Body dysmorphic disorder symptoms among patients with acne vulgaris

Background: Acne is one of the most common concerns of patients with body dysmorphic disorder (BDD), a psychiatric condition defined as a preoccupation with a slight or imagined defect in appearance that causes significant disruption in daily functioning. Objective: We sought to screen for BDD symptoms among patients with acne across a spectrum of acne severity. Methods: We used a validated self-report questionnaire and an objective assessment of acne severity by a single observer. Results: Rates of BDD ranged from 14.1% using more stringent criteria to assess acne severity to 21.1% using less stringent criteria. Two-fold increased odds of having BDD was seen in patients requiring systemic isotretinoin therapy. Limitations: Cross-sectional study design is a limitation. Conclusion: A significant proportion of patients, regardless of their acne severity at the time of examination, have substantial distress and preoccupation related to their facial appearance.