Signs and symptoms of body dysmorphic disorder include:

• Being extremely preoccupied with a perceived flaw in appearance that to others can't be seen or appears minor
• Strong belief that you have a defect in your appearance that makes you ugly or deformed
• Belief that others take special notice of your appearance in a negative way or mock you
• Engaging in behaviors aimed at fixing or hiding the perceived flaw that are difficult to resist or control, such as frequently checking the mirror, grooming or skin picking
• Attempting to hide perceived flaws with styling, makeup or clothes
• Constantly comparing your appearance with others
• Always seeking reassurance about your appearance from others
• Having perfectionist tendencies
• Seeking frequent cosmetic procedures with little satisfaction
• Avoiding social situations
• Being so preoccupied with appearance that it causes major distress or problems in your social life, work, school or other areas of functioning

You may obsess over one or more parts of your body. The feature that you focus on may change over time. The most common features people obsess about include:

• Face, such as nose, complexion, wrinkles, acne and other blemishes
• Hair, such as appearance, thinning and baldness
• Skin and vein appearance
• Breast size
• Muscle size and tone
• Genitalia

Insight about body dysmorphic disorder varies. You may recognize that your beliefs about your perceived flaws may not be true, or think that they probably are true, or be absolutely convinced that they're true.

Body dysmorphic disorder typically starts in the early teenage years and it affects both males and females. An obsession that body build is too small or not muscular enough (muscle dysmorphia) occurs almost exclusively in males.

It's not known specifically what causes body dysmorphic disorder. Like many other mental illnesses, body dysmorphic disorder may result from a combination of causes, such as:

• Brain differences. Abnormalities in brain structure or neurochemistry may play a role in causing body dysmorphic disorder.
• Genes. Some studies show that body dysmorphic disorder is more common in people whose blood relatives also have this condition or obsessive-compulsive disorder.
• Environment. Your environment, life experiences and culture may contribute to body dysmorphic disorder, especially if they involve negative social evaluations about your body or self-image, or even childhood neglect or abuse.

Certain factors seem to increase the risk of developing or triggering body dysmorphic disorder, including:

• Having blood relatives with body dysmorphic disorder or obsessive-compulsive disorder
• Negative life experiences, such as childhood teasing and trauma
• Certain personality traits, such as perfectionism
• Societal pressure or expectations of beauty
• Having another psychiatric disorder, such as anxiety or depression

Complications that may be caused by or associated with body dysmorphic disorder include, for example:

• Major depression or other mood disorders
• Suicidal thoughts or behavior
• Anxiety disorders
• Health problems from behaviors such as skin picking
• Obsessive-compulsive disorder
• Eating disorders
• Substance abuse