On occasion I come across a patient who has no gross or microscopic signs of hair loss whatsoever and yet he is convinced that he is losing his hair and is extremely concerned about the possibility of losing his hair. Some of these patients even previously received hair transplant surgery from another clinic.
This condition is commonly known as Body Dysmorphic Disorder (BDD) or Body Dysmorphia. Body dysmorphia is a form of mental illness in which a patient is constantly preoccupied with his or her appearance and is unable to focus on anything else but their personal physical flaws. This can be an exaggerated preexisting condition or completely imaginary.
Patients who suffer from Body Dysmorphic Disorder often suffer from severe anxiety and usually do not have the desire to be seen by anyone because they feel their appearance is unacceptable. BDD can afflict both men and women and its estimated that 1-2% of the world’s population meets the description and diagnostic criteria for Body Dysmorphic Disorder.
Patients with BDD are overly obsessed with their overall appearance and body image. The consuming thoughts can take a hold of them for several hours of the day. If left untreated the BDD can even affect their lifestyle or work habits. In an attempt to perfect their perceived image, sufferers of Body Dysmorphic Disorder may request several cosmetic procedures, however they are very rarely satisfied with the outcome, and their perfected image may never be achieved.
It is possible for a cosmetic surgeon who agrees to perform a procedure on someone whom suffers from BDD to be blamed for some (or all) of the physical imperfections that the patient envisions. Because of this, it is very important for cosmetic surgeons to pay attention to all the tell tale signs of Body Dysmorphic Disorder to better diagnose the patient and have them see a therapist for their mental health before pursuing any physical modifications on the patient.
How to Diagnose Body Dysmorphic Disorder
- Body Dysmorphic Disorder is generally diagnosed clinically when patient shows signs of preoccupation with an imagined imperfection or slight defect in appearance. If a slight physical anomaly is present, the person’s show of concern is markedly excessive.
- The preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of interaction and functioning.
- The preoccupation is not better accounted for by another mental disorder (e.g., dissatisfaction with body shape and size in Anorexia Nervosa)
Dr. Katharine Philips performed research on over 500 patients with BDD. The research shows the percentages of the areas of the body that patients were most concerned about. Dr. Philips was able to come to the conclusion that after skin issues hair loss was reported as the second most common issue (coming in at 56%).
Body Dysmorphic Disorder Treatment
In order to successfully treat patients with Body Dysmorphic Disorder, the patient must be involved in cognitive-behavior therapy which includes education on Body Dysmorphic Disorder (BDD), its treatment, and specific actions to aid managing troubled thoughts. Some patients may need to be prescribed medications as well, by a licensed physician.
Hair transplant is not indicated in most patients with BDD since they may not even have any real balding problem. If patient has balding that requires hair restoration surgery, the surgeon should make sure that his or her mental problem is treated first before he commit to performing a surgery on the patient.
Parsa Mohebi, M.D.
Blake – aka Future_HT_Doc
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