Google Trends is a widely used online analytics tool that provides insights into public interest in various topics by tracking search queries on Google. Instead of reporting the absolute number of searches, Google Trends normalizes data and presents it as a relative search volume (RSV) ranging from 0-100, with higher values indicating greater search interest. The numbers show search interest relative to the highest point on the graph for a specific region and time. Given its ability to reflect real-time public interest, Google Trends has gained increasing attention in medical research, including dermatology.Reference Sivesind, Szeto and Kim 1 Studies have utilized this tool to explore population interest in topics such as psoriasis, eczema, tattoos, sun protection, skin cancer, cosmetic procedures, and other dermatological conditions.Reference Oh and Rootman 2 –Reference Hopkins and Secrest 6 The insights derived from Google Trends can serve as a valuable resource for guiding public health initiatives, enhancing patient education, and addressing emerging health concerns in a timely manner.
Natural disasters, such as earthquakes, can significantly alter public health priorities and concerns. On February 6, 2023, 2 devastating earthquakes struck southeastern Türkiye, with epicenters in Kahramanmaraş’s Pazarcık and Elbistan districts. These earthquakes severely impacted 11 provinces, including Kahramanmaraş, Hatay, Adıyaman, Gaziantep, Malatya, Kilis, Diyarbakır, Adana, Osmaniye, Şanlıurfa, and Elazığ. Collectively, these regions are home to over 14 million people, representing approximately 16.4% of Türkiye’s total population.Reference Dincer, Akyol Phd and Emre 7 , 8 The disaster resulted in over 50 000 fatalities and left more than 100 000 individuals injured. Additionally, widespread structural damage led to the destruction of approximately 345 000 buildings. In the aftermath, the International Organization for Migration estimated that nearly 3 million people were in urgent need of new housing, highlighting the significant humanitarian crisis triggered by the earthquakes.Reference Beypinar 9 Such a large-scale disaster not only caused massive physical destruction but also raised significant public health concerns, including dermatological issues.Reference Öztas, Önder and Öztas 10 , Reference Bayramgürler, Bilen and Namlı 11
This study aimed to assess the impact of this disaster on Google search trends related to dermatological issues. By analyzing these trends, the primary concerns and needs of earthquake survivors can be identified, providing insights that may help address their post-disaster health care challenges.
Methods
Selection of Topics
To ensure a comprehensive evaluation, we initially identified 30 dermatologic conditions that could be influenced by disaster-related factors, including stress, poor hygiene, inadequate shelter, and increased sun exposure. The selection process was guided by dermatology textbooks and expert discussions between 2 dermatologists (C.A.G. and H.A.K.), with priority also given to diseases that were reported to increase after earthquakes in previous studies. These conditions encompassed infectious, inflammatory, and oncologic dermatologic diseases, considering their potential to be exacerbated or triggered in post-disaster settings. However, due to the limitations of Google Trends, which only provides data for popular search terms, several conditions—including “redness,” “rosacea,” “demodex,” “contact dermatitis,” “atopic dermatitis,” “seborrheic dermatitis,” “insect bites and stings,” “leishmania,” “pediculosis,” “tinea,” “onychomycosis,” “tinea versicolor,” “pemphigus,” “pemphigoid,” “squamous cell carcinoma,” “basal cell carcinoma,” “melanoma,” “mycosis fungoides,” “vitiligo,” and “melasma”—resulted in insufficient data and had to be excluded from the analysis. Ultimately, 10 topics were selected for analysis: “dermatology,” “acne,” “eczema,” “psoriasis,” “urticaria,” “hair loss,” “scabies,” “itching,” “shingles,” and “warts.” These topics were searched in Turkish to ensure relevance to the affected population.
Data Collection
The topics were queried using filters for the 3 most affected provinces by the February 2023 earthquake: Hatay, Kahramanmaraş, and Adıyaman. 8 The data collection period was set from February 6, 2022-February 3, 2024, enabling a comparative analysis of search trends for the 52 weeks preceding and the 52 weeks following the earthquake. This year-long comparison helped minimize the impact of seasonal variations on the results. For each dermatologic topic, Google Trends was queried separately for each province with the filters: “06/02/2022-03/02/2024” and “All categories.” Weekly data were then exported for further analysis. Because Google Trends allows a maximum of 5 topics to be displayed in a single graph for a given time frame and location, graphs including 4 topics were saved. All 10 topics analyzed for Hatay and Kahramanmaraş are represented across the 3 graphs. For Adıyaman, all 4 topics are presented in a single graph.
