Infantile cutaneous ideas

Abstract

Disturbances in body image are important in dermatological practice. Thus, patients with either trichotillomania or artefactual dermatitis may modify their body image in the hope of attracting the attention of others, whilst patients with dysmorphophobia have a more fundamental delusional defect of body image. Body image is partly abstract, partly intellectual and perceptual and capable of modification by social factors such as advertising. Unfortunately, the public at large has a mediaeval percept about the structure and function of skin, whilst the cosmetic industry remains happy to build on to these unrealistic concepts. Thus, cosmetic advertising demands that the mature woman in 1987 should have plenty of hair on her head, but none on her face, under her arms or on her legs. Her skin should be free from grease, spots and wrinkles and, moreover, should be odourless. She should be thin, with inconspicuous breasts. In short, her skin should be prepubertal and her skin care therefore infantile. A large gap exists between these aspirations and reality and this type of advertising pressure may be at least in part responsible for cosmetic neurosis and may also play some part in the pathogenesis of cosmetic-based psychosis.