Botched cosmetic treatments can increase the risk for anxiety disorders, depression, body dysmorphic disorder (BDD), and posttraumatic stress disorder (PTSD), according to a survey presented at the 2024 annual meeting of the American Society for Laser Medicine and Surgery in Baltimore.
For the study, researchers posted a 40-question survey in a Facebook cosmetic complication support group. Participants were asked to complete validated screening questionnaires including the Patient Health Questionnaire-2 (PHQ-2), Primary Care Post-Traumatic Stress Disorder (PC-PTSD), and Body Dysmorphic Disorder Questionnaire – Dermatology Version (BDD-DV), to assess for mental health impact following cosmetic complications.
Seventy-one people completed the survey. Participants were predominantly female, Treatments included microneedling with radiofrequency, laser, ultrasound for skin tightening, radiofrequency for skin tightening, microneedling, chemical peel, body contouring/sculpting, and others.
Procedures were performed by an esthetician/laser technician, non-dermatologist physician, board-certified dermatologist, advanced practice provider, or other. Just 14% of botched procedures were performed by a board-certified dermatologist.
Self-reported complications included scarring, hyperpigmentation, erythema, burns, blisters, or hypopigmentation. There were other instances of multiple complications occurring within a single individual, the survey showed.
Respondents agreed that before their complication, they were satisfied with their previous cosmetic care. Before the procedure, respondents did not feel adequately counseled on the risks of the procedure and that the procedure did not meet their expectations and anticipated outcome.
Before respondents underwent the treatment that led to their complications, 16% reported a history of generalized anxiety disorder, 15% a history of depression, and 1% a history of either BDD or PTSD.
Following the complication, 50% reported a positive depression screening, 63% had a positive BDD Questionnaire, and 63% had a positive PC-PTSD screen. There was a 5 times increased risk of a positive PC-PTSD among respondents who experienced burns as a complication when compared with their counterparts who did not get burned following treatment.
Respondents with a positive depression screening after their complication had a higher risk of a positive PC-PTSD screening.
Respondents reported thinking about their complication for more than three hours a day (46%), one to three hours a day (25%) and less than one hour a day (29%), the study showed. Among respondents who reported thinking about their complication more often, there was an increased risk of a positive PC-PTSD and depression screening, the study showed.
“During initial consultation, a thorough discussion assessing patient expectations is critical and patients should be counseled on risks and potential treatment complications,” the researchers conclude.
Screening for potentially undiagnosed mental health conditions should be considered during the initial consultation and in post-procedural care following a complication, they note.
“Further studies are needed to better understand the impact of cosmetic complications on mental health and the required tools to adequately provide mental health support to patients who have experienced cosmetic procedural complications.”
