Mar 31, 2026
3 min read
A mental health condition characterized by undercorrected, or completely perceived flaws in the skin, face, or body can lead to depression and social isolation.Lydia Spencer-Elliott talks to professionals and sufferers about living with skin dysmorphia - and how health professionals can help
Skin disfigurement: Has your preoccupation with beautiful skin turned into a mental health problem?
A mental health condition characterized by a fixation on minor or completely imaginary defects on the skin, face or body can lead to depression and social isolation.Lydia Spencer-Elliott talks to experts and sufferers about living with skin dysmorphia - and how healthcare professionals can help
Perry, now 44, is one of many patients suffering from skin dysmorphia, more commonly called acne dysmorphia in the US, where he lives in New Orleans, Louisiana."A few years later, a friend found an old photo of us - taken before Photoshop and filters - and I was surprised," he said.
"I was shocked. I always believed I would be remembered as the girl with the bad acne."
Dystrophy is an increasingly recognized condition where sufferers look in the mirror and believe there are flaws on their face.This can lead to a complex and obsessive skin care routine for flawless skin that often appears (thanks to filters and foundations) on social networks like TikTok and Instagram Reels.
Symptoms of this condition include excessive looking in the mirror, dissatisfaction with aesthetic or medical skin treatments, compulsive use or trying new products and procedures, intense emotional distress over minor or invisible skin problems, and even avoiding social situations because of how you think your skin looks.
The pervasive disorder often appears alongside depression, anxiety, isolation, and job loss or low grades, as sufferers become trapped in a loop of staring at the face they hate in the mirror, cutting out their reflection and trying to "fix" it, in any dangerous or costly way they can.
"The emotional and financial cost was enormous," says Perry."I've probably spent tens of thousands of dollars on skin care."
Excessive skin care routines, with many steps, active agents, or excessive scrubbing and scrubbing, are often adopted by skin dysmorphia sufferers and can expose people to a myriad of health risks, including scarring, irritation and sun damage, or worse.
In one case, a previously healthy 44-year-old woman experienced seizures and liver toxicity hepatitis, which researchers concluded was caused by long-term exposure to titanium dioxide in her skin products.
Although this is a serious condition, it is not uncommon for patients to concentrate longer than necessary due to fear of acne.
Maddie Ogle, 22, was given 150 mg of spironolactone for her hormonal acne at age 20. The drug — a diuretic, which can cause dizziness, low energy, rashes, headaches and loss of sex drive — cleared up her skin, but she was too scared to remove it, even though we were down to treating her.
"I had all these side effects," she said.
"I'm glad that my mom and my son told me that you have to take care of your health and your mental health before your skin because it's going to get better and that's it, so I'm glad I listened to them," she said, reflecting on her decision to quit medication and see how her skin responded.
"I was tired; my skin was on my mind."
Skin dysmorphia is a specific form of body dysmorphic disorder (BDD) that involves a severe, obsessive mental health condition with perceived or minor defects in physical appearance that are often invisible to others.This means that people with skin dysmorphia are less likely to get the help they need, as patients are more likely to visit dermatologists to treat their skin problems than to seek mental health support.
"The effects of mental illness affected my self-esteem and self-worth and made me socially vulnerable," Perry explains of his own symptoms.
He became aware of the situation.In January 2026, the Skin Dysmorphia Scale (SDS), published in the Journal of Cosmetic Dermatology, recommends that doctors take further steps to identify symptoms.A comprehensive evaluation and management of the emergency is recommended.However, whether it is used or not is still up to the practitioner.
Psychiatrist and mental health researcher Dr. Eleanor Chatburn says she would like to see more communication between dermatologists, specialists and mental health professionals to prevent people from falling through the cracks."I've worked with dermatologists in the past who are very ethical," she says. But there are also many who will happily take people's money and offer them a whole course of different treatments.
She notes that alerting a patient to a mental health problem can be a difficult conversation to have."People may still think it's a skin problem," says Chatburn."They go to a dermatologist or esthetician because they want a quick, off-the-shelf fix. If they hear, 'It's not as good as you think,' some people don't come back because they really want a product or a laser treatment. So they find someone who sells it to them."
Chatburn advises anyone who thinks they may be suffering from this disease to "do the research".Ask others around you if you spend most of your day looking at yourself in the mirror.Ask yourself if you are spending too much money on skin products and your time on social media comparing yourself to those who are flawless.Think about how those things affect your life.
Victims often spend less time socializing, reduce their hobbies, and spend less time going out."There's going to be a lot of things to avoid," Chatburn said.
"Also look for signs of low mood, depression, hopelessness and low self-esteem. I've heard people say, 'My skin is bad, therefore I'm bad.' So it gets internalized in a really, really toxic way."
Buying too much skincare is worse than ever.Nicola Liberos, a registered nurse and beautician based in London, says she is often "horrified" by patients who come to see her with 50 different medications in their bathroom."It's funny," she says.
"The skin is the largest organ in the body, so you have to look at everything - but there are practitioners who are just trying to sell a product."
In addition to buying products, many people buy the perfect skin condition.With 47.6 million videos (and counting) under the hashtag "skincare" on TikTok, it is not surprising that new studies show that the more intensive use of the app is the same as the higher dysmorphia skin conditions.
“Remember, kids have access to TikTok, Instagram, Boots and Superdrug,” Liberos reminds us of Gen Alpha's voracious appetite for products.'There are dangerous raw ingredients in it that are harmful to children;You can take anything and take it without a prescription.'
If you are feeling stressed or struggling to cope, speak to the Samaritans confidentially on 116 123 (UK and ROI), email jo@samaritans.org or visit the Samaritans website for details of your local branch.
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