Topics that showed a significant impact in at least 2 of 3 provinces, namely “dermatology” and “scabies,” were further analyzed across all 11 earthquake-affected provinces. Additionally, the national rankings of these provinces for “scabies” and “dermatology” searches were recorded for 2 periods: February 6, 2022-February 6, 2023 and February 6, 2023-February 6, 2024, allowing for a broader comparison of regional trends.
Statistical Analysis
Statistical analyses were performed using SPSS software (version 22.0, SPSS Inc., Chicago, IL, USA). Descriptive statistics, including means, standard deviations, and percentage changes, were used to summarize the data. The Wilcoxon signed-rank test was applied to compare the pre- and post-earthquake RSV, with a significance level set at a P value of less than 0.05.
Results
Search volumes for 10 dermatological topics were analyzed in 3 provinces; however, only 4 topics had sufficient data for Adıyaman. The search interest in “dermatology” significantly decreased in Hatay (-27.5%, P = 4.16×10−4) and Kahramanmaraş (-25%, P = 0.009). Among specific dermatological conditions, “scabies” searches showed a substantial and statistically significant increase in Hatay (+69%, P = 4.11×10-10), Kahramanmaraş (+112%, P = 6.96 × 10-8), and Adıyaman (+144%, P = 0.017). Other conditions, including “acne,” “eczema,” “psoriasis,” “urticaria,” and “wart” exhibited varying trends, but none of these changes reached statistical significance. Detailed information on search volume trends is presented in Table 1.
Comparison of relative search volume trends in dermatology before and after the earthquake in the 3 most affected provinces
+ Wilcoxon test was used. P < 0.05 was considered significant.
Note: The table compares weekly relative search volume trends for 1 year before and 1 year after the earthquake, with 52 weeks in each period. In Adıyaman, due to insufficient data for 6 topics, only 4 topics were evaluated.
As seen in Figure 1, scabies and other dermatologic topics were compared in terms of search trends. Because Google Trends allows a maximum of 5 topics in a single graph, Hatay and Kahramanmaraş are presented in 3 separate graphs each, all including scabies. Although acne searches were not affected by the earthquake, it was the most frequently searched topic among the 10 selected dermatologic conditions. Itching and scabies were the second and third most searched topics after acne.
Relative search interest of scabies compared to other dermatologic conditions in Hatay, Kahramanmaraş, and Adıyaman (February 6, 2022-February 6, 2024).
***Because Google Trends allows a maximum of 5 topics in a single graph, Hatay and Kahramanmaraş are each presented in 3 separate graphs, all including scabies. All 10 topics analyzed for Hatay and Kahramanmaraş are represented across the 3 graphs. For Adıyaman, all 4 topics are presented in a single graph.
Table 2 shows a statistically significant increase in “scabies” RSVs across all affected provinces. Additionally, Türkiye-wide ranking data indicate a notable shift in search interest. Hatay, which ranked 9th in pre-earthquake scabies searches, became the leading province post-earthquake. Other provinces, except for Adana and Elazığ, also moved up in the rankings following the earthquake.
Comparison of relative search volume trends for “scabies” before and after the earthquake in all affected provinces
* Due to insufficient data for Kilis province, it was not included in the analysis.
+ Wilcoxon test was used. P<0.05 was considered significant.
Table 3 results indicate a general decrease in search volume trends for “dermatology” across most affected provinces following the earthquake. Statistically significant reductions were observed in Hatay (-27.5%, P = 4.16×10-4), Kahramanmaraş (-25%, P = 0.009), and Malatya (-56.9%, P = 0.0005), highlighting a decline in online interest. Conversely, Diyarbakır was the only province that exhibited an increase (+7.4%), though this change was not statistically significant (P = 0.1118). Türkiye-wide ranking data further illustrate this shift, as provinces such as Hatay and Malatya dropped notably in ranking. These findings suggest a reduced focus on dermatology-related concerns in the aftermath of the disaster.
Comparison of relative search volume trends for “dermatology” before and after the earthquake in all affected provinces
* Due to insufficient data for Kilis and Adıyaman provinces, they were not included in the analysis.
+ Wilcoxon test was used. P<0.05 was considered significant.
