The critical role of body dysmorphic disorder in dermatological patients’ body image: patients’ desire to seek even more medical treatments increases after dermatological treatment

Abstract

Objective: To investigate whether patients with a visible skin disorder (acne) and non-visible disorder (psoriasis/eczema) present body image changes after dermatological treatment. Secondly, to examine whether the existence of body dysmorphic disorder (BDD) influences patients’ desire to receive more medical treatments after initial treatment.Materials and methods: A battery of questionnaires assessing body image, BDD and satisfaction with the medical outcome was shared with patients before treatment and with a six-month follow-up (after each patient completed their treatment). The sample included 54 patients with visible facial acne, 54 patients with non-visible psoriasis/eczema, and 54 participants without a dermatological disorder (control group). All patients were treated by dermatologists and were 18-35 years old. We examined body image and demographic characteristics using Multivariate analysis of covariance (MANCOVA) between all the study groups. Performing MANCOVA analysis we investigated patients’ body image and appearance satisfaction, before and after treatment, compared to the control group. Finally, to examine the role of BDD on patients’ desire to receive more treatments, MANCOVA analysis was performed, with BDD diagnosis as a covariate variable.Results: At both research phases, both groups of dermatological patients exhibited lower levels of appearance satisfaction, compared to the control group. MANCOVA analysis revealed that after treatment, acne patients diagnosed with BDD presented even lower levels of facial and overall satisfaction. Moreover, acne patients showed a higher desire for more treatments that improve the skin’s appearance, compared to psoriasis/eczema patients. Conclusion: Dermatological disorders negatively affect patients’ body image, which does not improve even after dermatological treatment completion. Patients with acne seem to be more dissatisfied with their facial and overall appearance, while their dissatisfaction is projected on other body parts. Lastly, the coexistence of BDD symptomatology increases patients’ desire to seek further aesthetic and cosmetic treatments, to further improve the skin’s appearance after treatment.