Topical steroid withdrawal through the lens of social media

The term ‘topical steroid withdrawal’ (TSW) describes an adverse effect that generally occurs with inappropriate prolonged use of high-potency topical corticosteroids (TCS). The presence of user-generated content relating to TSW on social media (SoMe) has not been well-defined to date. We aimed to explore content relating to topical steroid withdrawal on SoMe. Using a data analytics platform, we retrospectively analysed the hashtag #topicalsteroidwithdrawal on SoMe over a 5-year period from 8 February 2016 until 8 February 2021. We assessed interactions, performance, shares, likes, mentions, language and country of origin using descriptive statistics. Across all SoMe platforms, there was a 274% increase in mentions of the hashtag #topicalsteroidwithdrawal in the year 2020 (n = 7992) compared with the year 2016 (n = 2138). The top associated hashtags included #TSW, #eczema and #topicalsteroidaddiction. On Instagram, we found a 288% increase in number of mentions and a 592% increase in performance of #topicalsteroidwithdrawal in 2020 (n = 618 354) compared with 2016 (n = 89 390). Our results confirm an increase in the presence of user-generated content relating to TSW on SoMe and also highlight its extent. Large numbers of patients are exposed to this content, which could influence their engagement with TCS.