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Obsess Over Your Pimples? The Truth About Acne Dysmorphia

You’ve likely heard of body dysmorphic disorder (BDD), a mental disorder that causes a person to obsess about perceived flaws in their appearance — “flaws” that oftentimes outside observers don’t see. But have you heard of ADD? Nope, we’re not talking about the inability to concentrate. ADD stands for acne dysmorphic disorder and it’s a subset of BDD. Much like BDD, those who suffer from acne dysmorphic disorder find their thoughts dominated by perceived or real issues, but their excessive worry centers on their skin. In particular, their acne… whether they currently have pimples or not.

And, just like with BDD, the negative thoughts that flood the head of someone who’s suffering from acne dysmorphic disorder can result in emotional distress, which can lead to anxious behavior and even isolation from social situations, family and friends. Here, we take a look at what triggers acne dysmorphic disorder and how you can treat it.


Who suffers from ADD?

According to the American Psychiatric Association, around 2.5% of males and 2.2% of females in the United States experience BDD, with the disorder typically starting between ages 12 and 13 years. (Since acne dysmorphic disorder is a subset of BDD, a smaller percentage of those affected by BDD experience acne dysmorphic disorder.)

Everyone afflicted with acne dysmorphic disorder looks different —some have little or no acne while others have mild-to-moderate skin issues, have a previous history of acne and/or suffer from permanent acne scarring. What’s confusing is that, even though a person with acne dysmorphic disorder may have had more troublesome acne growing up, once it clears in adulthood the psychological impact doesn’t necessarily disappear with the pimples.

For these individuals, small flare-ups are perceived as full-scale acne issues. Even though acne dysmorphic disorder sufferers may actually outwardly realize they no longer have acne, they can’t convince their brain that the skin issue no longer afflicts them to the same degree — if at all. Doctors theorize that this is because the person believes that the acne will resurface at any time, causing them to live in a constant state of panic.

What are the causes and triggers of ADD?

Though doctors remain unsure of what specifically causes BDD (and, therefore, acne dysmorphic disorder), there is a theory that a confluence of brain abnormalities, genes and environment (such as life experiences and cultural influences — especially if they are negative) work together to cause BDD. Certain risk factors trigger or cause the development of BDD, including societal expectations of beauty, low self-esteem, childhood teasing, a tendency toward perfectionism and anxious behaviors. Because acne dysmorphic disorder is a subset of BDD, many of these risks and possible causes apply to acne dysmorphic disorder as well.

It’s not shocking that low self-esteem factors into the development of acne dysmorphic disorder. Problematic skin conditions like acne often affect our mental health, confidence and quality of life. In a survey conduced by the British Skin Foundation, 66% of participants reported a decrease in self-confidence due to skin issues, while 95% said that their acne impacts them daily. And, not surprisingly, teasing and public perception play roles in the adverse effects of acne dysmorphic disorder. The same survey found that 40% of respondents had been bullied due to acne, while a third (33%) received unfair treatment at work or school.

What does this mean for ADD sufferers?

Unfortunately, people who believe that acne prevents them from career success or positive relationships may live in a constant state of panic that their acne could return and spoil the achievements they secured when their skin is clearer. This constant worry presents in several ways: The sufferer could become obsessive about camouflaging her perceived flaws through excessive makeup or scarves; become fixated on comparing her skin to other peoples; spend an inordinate amount of time analyzing her skin in the mirror; or, in the opposite direction, going to great lengths to avoid mirrors altogether. All of these actions have a negative impact on day-to-day activities.

Additionally, such anxiety over how others perceive them could lead to acne dysmorphic disorder sufferers withdrawing from social situations, skipping out on work or school, and even considering self-harm or suicide.

How do you treat ADD?

Treating ADD is all about adopting new positive behaviors to counteract negative ones. Treating your acne may be the first step, in finding a skincare routine and/or dermatologist you trust to help you get your skin into better condition.

But first and foremost, seek out a mental health professional to discover what path you should take for treatment. Effective treatments include cognitive-behavioral therapy (CBT), which teaches you how to identify irrational thoughts and behaviors and replace them with positive ones, and/or antidepressant medication, such as serotonin reuptake inhibitors (SSRIs) that can quell some of the obsessive and compulsive behaviors associated with BDD and acne dysmorphic disorder.

If you yourself are suffering from BDD or ADD, or know somebody who may be, help is available, and there are lots of effective resources online. Here’s a comprehensive list.

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