Figure 2 presents line graphs for each of the 10 affected provinces, illustrating weekly scabies RSV trends before and after the earthquake. Due to insufficient data, Kilis could not be included in the analysis.
Weekly scabies search trends before and after the earthquake in all affected provinces.
***Due to insufficient data, Kilis could not be included in the analysis.
Limitations
This study has several limitations. First, the findings should be interpreted with caution before generalizing to the entire population, as the data were derived exclusively from individuals with internet access. Moreover, the earthquake directly disrupted internet access in the affected regions, undoubtedly influencing search trends. Second, Google Trends normalizes search volumes, making direct comparisons between different topics and across different locations challenging. Additionally, the platform restricts the number of topics that can be analyzed simultaneously, allowing a maximum of 5 topics per query, which may have limited the scope of comparisons. Furthermore, due to the limitations of Google Trends, which only provides data for popular search terms, some dermatological conditions with potentially relevant search interest were excluded from the analysis. Finally, although the search terms were carefully selected by 2 experienced dermatologists, some relevant dermatologic conditions may not have been included.
From an ethical perspective, while this study relied on publicly available aggregated data and did not involve individual-level information, the interpretation of online search trends still carries potential biases. Internet search behavior may not accurately reflect true disease prevalence, as searches can be influenced by factors such as education level, public awareness of a given disease, and social media influence, rather than actual disease burden. Further studies should evaluate the consistency of Google Trends data by comparing it with data from field hospitals and regular hospitals to assess its reliability and accuracy in reflecting real-world health trends. Additionally, further research should explore the effectiveness of interventions based on Google Trends data and broaden the scope to include a wider range of dermatological conditions, complementing the data with surveys for a more comprehensive understanding of public health needs post-disaster.
Discussion
In natural disasters like earthquakes, the skin plays a crucial role and needs special care due to its direct exposure to environmental factors. This study analyzed whether public interest in dermatology changed after the February 6, 2023 Türkiye earthquake compared to the previous year. While search interest in “dermatology” significantly decreased in Hatay, Kahramanmaraş, and Malatya, searches for “scabies” showed a statistically significant increase across all 10 analyzed provinces.
The decline in search interest for “dermatology” after the earthquake was most likely related to infrastructural damage affecting internet access. Given that earthquakes can lead to widespread power outages and disruptions in communication networks, individuals in affected areas may have been unable to conduct online searches. In addition, shifting priorities and psychological effects may have also played a role, as individuals focused on immediate concerns such as shelter and safety, placing less emphasis on dermatological issues. Despite this decline, the significant rise in searches related to scabies is noteworthy.
Google search query data has been effectively utilized in population health research, initially for the early detection of influenza epidemics. In 2009, a collaboration between Google and the Centers for Disease Control (CDC) demonstrated that the frequency of searches for influenza-like illnesses correlated with physician visits, offering a faster reporting mechanism compared to traditional methods. Since then, the application of Google Trends has expanded to monitor other infectious outbreaks, such as Lyme disease, syphilis, HIV, and Zika virus. Additionally, changes in suicide-related search volumes have been used to signal shifts in mental health risks, particularly among younger individuals and middle-aged womenReference Arora, McKee and Stuckler 12. While no prior studies have analyzed dermatological topics using Google Trends in post-earthquake settings, several field studies have documented dermatologic conditions among survivors.Reference Öztas, Önder and Öztas 10 , Reference Bayramgürler, Bilen and Namlı 11 The consistency between our findings and existing clinical studies underscores the potential of Google Trends as a valuable tool for identifying and monitoring public health needs following disasters.
