A mild disturbance with body image is quite common. Many of us will think a certain part of our body is less than ideal. We often find our teenagers complaining about their acne, teeth and everything else on their body and face. This can be passed as normal in that stage of life. A more severe form of body image disturbance often goes unrecognized as a disease. The condition is called “Body Dysmorphic Disorder” or “Dysmorphophobia”. It is a relatively common psychiatric disorder resulting in significant impact in the patient's quality of life. It affects similar proportion of men and women.

The patient is preoccupied with a slight defect, or even an imagined defect, in appearance, causing him or her much distress and dysfunction. He /she goes to the dermatologists or cosmetic surgeons requesting treatment. Many of them end up multiple operations which cannot satisfy them at all. Many of them need hospital admissions, become housebound or even suicidal. For women, the defect in question is often a skin defect, e.g. acne, a mole, or a small prominent vein. For men, it is often acne, scarring, loss of hair, disproportioned nose or genital. Many men are troubled by an imagined lack of muscle and work out compulsively, or even take anabolic steroids.

The condition often hinders normal daily activities including social life and work. It is important that they are diagnosed and referred for psychiatric treatment rather than cosmetic or dermatologic treatment which can be detrimental to them. The usual treatment if with the group of drugs classified as “serotonin reuptake inhibitors”. Treatment with cognitive behavioral therapy is also helpful. Telling them off or asking them to stop being silly is definitely off the mark and does not help at all.