Dermatologists criticise Facebook and Instagram for removing psoriasis imagesBMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k1137 (Published 09 March 2018) Cite this as: BMJ 2018;360:k1137
German and British dermatologists have accused Facebook and Instagram of discrimination and censorship for removing photographs of skin affected by psoriasis and blocking hashtags relating to psoriasis from their platforms.1
The accusations come as patients are increasingly posting photos of their skin on social media in an attempt to generate support, raise awareness, and destigmatise skin problems, according to support groups.
In response to the social media bans, the UK Psoriasis Association launched an online petition to “stop the censorship of psoriasis on social media.”2 (www.change.org/p/instagram-and-facebook-stop-the-censorship-of-psoriasis-on-social-media)
A spokesperson for Facebook, which owns Instagram, issued a statement saying that the bans were only temporary and are no longer in effect.
“People use Instagram and Facebook to connect around the things that matter to them, including sharing their experiences of psoriasis to raise awareness of the condition and get support from the community,” the statement said. “In this instance, some hashtags had been temporarily restricted while we removed spam content which violated our guidelines. The issue has now been resolved and these hashtags can again be freely used by the community in the spirit in which they were intended.”
Dominic Urmston, digital communications officer at the UK Psoriasis Association, told The BMJ that the statement is only partially correct. “Certain hashtags, including #psoriasisisnotcontagious, #guttatepsoriasis, and #scalppsoriasis, are still restricted,” he said.
Ralph von Kiedrowski, a dermatologist and member of the Association of German Dermatologists (BVDD), told The BMJ that the association learnt in February of social media censorship of psoriasis photos. The BVDD responded with a statement3 denouncing the “discrimination” and “censorship” of people with skin problems.
The statement was posted on a website that also provides information about the BVDD’s “Please Touch” campaign,4 which was launched in 2016 to stress that psoriasis is not contagious and to “work against the isolation of patients with psoriasis.”
He said that the censorship had created “great confusion and resentment” among patients. As a doctor he often heard patients talk about their “trouble with stigmatisation” and that social media “bears a great responsibility” for the stigmatisation of people with psoriasis.
Urmston said that the Psoriasis Association was alerted in February that Instagram was blocking hashtags such as #psoriasisawareness, #getyourskinout, and #psoriasisuk.
“We were confused as to why these hashtags were being blocked and worried that it could be Instagram deeming images of psoriasis offensive or undesirable,” Urmston said.
The blocked hashtags meant that they did not appear in searches, Urmston said, adding that “a significant number of people would have been affected” around the world.
He noted, though, that the ban did have a positive effect on one woman, who messaged the association to say that the ban had convinced her to go public about her psoriasis, “which,” she said, “I’ve never had the courage to do before.”
At the time, Instagram gave no explanation for the blocked hashtags, except that there had been reports that “some content that may not meet community guidelines.” Von Kiedrowski said Instagram and Facebook failed to explain which community guidelines had been breached.
Urmston said that by 19 February some hashtags, including #psoriasis, #psoriasisuk, #getyourskinout and #psoriasisawareness, appeared to have been reinstated. By 22 February additional hashtags, including #psoriasislife, #psoriasissupport and #skincondition, were working on searches again, although search results appeared to be smaller than “they should have been,” he said.
Urmston said that British Association of Dermatologists backed the concerns raised by the Psoriasis Association. “We are keen for the medical community to support us in raising awareness and appealing to social media companies to recognise that people living with psoriasis and other long term conditions must not be censored or cut off from support networks,” he said.