Symptoms of body dysmorphic disorder may develop gradually or abruptly, vary in intensity, and tend to persist unless appropriately treated.
Concerns commonly involve the face or head but may involve any body part or several parts of the body and may change from one body part to another. For example, individuals may be concerned about perceived hair thinning, acne, wrinkles, scars, colour of complexion, or excessive facial or body hair. Or Individuals may focus on the shape or size of a body part, such as the nose, eyes, ears, mouth, breasts, legs, or buttocks.
Some men with normal or even athletic builds think that they are puny and obsessively try to gain weight and muscle – a condition called muscle dysmorphia.
Individuals may describe the disliked body parts as being ugly, unattractive, deformed, hideous, or monstrous.
Most individuals with body dysmorphic disorder are not aware that they actually look normal.
Most individuals with body dysmorphic disorder have difficulty controlling their preoccupations and spend hours each day worrying about their perceived defects.
They may think that other people are staring at them or mocking them because of their appearance. Most individuals check themselves often in mirrors, others avoid mirrors, and still others alternate between the two behaviours.
Many individuals compulsively and excessively groom themselves, pick at their skin (to remove or fix perceived skin defects), and seek reassurance about the perceived defects.
They may frequently change their clothes to try to hide or camouflage their nonexistent or slight defect or try to improve their appearance in other ways. For example, people may grow a beard to hide perceived scars or wear a hat to cover slightly thinning hair.
Many have cosmetic medical (most often, dermatological), dental, or surgical treatment, sometimes repeatedly, to correct their perceived defect. Such treatment is usually unsuccessful and may intensify their preoccupation.
Men with muscle dysmorphia may take anabolic steroids (such as testosterone), which may be dangerous.
Because individuals with body dysmorphic disorder feel self-conscious about their appearance, they may avoid going out in public, including going to work, school, and social events.
Some with severe symptoms leave their home only at night, and others not at all.
Thus this disorder often results in social isolation.
Distress and dysfunction caused by the disorder can lead to depression, repeated hospitalisation, suicidal behaviour, and suicide.