Mental health
Medicines for Body dysmorphic disorder (BDD)
A mental health condition in which a person becomes preoccupied with one or more perceived flaws in their appearance that others barely notice, causing real distress and repetitive behaviours such as mirror-checking or seeking cosmetic procedures; it is related to OCD and is treated with psychological therapy and, where needed, an SSRI — cosmetic procedures do not help and can make it worse.
Education and reference only. This explains which medicines are used and why, in plain language — it deliberately contains no doses and is not a substitute for advice from your doctor or pharmacist. Always discuss your own treatment with a qualified clinician, and check the BNF and the product labelling for prescribing detail.
Quick answer
What is Body dysmorphic disorder (BDD)?
Body dysmorphic disorder, or BDD, is a mental health condition in which a person spends a lot of time worrying about one or more perceived flaws in their appearance — flaws that other people barely notice or cannot see at all. The worry feels very real and causes genuine distress, and it tends to drive time-consuming, repetitive behaviours: checking themselves in mirrors or avoiding mirrors altogether, comparing their looks with other people, grooming or trying to camouflage the perceived flaw, picking at their skin, and repeatedly asking others for reassurance.
- How it is treated: Treatment is built around psychological therapy and, where needed, medication, tailored to how much the condition is affecting the person.
- Self-care: Alongside professional treatment, recovery is supported by gradually cutting down on appearance-checking, reassurance-seeking and comparing yourself with others rather than feeding the worry, resisting the urge to pursue cosmetic procedures, being open with someone you trust instead of hiding the distress, looking after your general wellbeing through sleep, activity and connection with others, and reaching out to a charity such as Mind for support.
- When to seek help: Speak to your GP if worries about your appearance are taking up a lot of your time, causing real distress, or driving behaviours such as constant mirror-checking, seeking reassurance, skin-picking or pursuing cosmetic procedures, and are affecting your daily life — BDD is a recognised, treatable condition and is not vanity.
What it is
Body dysmorphic disorder, or BDD, is a mental health condition in which a person spends a lot of time worrying about one or more perceived flaws in their appearance — flaws that other people barely notice or cannot see at all. The worry feels very real and causes genuine distress, and it tends to drive time-consuming, repetitive behaviours: checking themselves in mirrors or avoiding mirrors altogether, comparing their looks with other people, grooming or trying to camouflage the perceived flaw, picking at their skin, and repeatedly asking others for reassurance. Many people with BDD also seek out cosmetic or dermatological procedures in the hope of "fixing" the problem. It is closely related to obsessive-compulsive disorder (OCD), sharing the pattern of intrusive worries and repetitive behaviours, and people often feel deeply ashamed and go to great lengths to hide it. BDD is not vanity and it is not the same as ordinary concern about appearance; it is a recognised illness that can be very disabling, often interfering with work, study, relationships and social life. Importantly, it can carry a significant risk of depression and thoughts of suicide, so taking the distress seriously matters. It is treatable.
How it is treated
Treatment is built around psychological therapy and, where needed, medication, tailored to how much the condition is affecting the person. The recommended psychological therapy is cognitive behavioural therapy (CBT) adapted for BDD, including a technique called exposure and response prevention, which gently helps a person face appearance-related worries and situations while resisting the urge to carry out checking, reassurance-seeking and other repetitive behaviours that keep the problem going. Because BDD is related to OCD, an SSRI antidepressant is the medicine most often used, on its own or together with therapy; SSRIs for BDD are often used at the higher end of the range and may need to be taken for a longer period before the benefit is clear, so patience and regular review are part of the plan. A crucial point is that cosmetic, dermatological or surgical procedures do not treat BDD and frequently leave people just as distressed or worse, often shifting the worry to another part of the body, so they are not the answer. Because of the risk of depression and suicidal thoughts, treatment also keeps a close eye on mood and safety, and addresses any linked depression or anxiety.
For this condition, these medicines
Medicine classes used for Body dysmorphic disorder (BDD)
Each links to a full, dose-free guide — what it is, how it works, who can and cannot use it, side effects, interactions and FAQs.
