Abstract
Social media is an underutilized method for the surveillance of the patient perspective regarding their pharmacologic therapies. The purpose of this study was to investigate the nature of content posted on the social media platform Instagram with respect to the systemic acne medication isotretinoin.The search term “#accutane” was queried into Instagram to generate all public posts using this hashtag between February 1 and May 31, 2018. Four independent investigators then scrutinized posts for eligibility. Our inclusion criteria were posts written in English, accessible by URL, primarily focused on isotretinoin, and posted by users of the medication. Data regarding multiple variables (tone of post, reason for positive or negative elements, posting of a face or other body part, mention of side effects, etc.) from each individual post was then entered into a Microsoft Excel template.Of 7,661 posts, 3,082 were eligible. Among posts that contained negative tone (n=1312), this element was more commonly due to the presence of side effects (65%) than lack of improvement in skin appearance (33%). Overall, 1,263 posters (41%) mentioned adverse effects of oral isotretinoin, most commonly dry facial skin (17%), dry/cracked lips (16%), or arthralgias/myalgias (8%). Neuropsychiatric side effects were also documented, with users reporting fatigue (4%), mood changes (3%), and headache (2%).In conclusion, reported side effects of oral isotretinoin on Instagram closely tracked its known side effects in frequency. Social media may be a valuable tool to surveil the general pattern and burden of adverse effects for patients undergoing treatment of dermatologic conditions.
Highlights
Acne vulgaris is a common dermatological disease of the pilosebaceous unit due to an overproduction of sebum
The purpose of this study was to investigate the nature of content posted on the social media platform Instagram with respect to the systemic acne medication isotretinoin
While acne has been studied extensively with regards to its epidemiology and pathophysiology, a better patient-centered understanding of its most effective pharmacological treatment, isotretinoin, could be of use; our study investigates the nature of isotretinoin-related content posted on the social media platform Instagram
Summary
Acne vulgaris is a common dermatological disease of the pilosebaceous unit due to an overproduction of sebum. In 2013, 5.1 million Americans sought treatment for acne, which resulted in $398 million of lost productivity for patients and caregivers. Affected patients frequently suffer from pain, erythema, swelling, and dryness in affected areas, and face an increased risk of permanent scarring and hyperpigmentation [1]. For patients with scar formation significant enough to warrant systemic therapy or for those who have failed other treatments, isotretinoin is the first-line option [2]. Social media platforms like Instagram allow users to share their own perspective on activities of daily living, including personal hygiene. Consumers can use this platform to share their life journey, and they use builtin features like hashtags and emojis as expressive tools. The platform records the number of likes for both photos and videos to highlight the popularity of a post, and it records view counts for videos to highlight the public reach of the post
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