Cosmeticorexia in Adolescence: A Case Report and Psychodynamic Formulation

Cosmeticorexia is a provisional descriptive label, not a DSM-5-TR or ICD-11 diagnosis, for impairing skin-focused preoccupation and excessive cosmetic routines. It overlaps with body dysmorphic disorder (BDD); its proposed emphasis is a culturally sanctioned product ritual that may cause objective skin damage. The psychodynamic formulation offered here is interpretive and hypothesis-generating.

The patient was a 14-year-old girl referred after recurrent periocular dermatitis, burning, and acneiform eruptions associated with cosmetic overuse. She applied 10-12 products before school, avoided school when use was restricted, repeatedly checked and sought reassurance about skin flaws, and spent 4-5 hours daily viewing and comparing skincare content.

Dermatological assessment identified irritant contact dermatitis and acne medicamentosa. The BDDQ-DV screen was positive; clinician-derived BABS (19/24) and BDD-YBOCS-A (38/48) ratings reconstructed from routine interviews descriptively suggested marked preoccupation, repetitive behavior, avoidance, and poor insight. They were non-diagnostic, and no structured psychiatric interview was conducted. Care combined skin-barrier repair and routine simplification with psychological formulation.

This case illustrates an impairing BDD-like presentation in which cosmetic behavior and skin injury reinforced one another. It does not validate cosmeticorexia as a distinct diagnosis or establish a psychodynamic mechanism. The findings support integrated dermatological and mental health assessment while avoiding pathologization of normative adolescent grooming.