Beauty and Body Dysmorphic Disorder : A Clinician's Guide

Over the decades, research has demonstrated that in categories of life deemed to be important, beautiful people achieve more desirable outcomes, are judged more favorably, and receive preferential treatment. An understanding of the historical aspects, science, and implications of what the human mind finds aesthetically pleasing is quintessential for dermatologists, plastic surgeons, and others who practice aesthetic medicine as the importance of beauty in today’s society is what brings patients into clinics.

While an element of dissatisfaction with one’s appearance is commonplace, clinicians should remain vigilant for individuals who seek cosmetic procedures to quell excessive body image concerns that are out of proportion to objective physical findings. Body dysmorphic disorder (BDD) is a disorder of self-perception; it is the impairing preoccupation with a nonexistent or minimal flaw in appearance. According to recent statistics, BDD occurs in 0.7–2.4% of the general population; however, multiple studies have suggested an incidence of 6–16% in patients seeking aesthetic medical treatments. Moreover, a vast majority will at some point seek dermatologic treatment and cosmetic surgery. Such patients are unlikely to be satisfied with corrective procedures, and only 15% of dermatologists surveyed thought that they could successfully treat BDD. Therefore, Beauty and Body Dysmor

phic Disorder aims to assist dermatologists, plastic surgeons, and other aesthetic providers in recognizing key characteristics as well as providing treatment strategies to help in caring for those with BDD.

Neelam A. Vashi, MD, FAAD is a board certified dermatologist and a fellow of the American Academy of Dermatology.  She is an Assistant Professor of Dermatology at the Boston University (BU) School of Medicine and teaches dermatology to BU residents, international trainees, and medical students.  She is also the Director of Research in Cosmetic and Laser Medicine and the Founder and Director of the Boston University Center for Ethnic Skin.  Dr. Vashi received her medical degree from Northwestern University Feinberg School of Medicine, where she was inducted into the Alpha Omega Alpha Honor Medical Society.  After her internship in internal medicine at Northwestern University, Dr. Vashi completed her dermatology residency at New York University (NYU) in the Ronald O. Perelman Department of Dermatology. Dr. Vashi is a recognized leader in medical and cosmetic dermatology and in patients with skin of color.  She is widely published in the peer-reviewed literature, author of several book chapters, and is a frequent lecturer at both national and international dermatology meetings.