Worldwide, sporadic cases, outbreaks, and epidemics of infectious diseases triggered by earthquakes have been well documented. Among these, wound and skin infections, along with respiratory, gastrointestinal, and vector-borne infections, constitute a significant proportion of the reported cases in affected populations.Reference Mavrouli, Mavroulis and Lekkas 13 A study conducted at a general hospital in Banda Aceh after the 2004 Indian Ocean earthquake found that infections and infestations were the most common skin conditions, followed by eczemas and traumatic skin disorders, particularly in men.Reference Lee, Choi, Eun and Kwon 14 Similarly, Bayramgürler et al. reported that in the first 3 months after the 1999 İzmit earthquake, one of the major disasters in Türkiye, dermatology clinic visits were primarily for infections and infestations due to poor hygiene and infrastructure damage. In the following months, erythematous squamous diseases, pruritus, neurocutaneous dermatoses, and eczemas became more prevalent, likely driven by psychoemotional stress related to the earthquake.Reference Bayramgürler, Bilen and Namlı 11 Additionally, a field study conducted after the 1999 Düzce earthquake found that parasitic infestations, particularly scabies and pediculosis capitis, were the most common skin conditions among survivors, followed by microbial infections and allergic skin disorders. The high prevalence of these conditions was attributed to poor hygiene, overcrowded living conditions, and exposure to new environmental factors. Additionally, stress-related skin disorders, such as alopecia areata and neurotic excoriation, were reported, highlighting the psychological impact of disasters on dermatological health.Reference Öztas, Önder and Öztas 10
Several studies have investigated parasitic diseases in the aftermath of the February 6, 2023 earthquake, highlighting the increased risk of scabies outbreaks in both the affected region and across Türkiye.Reference Tetik Aydoğdu, Daşgın and Yürekli 15 , Reference Mustafa Beyoğlu and Enes Gokler 16 The current study’s results align with these previous studies, showing a significant shift in scabies-related search interest across all affected provinces following the earthquake. Hatay, which ranked 9th in pre-earthquake searches, became the leading province afterward. Scabies-related internet searches in Hatay have continued consistently, with no week passing without inquiries, even during the earthquake week.
The displacement of tens of thousands of earthquake victims into crowded dormitories and temporary shelters has created conditions that facilitate the rapid spread of Sarcoptes scabiei. Overcrowding, inadequate hygiene facilities, and limited health care access further exacerbate transmission. Additionally, large-scale and uncontrolled migration from the disaster zone to other parts of the country may contribute to the rising prevalence of scabies, making it an even more significant public health concern. To mitigate its impact, targeted interventions should focus on improving hygiene infrastructure, ensuring timely medical care, and conducting public health education campaigns. Strengthening surveillance systems and fostering collaboration among health care providers, community leaders, and policymakers are essential to controlling outbreaks and protecting vulnerable populations.Reference Tunalı, Harman and Özbilgin 17
Google Trends can play a crucial role in this context. Studies have shown that during significant health events like COVID-19, there is a noticeable shift in public interest in various health-related issues, including dermatology.Reference Esen-Salman, Akın-Çakıcı and Kardeş 18 –Reference Kardeş, Kuzu and Raiker 21 Similarly, during the aftermath of the earthquake, monitoring search trends related to scabies using Google Trends can offer valuable insights into the level of public concern, potentially guiding timely public health responses. By tracking such trends, authorities can better allocate resources, prioritize interventions, and design targeted awareness campaigns to address the rising prevalence of scabies and other dermatological issues.
Beyond scabies, other infectious skin diseases, such as leishmaniasis, are increasingly spreading due to factors like climate change, migration, and post-disaster situations, further straining health care systems. A study has highlighted that that weak health infrastructure exacerbates the spread of visceral leishmaniasis, underscoring the need for improved surveillance and response strategies. In this regard, digital tools like Google Trends can complement traditional epidemiological methods, enhancing outbreak prediction and preparedness efforts.Reference Abbasi 22
Moreover, leveraging databases like Google Trends can enhance health care professionals’ awareness and knowledge in regions where demand for dermatological care is rising. By continuously integrating such data into medical education and public health planning, the quality of health care services can be improved, ensuring a more proactive and data-driven approach to disease monitoring and intervention.Reference Abbasi 23
Conclusions
This study demonstrates the significant shift in public interest regarding dermatological issues, particularly scabies, in the aftermath of the February 6, 2023 earthquake. Google Trends analysis revealed a substantial increase in scabies-related searches across all affected provinces, with Hatay emerging as the leading province post-earthquake. These findings align with previous research documenting the rise in parasitic infestations following natural disasters, emphasizing the need for targeted public health interventions to address the rising prevalence of scabies and other dermatological conditions.
Author contribution
Concept: C.A.G., Design: C.A.G., Data Collection or Processing: C.A.G., H.A.K., Analysis or Interpretation: C.A.G., H.A.K., Literature Search: C.A.G., H.A.K., Writing: C.A.G.
Funding statement
There is no funding.
Competing interests
The authors have no conflicts of interest to declare.
Ethical standard
Because the study is based on publicly available data, institutional review board approval was not required.
