Psychology and Cosmetic Medicine
Assessment of the psychological needs of our patients is an essential aspect of good medical practice, and it is what separates the medical model from the purely “cosmetic model.”
It probably seems intuitive to suggest that there is a connection between our minds and our physical health. And the evidence holds that patient psychology matters massively in aesthetic medicine.
In this article we are going to briefly summarise some of the basic ways that cosmetic medicine and psychology intersect for clinicians.
Part of medical ethics emphasises that we are always keeping the healthcare benefits to our patients at the forefront of our minds whenever we begin developing a treatment plan. It is our first and most important concern. Cosmetic procedures can have a profound effect - both negative and positive - on our patients’ psychological health.
Pros and Cons
Historically, the treatment of psychological concerns was a way for cosmetic medicine to make itself legitimate when it had previously been relegated to the remit of “beauty doctors” (who were often quacks). There is work being done in the literature investigating the psychological benefits of aesthetic treatments.
A systematic review and and meta-analysis conducted in 2021 showed that having a botulinum toxin treatment in the glabellar region, aka the “frown lines,” showed a statistically significant improvement in depressive symptoms. For a more in-depth dive into this, check out our piece summarising the basics of Botox and Depression, and read my in-depth review in the Aesthetics Journal.
The most important thing to remember that the relationship between aesthetic medicine and psychology is extremely complex and nuanced.
When assessing patients for psychiatric presentation, we can divide them broadly into three categories.
Primary Psychiatric Presentations
These are psychiatric concerns where there is not initially any skin or cosmetic pathology associated with the concern.
The most well-known example of this, and one that cosmetic clinician must be very aware of, is body dysmorphic disorder (BDD). It is vital to be screen and be aware of this in our patients, there is a higher percentage of people who suffer BDD in patients seeking cosmetic treatments than in the general population. Other examples of primary psychiatric presentations include excoriation (skin picking) and delusions like parasitosis.
Secondary Psychiatric Presentations
These conditions refer to the stress or distress that we can feel as a consequence of dermatological or cosmetic issues. This is a very important aspect of cosmetic medicine, as many of the skin concerns we manage may appear to be primarily “cosmetic” in nature, but can have a profound effect on our patients’ quality of life and confidence.
These issues include things like depression and anxiety, low self-esteem, fear of negative reactions from others and concern about appearance.
Psychophysiological Presentations
This is an example of our state of mind directly affecting our skin. Many might relate to this - when stress can trigger an underlying skin issue like eczema or alopecia.
Final Thoughts
This complex interplay helps to emphasise the importance of treating these treatments via the medical model, and as clinicians we should make sure we are adequately trained and experienced in order to diagnose and manage these basic concerns, as well as refer on as appropriate.
References
Parsaik AK, Mascarenhas SS, Hashmi A, Prokop LJ, John V, Okusaga O, Singh B. Role of Botulinum Toxin in Depression. J Psychiatr Pract. 2016 Mar;22(2):99-110. doi: 10.1097/PRA.0000000000000136. PMID: 27138078.
The concept of neurocosmetics represents a fascinating convergence of neuroscience and skincare, marking a significant shift in how we perceive beauty and wellness. This emerging field, also known as psychodermatology, delves into the intricate relationship between the skin and the nervous system.