‘My “Facial Dysmorphia” Destroyed My Ability to Be Free’ (2025)

Photo: Elena Kulikova/Getty Images

Nika Motiie says she cannot go a day without “obsessively” photographing herself — to date, the 20-year-old has over 50,000 selfies in her camera roll. “I take them throughout the day, like almost every hour,” she tells me. “I’m trying to analyze how others see me so I know what they think I look like. It’s an exhausting cycle, but it feels like the only way for me to understand or control how I look to others.”

It didn’t always used to be this way. Motiie, an undergrad at the University of Arkansas, says that she used to be confident in her appearance during her middle school years — until she began building a presence on social media (she currently has 368,000 followers on TikTok). “I started seeing videos of very pretty girls who would go viral, with everyone in the comments talking about how perfect they looked,” she says. “Naturally, I just started comparing myself to all these videos and images online — my face structure just felt so different. That’s what made me question whether I was truly pretty.”

Over time, the confidence Motiie once had “just completely disappeared.” Nowadays, she says, “my face is all I ever think about.” Now, most of the time, Motiie avoids social situations. “Whenever I’m invited to go to plans, my first thought is: What do I look like today? And then I often make a last-minute decision based on whether I think I look good enough to be seen by others,” she says. If she had to estimate, Motiie says she’s canceled more plans than she’s attended.

These feelings led Motiie down “a path of self-hatred and low worth,” eventually prompting her to seek professional help three years ago. She is now on medication to treat depression and anxiety. “I don’t have an official diagnosis for body dysmorphic disorder,” she says, “but I’ve experienced the struggles that come with constantly feeling uncomfortable in my own skin.”

Body dysmorphic disorder (BDD) is a serious mental-health condition that affects how you see and feel about your body and appearance. Dr. Katharine Phillips, a psychiatrist at Weill Cornell Medicine and NewYork-Presbyterian specializing in BDD, says it’s important to distinguish BDD from “normal” body-image concerns. “When we’re considering if someone is suffering from BDD, we usually ask: Is the person thinking about these perceived flaws for at least an hour a day (if they add up all the time they spend each day)? And do the concerns cause significant emotional distress or impairment in day-to-day functioning?”

Daisy Wilson, a 19-year-old biochemist from Oxford, England, posts openly on TikTok to her 37,200 followers about her struggles with “facial dysmorphia” — the term has been gaining traction on social media to describe this experience of having a warped perception of one’s own face. Other terms like “Zoom dysmorphia” and “Snapchat dysmorphia” have also emerged to describe the distorted self-image many people develop after staring at their face for too long via their front camera. Wilson’s self-image only started to improve about a year ago, she says, after about a decade of struggling with near-constant “horrible” thoughts about her appearance.

Like Motiie, Wilson would endlessly scrutinize perceived flaws. She recalls once taking a selfie and circling the parts she didn’t like on a drawing app. “I circled my nose, because it’s wonky,” she says. “I circled my eyes because they’re too small. I circled my lips, because they’re uneven.”

Her anxiety around her appearance was at its worst at school, when her face was on full display to her classmates. “People would be having normal conversations with each other, whereas always in the back of my head I was thinking: You look ugly. Your nose is wonky. They’re thinking about it. They’re looking at it.”

Things came to a head during her first year of college, when Wilson had a panic attack in front of the mirror while she was doing her makeup before a night out. The more she looked at herself, the more she couldn’t recognize herself. She was so distressed by the sight of her own reflection, that she collapsed onto the floor of her bedroom, sobbing. Looking back, Wilson feels robbed of what should have been some of the best years of her life. “My facial dysmorphia destroyed my confidence and my self-esteem,” she says, “and the ability to be free, let loose, and be a teenager.”

On TikTok, users uploading videos under the hashtag #facialdysmorphia, which has thousands of posts on the app, describe not recognizing themselves and having “no real idea” what they look like, with some videos amassing hundreds of thousands of views. A related trend sees TikTok users inviting others to assess their appearance in the comments, by posing the question: “Is it facial dysmorphia, or am I just ugly?” Meanwhile, viral filters — such as “inverted filter” and “true self” — tap into these insecurities by claiming to show users what they really look like. The experience of using these filters has sent some people spiraling. “I’ve used the inverted filter on my camera,” says Wilson, “and seeing the inverts of my face makes me feel sick.”

Wilson describes the experience of seeing photos of herself at the height of her BDD in a similar way. “I’d think: That’s not me. I just had no idea who I was and what I looked like and how people perceive me.” In one video, Wilson writes, in captions layered atop a carousel of selfies, of how her face often “doesn’t feel real,” and how she used to “hate” her appearance. She is surprised by how many people have reached out to her in response, saying they also have “facial dysmorphia” and feel “exactly the same.” “It makes me feel less crazy, and alone,” Wilson says.

For Vivien Lovrin, a content creator who lives between London and Berlin, just the idea of being photographed was enough to keep her home. “I’ve avoided a lot of trips with friends, missed out on important events like birthdays and my best friend’s engagement party — all because I was so worried about how my face looked,” she says. Lovrin has been plagued by negative thoughts about her face since her early teenage years, but says that a botched rhinoplasty at age 18 was what made her spiral.

Seeing herself in photos — particularly ones others have taken where she can’t control the angles or lighting — is a deeply unsettling experience and has triggered panic attacks. “When my BDD was at its worst, I used to constantly ask myself: Is that what I really look like?” says Lovrin. “Because when I looked in the mirror, I saw something else.” Lovrin says she only has two photos of herself between ages 18 and 28.

