摘要

Objectives: 1. To define psychodermatology and its clinical relevance in dermatologic and aesthetic settings. 2. To describe the epidemiology, diagnostic criteria, and neurobiological underpinnings of Body Dysmorphic Disorder (BDD). 3. To identify clinical red flags of BDD in Aesthetic practice. 4. To propose screening strategies in dermatologic and aesthetic settings Introduction: Psychodermatology is an interdisciplinary field that explores the bidirectional relationship between the skin and the mind. Among psychiatric conditions encountered in dermatologic practice, Body Dysmorphic Disorder (BDD). This condition is characterized by a preoccupation with perceived defects in physical appearance that are not observable or appear minor to others. In dermatology and aesthetic clinics, patients with BDD frequently seek repeated cosmetic procedures, often with persistent dissatisfaction despite objectively satisfactory outcomes. Materials / method: The lecture reviews current literature from dermatology, psychiatry, and psychodermatology research, including DSM-5-TR diagnostic criteria, epidemiologic data, and evidence-based treatment guidelines. Screening tools such as the Body Dysmorphic Disorder Questionnaire (BDDQ) and other psychosocial screening tools will be presented. Results: Evidence indicates that BDD prevalence in dermatology and cosmetic settings (estimated 9–15%) is significantly higher than in the general population (approximately 1–3%). Commonly targeted concerns include acne, pigmentation, scarring, hair thinning, and facial symmetry. Clinical indicators include disproportionate distress, doctor shopping, procedural dissatisfaction, compulsive mirror checking, social avoidance, and unrealistic expectations. Studies report that cosmetic procedures rarely alleviate BDD symptoms and may exacerbate psychological distress. Conclusion: Body Dysmorphic Disorder represents a critical psychodermatologic condition requiring heightened awareness in dermatologic and aesthetic practice. Dermatologists occupy a frontline role in detection and early intervention. A biopsychosocial approach—integrating screening, compassionate boundary-setting, and collaboration with mental health professionals—optimizes patient safety and therapeutic outcomes. Recognizing when not to treat cosmetically may constitute the most ethical and therapeutic intervention in psychodermatology.