Welcome to Difficult Conversations About Beauty, a podcast hosted by Anita East — author of the book Beautiful Unique Faces and a Nurse Practitioner with a special interest in dermatology, primary care, non-surgical cosmetic medicine, women’s health, and nutritional medicine.
This podcast explores the science, psychology, and social impact of beauty through honest and evidence-based conversations.
Before we begin, please note that the information shared in this podcast is intended for general educational purposes only. It does not replace personalised medical advice, diagnosis, or treatment. Every individual’s health needs are unique, and listeners are encouraged to seek guidance from a qualified health-care professional who understands their personal medical history.
If medicines or prescription-only products are discussed in this episode, that information is intended solely for registered health-care professionals and is provided in accordance withAHPRA and TGA regulations. These discussions are not advertisements, endorsements, or recommendations for use.
By continuing to listen, you acknowledge that Difficult Conversations About Beauty provides professional discussion and education — not direct clinical advice.
Body Dysmorphic Disorder (BDD) is a health condition where a person obsesses over one or more perceived flaws in their appearance. AHPRA, our governing body, has recently put new regulations in place for practitioners who perform cosmetic medicine. Starting July 1st, practitioners must follow specific guidelines for patient care, including referrals, consent, social media use, and more. While we're happy about these improved standards, there are some areas that need clarification. That's why we spoke with Dr. Toni Pikoos.
Toni is a therapist and psychologist who specialises in BDD and body image. We met at an Aesthetic Medicine conference in Melbourne last year, where I discussed ethical patient treatment and Toni talked about BDD. Toni was on AHPRA's advisory panel for these new regulations, and she shares her insights on how clinicians can meet the new regulations, how patients can stay safe and seek mental health treatment if necessary, and interesting information for all our listeners with an interest in psychology.
I use Leslie Fletcher's questionnaire with good effect in my clinical practice. It's called "Development of a multiphasic, cryptic screening protocol for body dysmorphic disorder in cosmetic dermatology" and it allows a grading system of assessment. While Toni endorses this tool, she's also creating her own and it will be available on her website https://www.readymind.com.au/ before July 1st.
Psychologists who specialise in body image disorders are prepared for our referrals, with communication ensuring awareness of the patient's progressions. Toni and her colleagues have put in place measures to ensure a timely turnaround, recognizing that patients and practitioners don't want to wait in limbo for appointments despite long waitlists for mental health assessments.
Can BDD be cured? Toni suggests that the way a patient presents can be influenced by their life circumstances. For instance, a person may feel aesthetically inferior due to input from someone else, which leads to BDD behaviours. Additionally, feeling a lack of control during a certain period can also contribute to BDD. However, with proper assistance, a person can overcome these challenges and cultivate a positive self-image.