Symptom checker
Symptoms that can point to Body dysmorphic disorder (BDD)
Body dysmorphic disorder (BDD) can be one cause of these symptoms. Each guide explains the other possible causes and the red-flag warning signs that mean you should get urgent help:
Beyond medication
Lifestyle and self-care
Alongside professional treatment, recovery is supported by gradually cutting down on appearance-checking, reassurance-seeking and comparing yourself with others rather than feeding the worry, resisting the urge to pursue cosmetic procedures, being open with someone you trust instead of hiding the distress, looking after your general wellbeing through sleep, activity and connection with others, and reaching out to a charity such as Mind for support. Because the distress can be intense, it is important not to struggle alone.
When to get help
When to see a doctor
Speak to your GP if worries about your appearance are taking up a lot of your time, causing real distress, or driving behaviours such as constant mirror-checking, seeking reassurance, skin-picking or pursuing cosmetic procedures, and are affecting your daily life — BDD is a recognised, treatable condition and is not vanity. It is especially important to seek help because BDD carries a significant risk of depression and thoughts of suicide, so any such distress must be taken seriously. It is also worth knowing that cosmetic or surgical procedures do not treat BDD and often make things worse, so getting the right mental health support is far more likely to help. Get help straight away if you have thoughts of harming yourself or feel unable to keep yourself safe: call 999 or go to A&E if anyone is in immediate danger, call 111 for urgent mental health advice, and the Samaritans are there day or night on 116 123.
Not sure how urgent it is? It is always OK to call NHS 111 for advice, day or night.
Answers
Body dysmorphic disorder (BDD): frequently asked questions
What medicines are used for body dysmorphic disorder?
The medicine most often used for body dysmorphic disorder is an SSRI antidepressant, reflecting how closely BDD is related to obsessive-compulsive disorder. An SSRI may be used on its own or alongside cognitive behavioural therapy. For BDD, SSRIs are often used at the higher end of the range and may need to be taken for a longer period before the benefit becomes clear, so patience and regular review with your doctor are important. Medicine is one part of treatment, used together with psychological therapy. Cosmetic procedures are not a treatment for BDD and can make it worse.
Will cosmetic surgery or procedures fix BDD?
No. This is one of the most important things to understand about body dysmorphic disorder. Cosmetic, dermatological or surgical procedures do not treat BDD, and they often leave people just as distressed, or worse — frequently the worry simply moves to another part of the body, or the person feels the result was not good enough. Because the problem is in how distressing and preoccupying the worry feels rather than in the appearance itself, the help that works is psychological therapy and, where needed, an SSRI. If you are tempted to seek a procedure to "fix" a perceived flaw, it is worth talking to your GP first.
How is BDD related to OCD?
Body dysmorphic disorder is closely related to obsessive-compulsive disorder (OCD). Both involve intrusive, distressing worries that are hard to get rid of, and both drive repetitive behaviours aimed at easing the anxiety — in BDD these include mirror-checking, comparing, grooming, skin-picking and seeking reassurance. Because of this link, the treatments overlap: the recommended talking therapy is cognitive behavioural therapy including exposure and response prevention, and the medicine most often used is an SSRI, just as in OCD. Recognising BDD as part of this family helps explain why these particular treatments are the ones that work.
Is body dysmorphic disorder serious?
Yes, BDD is a serious and often very disabling condition, not vanity or ordinary concern about appearance. It can take up hours of the day and interfere with work, study, relationships and social life, and people often feel deeply ashamed and hide it. Importantly, BDD carries a significant risk of depression and of thoughts of suicide, so the distress it causes should always be taken seriously and help sought. The reassuring side is that it is treatable — psychological therapy and, where needed, an SSRI can make a real difference — and reaching out to a GP or a charity such as Mind is an important first step.
Sources
Where this is drawn from
- NICE CKS: Body dysmorphic disorder.
- Mind.
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