{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T05:00:24Z","timestamp":1790830824729,"version":"4.1.0"},"reference-count":30,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Dermatol"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Psychological stress is known to exacerbate dermatologic conditions such as acne, eczema, and compulsive skin behaviors. The COVID-19 pandemic introduced a global stressor with widely experienced psychosocial effects and potential impacts on skin health. This study analyzes US public interest in stress-induced dermatologic conditions and psychodermatologic disorders to test for pandemic-associated shifts in 6 search terms.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to assess whether the onset and resolution of the COVID-19 pandemic were associated with changes in Google Search interest in psychodermatologic and stress-related skin conditions in the United States.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Monthly relative search volume (RSV; 0-100 scale) for 6 terms (\u201cskin picking,\u201d \u201ctrichotillomania,\u201d \u201cstress rash,\u201d \u201ceczema flare up,\u201d \u201cdermatillomania,\u201d and \u201canxiety skin picking\u201d) was obtained from Google Trends for January 2018 through December 2024 (n=84 monthly observations per term); the 6 primary and 4 secondary exploratory terms were extracted in April 2025 and the 5 synonymic terms in July 2026, using the identical query window. A segmented regression model with break points at the World Health Organization\u2019s (WHO) pandemic timeline (March 2020 declaration; May 2023 end of concern) tested for level and slope changes at pandemic onset and post pandemic. Newey-West (heteroskedasticity and autocorrelation consistent) SEs corrected for residual autocorrelation, and joint\n F<\/jats:italic>\n tests with Bonferroni and Benjamini-Hochberg (false discovery rate [FDR]) corrections assessed whether each period differed from the prior trend. A sensitivity analysis applied the identical model to 5 synonymic terms, each paired with 1 primary term, and to 4 unpaired, secondary, exploratory terms (\u201cacne,\u201d \u201cstress acne,\u201d \u201cstress hives,\u201d and \u201chair loss from stress\u201d).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 2 of the 6 terms showed a statistically significant pandemic-onset effect after correction: \u201cdermatillomania\u201d (level shift +15.20 RSV points; Bonferroni\n P<\/jats:italic>\n =.007; FDR\n P<\/jats:italic>\n =.007) and \u201canxiety skin picking\u201d (slope change +0.70 RSV points\/month; Bonferroni\n P<\/jats:italic>\n =.02; FDR\n P<\/jats:italic>\n =.01). \u201cStress rash,\u201d \u201cskin picking,\u201d and \u201ceczema flare up\u201d reached significance under FDR correction only (\n P<\/jats:italic>\n =.04, .04, and .03, respectively); \u201ctrichotillomania\u201d showed no effect under either correction (FDR\n P<\/jats:italic>\n =.08). \u201cAnxiety skin picking,\u201d \u201ctrichotillomania,\u201d and \u201cstress rash\u201d showed postpandemic reversals robust to both corrections. The synonymic sensitivity analysis showed weaker, inconsistent support: only 1 of 5 pairs (\u201cdermatillomania\u201d\/\u201cexcoriation disorder\u201d) showed partial agreement under FDR correction, while the remaining 4 diverged, indicating sensitivity to search-term phrasing. The secondary exploratory analysis found no pandemic-onset effects under either correction.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Public search interest in a subset of psychodermatologic conditions, specifically \u201cdermatillomania\u201d and \u201canxiety skin picking,\u201d showed statistically significant shifts temporally coinciding with COVID-19 pandemic onset. A sensitivity analysis using synonym terms did not consistently reproduce these findings, indicating sensitivity to both analytic choices and search-term phrasing. These results support further research into psychodermatology and illustrate how public search behavior can reflect societal stress, though causal interpretation is unwarranted from search-volume data alone.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/93458","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T21:00:08Z","timestamp":1788901208000},"page":"e93458-e93458","source":"Crossref","is-referenced-by-count":0,"title":["Public Interest in Stress-Induced Dermatologic Conditions and Psychodermatologic Disorders Before, During, and After the COVID-19 Pandemic: Segmented Regression Analysis"],"prefix":"10.2196","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-6597-5158","authenticated-orcid":false,"given":"Marisa N","family":"Fat","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5885-0783","authenticated-orcid":false,"given":"Hayden C","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6749-2551","authenticated-orcid":false,"given":"Michael","family":"Bernas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0915-057X","authenticated-orcid":false,"given":"Cheryl L","family":"Hurd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8003-192X","authenticated-orcid":false,"given":"Robert C","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"issue":"3","key":"R1","doi-asserted-by":"publisher","first-page":"203","DOI":"10.4088\/pcc.v09n0306","article-title":"Psychodermatology: a guide to understanding common psychocutaneous disorders","volume":"9","author":"Jafferany","journal-title":"Prim Care Companion J Clin Psychiatry"},{"issue":"11","key":"R2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.48657","article-title":"Association of psychological stress with skin symptoms among the population in Saudi Arabia: a cross-sectional study","volume":"15","author":"Altalhi","journal-title":"Cureus"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2023.12.005","article-title":"Role of stress in skin diseases: a neuroendocrine-immune interaction view","volume":"116","author":"Zhang","journal-title":"Brain Behav Immun"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2020.08.001","article-title":"Impact of COVID-19 pandemic on mental health in the general population: a systematic review","volume":"277","author":"Xiong","journal-title":"J Affect Disord"},{"key":"R5","unstructured":"COVID-19 pandemic triggers 25% increase in prevalence of anxiety and depression worldwide. 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