ABSTRACT
This chapter looks at the phenomenon of people intentionally causing changes in their own physical appearance, creating disfiguring scars on their own flesh as a way of modulating and expressing their inner pain. The appearance of the skin can profoundly affect overall body image, with improvement in acne severity having been shown to lead to greater satisfaction with unrelated body aspects such as weight and shape. Skin condition and appearance are the most common concerns for people diagnosed with body dysmorphic disorder, with around 65% focusing on it and worrying about acne and scarring. In a cruel Catch-22 situation, negative psychosocial experiences might also affect the progression, and even the onset, of appearance-changing conditions such as acne, eczema, and psoriasis. Self-esteem is also mediated by the level of importance an individual places on physical appearance.
