271 “Moisturize and get off any steroid cream”: An analysis of social media posts regarding TCS use in AD

Abstract

Analyses of online interactions among atopic dermatitis (AD) patients are limited. This study aims to analyze the content and engagement of online posts on topical corticosteroid (TCS) use in AD. Of 2047 posts extracted from 5 social media groups, 949 referenced TCS safety, defined as a higher-order theme (HOT). Within the HOT of TCS safety, 11 lower-order themes (LOTs) were identified: TCS use and Addiction/Withdrawal (36.7% of posts), Patterns of TCS use (15.0%), TCS use is harmful (9.8%), Avoidance of TCS use (9.0%), TCS use and Skin Thinning (7.9%), Other side effects of TCS use (7.4%), Fear of using TCS (4.0%), Overuse of TCS (3.6%), Questions about TCS use (2.8%), TCS use on the face (2.6%), and Benefits and Risks of TCS use (1.2%). Posts were assigned positive, negative, or neutral sentiment and an engagement score. Negative sentiment was more prevalent (n=655; 69.0%) compared to positive (n=60; 6.3%) or neutral sentiment (n=234; 24.7%). Sentiments were given a value of -1 (negative), 0 (neutral), and 1 (positive). All subgroups had negative mean sentiment scores (FB_EczemaSupportGroup -0.93, 95% CI [-1.01--.84]; r/eczema -.60 [-.64--.56]; r/SkincareAddiction -.50 [-1.01--.006]; r/TS_Withdrawal -.92 [-1.00--.84]; r/EczemaCures -.39 [-.74--.04]). Mean engagement was significantly higher (p<0.001) in subreddits compared to the Facebook group (FB_EczemaSupportGroup 0.9, 95% CI [0.37-1.42]; r/eczema 4.75 [3.97-5.54]; r/SkincareAddiction 7.3 [2.16-12.4]; r/TS_Withdrawal 9.16 [7.05-11.27]; r/EczemaCures 7.39 [3.66-11.1]). The information online regarding TCS use in AD is overwhelmingly negative; education efforts should incorporate concerns determined by sentiment and theme analysis.