Phillips explains how, paradoxically, when people spend extended periods of time looking at themselves, it can cause them to lose sight of what they actually look like. “Mirror-checking is a very common, compulsive behavior that people with BDD do,” Phillips says. “You end up zeroing in on teeny-tiny things that other people just don’t notice. You’re not seeing the holistic, big-picture view of how others see you. It can be disorienting, and you start getting this even more distorted view of how you look.”

It doesn’t help that staring at our faces — in selfies, on Zooms, during FaceTime calls, you name it — “probably trains our brain to be even more sensitive to tiny imperfections,” Phillips adds. Wilson experienced this after looking in the mirror led her to start obsessively picking at what she believed were blackheads on her face. She realized later that, in reality, these were just sebaceous fillings (a natural part of the skin that keeps the face moist).

“I had to go to the doctors, and they basically said: ‘You’ve got to stop doing this. Otherwise, you’re going to cause permanent scarring to your face,’” she says. She was instructed by the doctor to start wearing mittens indoors to prevent herself picking at her face. It also prompted her to cover up all the mirrors in her house. “My reflection was a trigger,” she says.

Some “facial dysmorphia” sufferers have turned to cosmetic procedures in an effort to help them cope. About a decade ago, Lovrin decided to get rhinoplasty and filler in her jawline. “Getting cosmetic surgery to keep my facial dysmorphia under control has gotten me in a fair amount of credit-card debt,” she says. “But I’ve thought to myself, Even if I end up being poor, I don’t care: I just want to look good and feel good about myself.”

Phillips warns that for people with BDD, the outcome of cosmetic surgery can be especially devastating, as they’re more likely to be dissatisfied with the results. “Some people become very depressed, very suicidal,” she says. “They feel that the surgeon ruined how they look.”(An estimated 2 percent of the population experiences BDD, with evidence indicating that approximately 80 percent of individuals with BDD experience lifetime suicidal ideation and 24 percent to 28 percent have attempted suicide.)

It’s been estimated that around 7 to 15 percent of aesthetic patients experience BDD, according to a study published in The Journal of the American Society of Plastic Surgeons in 1998, which is still often cited today. “These patients tend to have low self-esteem, high expectations, and be perfectionists,” says Dr. Michelle Hure, a cosmetic and medical dermatologist in San Jose, California. “Many times they jump from provider to provider, looking for their next treatment.” According to Dr. Hure, these patients will perceive flaws that simply aren’t there, or want to correct unique facial features — such as a distinctively shaped nose or lips — believing them to be flaws instead of just deviations from the beauty standard.

Dr. Hure says she has said “no” to more patients than “yes,” stressing that cosmetic surgery is not a cure for BDD — or for screen time. “I find the more chronically online people are, the more they focus on unattainable or difficult-to-attain features — such as ‘glass’ skin, perfect facial symmetry, or ‘lifting’ that can only be achieved through surgery,” she says. “It’s difficult to tell what is realistically possible when filters and Photoshopping are the norm.”

One study of 50 BDD patients found that 81 percent of BDD patients were dissatisfied or very dissatisfied with the results of cosmetic surgery. And, according to Phillips, even when they are happy with results, patients’ anxieties are often transferred to another aspect of their appearance. “That’s because even after surgery, you still have this tendency to over-focus on tiny details, to see yourself in a distorted way, and to obsess about it,” says Phillips.

This is true for Lovrin, who says not long after having multiple surgeries to fix her nose, she started “fixating” on other parts of her face. Nowadays, she says that getting repeat lip and jawline fillers has made it easier to live with “facial dysmorphia” — but she still gets “triggered” when someone takes a photo of her that she doesn’t like. In a recent TikTok, Lovrin admitted that — despite claiming to have overcome ‘facial dysmorphia’ thanks to cosmetic surgery in a previous post — she still struggles. “Am I truly healed? No,” she says. “Will I ever truly be healed? I don’t know.”

Instead of cosmetic surgery, Phillips advises that people with BDD should look to Cognitive Behavior Therapy (CBT) and medication-based treatment. “With CBT, people learn how to overcome the obsessive thoughts and all those repetitive behaviors,” she says.

Wilson, like Lovrin, has come to realize that there is no quick-fix solution. It took her three years to get from her lowest point to where she is now — a place of feeling “more confident and beautiful,” she says. It started with meditation. “When you’re obsessing over features of your face, you kind of don’t feel real. Meditation is a nice way to just touch base again.” She also started to do daily affirmations, repeating to herself out loud: “I’m beautiful, I am enough. I am pretty. I belong on Earth. I deserve to be here.”

Negative thoughts about her face are still something she has to overcome, and some days are better than others. But she is more accepting of herself now. “I can’t change my face, that is a fact,” she says. “I’ve got to live with it. And I love living with it now.”

For Motiie though, insecurities around her face still weigh heavily. “To this day, social media makes it hard for me to feel comfortable in my own skin,” she says. “There have been episodes where I’ve struggled so badly with how I see myself, that I’ve had to increase my depression-medication dosage to manage everything”.

Recently, she’s been trying to develop “new healthy habits,” which include reading self-help books (Jennie Allen’s Get Out of Your Head: Stopping the Spiral of Toxic Thoughts and Jen Sincero’s You are a Badass), eating healthier, and keeping her days busy by being more active. “Some days are really hard,” Motiie says, “but there are some that give me hope.”

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