Dysmorphic Concern, Body Dysmorphic Disorder More Prevalent in Women with Skin Conditions than Men

Women with skin conditions are more likely to experience dysmorphic concern and body dysmorphic disorder versus men with skin conditions, according to a study published in the Journal of the European Academy of Dermatology and Venereology.¹

Researchers reported that regardless of gender, individuals with dermatological concerns faced a combination of perceived and actual stigmatization.

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Background and Methods

Previous research has indicated that body dysmorphic disorder is significantly higher in prevalence among individuals with skin conditions than the general population. A 2016 study published in Body Image reported that dermatological patients have an 11.3% prevalence of body dysmorphic disorder, while the prevalence for the general population is 2%.²

Authors of the present study, Sampogna et al, noted that no prior studies have analyzed the gender differences relative to dysmorphic concerns in dermatology.

Their study included patients from 17 European countries and a control group of individuals without skin conditions. Researchers utilized questionnaires such as the Dysmorphic Concern Questionnaire (DCQ) to gather data on sociodemographic details, disease severity, and body dysmorphic concerns, and the EuroQol 5-D to measure psychological factors such as depression, anxiety, perceived stigmatization, and stress.

Findings

The study involved 5,847 dermatological patients, with 5,290 completing the body dysmorphic disorder questionnaire. Among participants with gender data, 56.8% were women, and the average age was about 48.7 years.

The prevalence of body dysmorphic disorder was around 10.5%, with higher rates among women (12.7%) compared to men (7.7%). The likelihood of body dysmorphic disorder increased with the severity of the skin condition, being highest in those with severe conditions.

In addition, women consistently reported higher average DCQ scores than men, particularly in various skin conditions such as acne, atopic dermatitis, and vitiligo. The effect size of these differences was generally moderate in nature.

Logistic regression analysis revealed that body dysmorphic disorder in both men and women was associated with higher levels of stress, perceived stigma, and in some cases, anxiety and depression. For patients with more mild skin conditions, stress and stigma were notably linked to body dysmorphia.

Conclusions

"Statistically significant differences in dysmorphic concern among genders, with small to medium effect size, have been reported in more than half of the observed skin conditions," according to Sampogna et al. "The most significant difference in dysmorphic concern was observed for patients with vitiligo."

Limitations of the study, as noted by its authors, included a sample size that may not be entirely representative of the general patient population (those with skin conditions), lack of available reliability data for clinical severity scaling, and that body dysmorphic disorder had not been diagnosed by a clinician.

Researchers noted that this study data may provide clinicians with a deeper understand of gender differences in perceived and actual stigmatization of skin conditions. Clinicians, they wrote, should be able to detect body-related concerns and utilize a multi-disciplinary, holistic approach to address them in their patients.

References

1. Sampogna F, Samela T, Abeni D, et al. A cross-sectional study on gender differences in body dysmorphic concerns in patients with skin conditions in relation to sociodemographic, clinical and psychological variables. J Eur Acad Dermatol Venereol. July 25, 2024. https://doi.org/10.1111/jdv.20247
2. Veale D, Gledhill LJ, Christodoulou P, Hodsoll J. Body dysmorphic disorder in different settings: a systematic review and estimated weighted prevalence. Body Image. September 2016. doi: 10.1016/j.bodyim.2016.07.003