Creation and Initial Validation of the Skin Dysmorphia Scale: Time for a New Concept to Arise in the Medical Field

BACKGROUND: Skin dysmorphia is an emerging construct that reflects experiences of concern with perceived imperfections pertaining to skin coupled with an obsession with skincare routines to achieve flawless skin. It increasingly poses unique challenges to healthcare professionals and thus urgently necessitates a comprehensive approach to assessment and management. This study represents the first concerted effort to design and validate a psychometrically sound scale for use in clinical assessment and future research on skin dysmorphia that we called "Skin Dysmorphia Scale" (SDS). METHOD: A cross-sectional survey was performed in July-August 2025 in Lebanon among adults from the general population. RESULTS: After removal of 11 items with significant cross-loadings, seven items remained which loaded onto a single factor and resulted in high internal consistency reliability (Cronbach's alpha = 0.83). A positive, moderate correlation was found between skin dysmorphia tendencies and general body dysmorphia symptoms, thereby supporting the convergent validity of the SDS. Heavier TikTok users showed significantly higher skin dysmorphia tendencies. Statistically significant correlations were observed between SDS scores and higher depression-anxiety symptoms. Moreover, skin dysmorphia symptoms were significantly and inversely correlated with self-esteem levels. CONCLUSION: Preliminary analyses suggest that the newly developed SDS is a valid and reliable instrument for assessing skin dysmorphic concern and ensuring adequate, timely intervention or referral. We believe that it is timely and useful that skin dysmorphia be given high priority and be formally recognized by the medical and scientific community so that affected individuals can get the necessary medical or mental health care. Clinicians and researchers are encouraged to begin using the SDS in their practice.