What Is Facial Dysmorphia?

The last few years have been filled with online video calls for things like work meetings, doctor’s appointments, virtual classrooms and to catch up with friends.

While those virtual calls have become an easy way for us to stay connected, it’s also easy to see your face on screen and start criticizing your appearance. My nose is too big. Oh, I’m having a bad hair day. When did I get all these wrinkles?

“We’re in meetings and we can see ourselves on screen and so we’re just more focused on our appearance,” says psychologist Leslie Heinberg, PhD. “But even prior to that, social media with the focus on selfies and the focus on using filters have likely led to an increase in concern about our facial appearance.”

And yes, it’s natural to think about ways to improve your appearance. But for some, it can turn into facial dysmorphia, a distorted way of viewing one’s appearance. You may start thinking constantly about your “flaws” and even view yourself as “ugly.”

Dr. Heinberg discusses what causes facial dysmorphia, how it’s treated and why it’s so important to seek help.

What is facial dysmorphia?

First, it’s important to understand that facial dysmorphia is a subset of the mental health disorder known as body dysmorphic disorder (BDD).

Body dysmorphic disorder can cause you to become anxious about your body or a perceived physical defect. Most times, you may just be imagining the defect or even making more of a minor defect.

“With facial dysmorphia, the individual is focused on the face,” explains Dr. Heinberg. “It could be your nose or eyes. It could be that you’re concerned about wrinkles or acne. And it can even be that your face is too thin. It’s really anything about your facial appearance.”

And that concern can start to consume your life, whether that’s avoiding time with friends and family, thinking about what’s “wrong” with your features for hours each day and even turning to plastic surgery to try and improve your appearance — often with disappointing results.

How it manifests

Sure, we all may have things we don’t like about our appearance. But with facial dysmorphia, an insecurity can turn into an obsession.

If you have facial dysmorphia, you may:

• Spend hours each day worrying about your appearance.
• Experience intense shame or embarrassment about your appearance.
• Seek reassurance from others about your appearance.
• Avoid social situations.
• Miss work or school.
• Spend a significant amount of time covering up “flaws” in your appearance with makeup.
• Undergo cosmetic surgery to “fix” your “flaws.”

“If you have facial dysmorphia, you may spend lots of time, money and effort on aesthetic procedures like Botox® and teeth whitening, then want more and more and more,” says Dr. Heinberg.

What causes facial dysmorphia?

While there isn’t a definitive cause for facial dysmorphia, some factors can contribute to its development:

• A family history of body dysmorphic disorder.
• Traumatic events or emotional conflict during childhood.
• A perfectionist personality.
• Low self-esteem.
• Societal pressures to look a certain way.

Though facial dysmorphia is most likely to occur in your early adolescence, it can happen at any age.

It’s also important to note that those with facial dysmorphia may have other disorders like eating disorders, anxiety disorders, depression and obsessive-compulsive disorder (OCD).

How is it treated?

Facial dysmorphia and body dysmorphic disorder are typically diagnosed by a mental health professional.

“The diagnosis is based on the kind of symptoms you’re experiencing and how much those symptoms are interfering in your life,” says Dr. Heinberg.

Your doctor may recommend psychotherapy like cognitive behavioral therapy (CBT).

“It’s important to work with a mental health professional who has some degree of specialty with body dysmorphic disorders or other body image disorders,” advises Dr. Heinberg. “And psychotropic medications like antidepressants or mood stabilizers can also be helpful in reducing obsessive thoughts.”

Impact of facial dysmorphia

Facial dysmorphia can impact you in a variety of ways. You may start avoiding social activities. It can impact your job. It can take over your life.

Alarmingly, the rate of suicide is high for those who have facial dysmorphia and body dysmorphic disorder. That’s why it’s so important to speak to a behavioral health professional and focus on your treatment.

“Facial dysmorphia is often very hard to manage on your own and you really do need the help of a behavioral health professional,” says Dr. Heinberg. “You may need medications.”

But there are some helpful steps you can take right now:

1. Use positive self-talk. Replacing negative thoughts with positive ones can help — even just telling yourself you’re smart, a good friend or you’re good at your job.
2. Stop worrying about what others think. Concerned that everyone is staring at you during a Zoom™ call? “Remind yourself that no one is as focused on your ‘flaws’ as you,” says Dr. Heinberg. “And that they’re probably on that same Zoom call and wondering how they look.”
3. Remember that social media isn’t real. “Remind yourself that when you look on social media that nobody looks like they do,” says Dr. Heinberg. “They probably took 25 selfies with filters and picked the very best one to post. In real life, they don’t look like that. And it’s unfair to compare yourself to that standard.”
4. Turn off your camera. If you struggle to focus during a video call, try turning off your camera. “Hide your camera and go back to the way we used to interact, where we focused on each other,” says Dr. Heinberg.

Whether it’s a Teams™ work call or you’re scrolling through social media, it’s key to focus on the positive parts of yourself and try not to dwell on any perceived negative factors. But if you’re struggling with staying positive and find yourself feeling anxious or depressed whenever you look in the mirror or at yourself on screen, it’s time to talk to a professional.

“Technology has been great at keeping us connected during the pandemic, but it’s just led us to be much more aware of our appearance,” says Dr. Heinberg.