Predictors of selfie‐phobia in individuals with visible skin or hair diseases: A large‐scale international study

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Photograph-based social media has skyrocketed over the past years, giving rise to new forms of self-presentation, in particular 'selfies'.1, 2 At the same time, a selfie-phobia (SP) has developed, which refers to a fear of taking selfies. Despite the increased use of social media in our daily lives, research in dermatology has only recently begun to investigate selfies.3, 4 Data on the experience of SP in participants with facial skin conditions (FSC) and/or hair conditions (HC) are lacking. Our objective was to conduct a worldwide study in order to investigate and compare the predictors of SP in participants with FSC and HC. This online survey was conducted on a representative sample of individuals aged 18 years or more using the quota method in of 20 countries spread over all five continents [China 5000, USA 5000, Brazil 4001, India 3000, Australia 2000, France 4000, Italy 4000, Canada 2500; Denmark 1000; Germany 2000; Israel 2000; Kenya 500; Mexico 2500; Poland 2500; Portugal 1000; Senegal300; South Africa 1000; South Korea 2500; Spain 2000; UAE 750], which together account for over 50% of the world's population. The questionnaire gathered information about demographics, presence of a dermatological condition that occurred in the past 12 months and about any feelings of stigma. Responders were considered to be suffering from SP if they reported that their FSC and/or HC has caused fear of taking a selfie. Logistic regression was used to evaluate SP predictors among demographic and clinical variables. Moreover, we compared feelings of stigma among in patients with FSC with and without SP. Out of 50,552, 12,744 individuals had FSC or HC, of which 7332 (57.5%) had HC, 1840 (14.4%) FSC and 3572 (28%) FSC + HC. There were 5305 males (41.6%) and 7439 females (58.4%) aged 38.12 ± 14.03 years (min 18–max 87). In total, there were 5712 (44.8%) responders who reported SP (3131 with HC, 700 with FSC and 1881 with FSC + HC). The percentage of participants suffering from SP was, respectively, 42.7% for HC, 38.0% for FSC and 52.7% for FSC + HC. There were 7032 (55.2%) participants considered non-SP. Characteristics of patients with SP and univariate/multivariate analysis to determine predictors of SP are represented in Table 1. Feelings of stigma were more common in SP (Table 2). This is the first study to establish the prevalence of SP in people with dermatological conditions. The higher prevalence of SP in younger people and in women can be attributed to feelings of insecurities in these categories of individuals.5, 6 Our results were able to identify several predictors of SP: vitiligo (OR = 2.72), acne (OR = 2.45), rosacea (OR = 2.24), hyperpigmentation (OR = 1.77), facial scar (OR = 1.59), psoriasis (OR = 1.46), hair loss (OR = 1.32), female gender (OR = 1.2) and atopic dermatitis (OR = 1.18). The presence of dandruff was not associated with a higher risk of SP. People with SP have significantly more frequent feelings of stigma7-10 compared to those without SP. In conclusion, dermatologists should always identify patients with FSC or HC who are at high risk of SP and stigmatization, and their psychosocial health should be evaluated before and after treatment in order to assess the effect of treatment on these psychological parameters. The authors acknowledge the technical support of Helene Chevalier (HC Conseil, Paris). This project was funded by the Patient Centricity of Pierre Fabre. Catherine Baissac, Nuria Perez Cullell and Marketa Saint Aroman are employees of Pierre Fabre, France. Bruno Halioua, Christelle Le Roux-Villet, Yaron Ben Hayoun, Charles Taieb and Charbel Skayem have no conflicts of interest. The data that support the findings of this study are available from the corresponding author upon reasonable request.

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