Body Modifications in Patients with Chronic Dermatoses: Associations with Body Dysmorphic Disorder and Illness Acceptance

Body modifications such as tattoos and piercings are increasingly popular, yet their psychological implications in dermatology patients remain understudied. This study examined the prevalence of body modifications, their association with body dysmorphic disorder (BDD) symptom tendencies and their relationship with illness acceptance. A cross-sectional survey was conducted among 333 consecutive dermatology outpatients in Wrocław, Poland. Participants provided demographic data, chronic skin disease status and information on tattoos and piercings. BDD symptoms were assessed with the Appearance Anxiety Inventory (AAI; score≥20 indicating high BDD risk), while the Acceptance of Illness Scale (AIS) measured psychological adaptation. Statistical analyses included t-tests, χ2 tests, ANOVA and Spearman's correlation. Overall, 29.4% of participants reported body modifications - 20.7% tattoos and 15.9%piercings. BDD symptom tendencies were present in 15.9% of patients but were significantly more frequent among those with tattoos (26.1%) and piercings (34%). Individuals with body modifications were younger and more often female. AIS and AAI scores showed a significant negative correlation, suggesting that lower illness acceptance was linked to higher BDD symptomatology. Body modifications among dermatology patients are associated with increased risk of screening positive for BDD tendencies and reduced acceptance of illness. These findings emphasize the need for psychological screening in dermatological practice and training dermatologists to recognize and address underlying mental health concerns.