A new viewpoint article published in JAMA Facial Plastic Surgery exposes the harmful effects of smartphone photo filters on body image issues and mental health conditions such as body dysmorphic disorder.

Body dysmorphic disorder (BDD) is a mental health condition affecting 1 in 50 people in the United States.

The disorder has been classified as part of the obsessive-compulsive spectrum.

People who have the disorder can spend hours obsessing over minor or nonexistent flaws in their appearance, picking their skin, or grooming themselves.

Some of the people living with BDD have a history of unnecessary or repeated cosmetic surgeries; the disorder has been associated with obsessive-compulsive disorder, major depression, and suicidal tendencies.

Although the causes of BDD are unclear at the moment, researchers think that several factors are at play, including genetics and neurobiological issues such as a faulty processing of the neurotransmitter serotonin (also known as the happiness hormone).

Additionally, several environmental factors may also influence a person's chances of developing BDD. Life experiences such as childhood trauma or personality traits can have a bearing on BDD risk.

Now, a new viewpoint article written by researchers at the Boston Medical Center (BMC) in Massachusetts suggests that there might be an additional risk factor: selfies.

Susruthi Rajanala, of the Department of Dermatology at the BMC, is the first author of the viewpoint.

How Snapchat filters may affect dysmorphia

In their article, the authors highlight the fact that the popularity of social media and the increasing accessibility of filters in apps, such as Snapchat and Facetune, have profound psychological effects.

"The pervasiveness of these filtered images can take a toll on one's self-esteem, make one feel inadequate for not looking a certain way in the real world, and may even act as a trigger and lead to [BDD]," they write.

Rajanala and colleagues quote research that shows that teenage girls who manipulate their photos tend to be more preoccupied with their body image. Also, teen girls with BDD turn to social media in search of aesthetic validation.

A survey referenced by the researchers found that in 2017, 55% of plastic surgeons dealt with people who were looking "to improve their appearance in selfies." Only 3 years ago, this proportion was 42%.

Study coauthor Dr. Neelam Vashi, the director of the Ethnic Skin Center at BMC, comments on the findings, saying, "Filtered selfies can make people lose touch with reality, creating the expectation that we are supposed to look perfectly primped all the time."

"A new phenomenon called 'Snapchat dysmorphia' has popped up [...] where patients are seeking out surgery to help them appear like the filtered versions of themselves."

Dr. Neelam Vashi

"This can be especially harmful for teens and those with BDD, and it is important for providers to understand the implications of social media on body image to better treat and counsel our patients," Dr. Vashi adds.

In their article, the researchers caution that surgery is not recommended in these cases, as it may worsen BDD symptoms. Instead, they suggest cognitive behavioral therapy and empathetic interventions.