” had zero posts, as did the “Humor” and “Before & After” tags, which are only allowed on Fridays.

Figure 1:

Frequency of posts with each tag in the time period. “Haul/shelfie” refers to a photo of a group of products (e.g. on a shelf). “PSA”: public service announcement. “DIY”: do-it-yourself. “Meta” refers to a post that references the subreddit itself

Posts explicitly seeking diagnosis or treatment advice for a skin concern are not allowed on r/skincareaddiction: automated, pre-programmed “moderators” remove many of them. Despite this, one third of posts analyzed (68/207) mentioned medical treatment for skin conditions, either in the original post, a comment, or both (Figure 2). Posts were characterized as “recommending” medical care if a) this care was mentioned only in a comment and not in the original post and b) the commenter wrote encouragingly about treatment, e.g., stating “I think you should ask a dermatologist” on a photo or description of a skin condition. There were 25 such posts that essentially “referred” the original poster to a physician, 18 specifically to dermatology, and 7 to general medical care. Of note, three of the “referral” comments came from self-identified dermatology residents, accounting for the categorization of 2/68 posts.

Figure 2:

Frequency of posts that mention or recommend medical treatment. Searched terms include dermatology, derm, dermatologist, doctor, professional, physician, primary care, appointment, medicine, medication, insurance, prescribe, and prescription

Discussion

The subreddit r/skincareaddiction is used by a large number of people, and is home to a variety of posts about skin conditions and treatments. An analysis of its tags shows that users are most concerned with the efficacy of skincare products, and of “routines” consisting of multiple products. These regimens address many complaints, particularly acne.

A subset of posts (33%) mention seeking medical advice. While the total number is relatively small, the constant activity on the subreddit means that a large number of potential patients are referred to medical care over time.

Further analysis is warranted to better characterize trends among Reddit’s skin care community. An understanding of the information patients receive on the internet will help board certified dermatologists strategize ways to offer expertise into the online conversation. More knowledge could also help dermatologists leverage this site as a platform for public health interventions similar to those that have been carried out on other social networks.