Dermorexia: ‘My pursuit of clear skin has cost me time, money and pain, but how far is too far?'

Irish Examiner

16-05-2025

I am gripping the sides of the bed, my knuckles white.
'I am sorry,' the esthetician says, 'it'll be worth it.'
I am receiving a BroadBand light laser treatment. Priced at €500 for a single session at my usual clinic, I was offered a session free of charge if I sat as a model for a staff member in training. Lucky me, I think, as tears spring.
I easily spend over €1,000 a year in this clinic to keep skin breakouts at bay. My esthetician knows that's my limit — I can't afford to spend more. We both know that if I could, I would.
The €1,000 just about covers a salicylic acid peel I get once a month. It's a quick, noninvasive chemical peel that exfoliates and removes dead skin cells for a smoother and brighter complexion. I try to stretch it to every two months if I can — but the esthetician scolds me because for 'best results' you are supposed to get it every four weeks.
The peel, which burns to the point where I need a motorised fan to help me bear it, is one element of my overall routine.
Alongside the monthly facial appointment, there are the skin nutrition supplements. Bought in bulk, they come in at €476. I've recently added a probiotic after it was suggested this might be the missing element to the elusive clear skin I've been chasing for years. If I stick with the probiotic, it will cost an additional €438 a year.
That's almost €2,000 a year before I look at the skincare I use daily, from cleansers to toners, serums and moisturisers, SPFs and retinol. For my sanity, I refuse to tot up what it costs annually. Let's just say, I wouldn't get change from a €50 note, and that's just for the retinol, which lasts a few months.
According to market research company Kantar, Irish consumers spent €15.4m on skincare between April 2024 and April 2025, a 4.9% growth from the previous year.
Over 200 Irish aesthetic clinics are listed on WhatClinic.com. In cities like Dublin, Cork, and Galway, there seems to be one on almost every street corner. In my hometown, with a population of 850, the local beautician has rebranded and now offers treatments like micro needling and medical-grade peels.
Every other ad I get on social media is for Botox or Profilo, with influencers of all descriptions undergoing procedures and marking their bright and breezy Instagram stories #ad, #gifted, #invite. That's not to mention trends like 'the morning shed' and children going viral with 10-step skincare routines.
Given the wrap-around pro-beauty feeds, it's hard to take a step back and recognise what a normal skincare routine — and 'normal' skin — should even look like.
An unhealthy obsession
Beauty critic Jessica DeFino recently suggested we should consider introducing a medical term, dermorexia, to describe those engaging in 'obsessive behaviours' related to skin care.
Likening it to orthorexia, a term used to describe an excessive preoccupation with eating healthy food, she argued, 'The same is happening with beauty today. It warrants medical attention.'
Facialist and aesthetician Eavanna Breen believes there is 'definitely' space for the term.
'It's something I see in the clinic quite frequently,' she says. Clients come in 'obsessing' about faults they perceive with their skin, when they are presenting with 'perfectly' healthy skin.
Eavanna Breen at her Skin & Laser Clinic in Dublin. Picture: Moya Nolan
She frequently hears female clients complain about their big pores: 'I'm looking at their skin, and on a scale of one to 10, their pores are maybe a two.
'They also say that they've got congested skin, and it's just a little bit of texture.'
Caitriona Ryan, a consultant dermatologist at the Institute of Dermatologists and Blackrock Clinic, has had similar experiences.
'Healthy skin habits and an interest in skincare can be empowering, but there are people who see imperfections that aren't there,' she says.
She has 'occasionally' seen patients who exhibit worrying signs of an unhealthy preoccupation with their skin — 'they are constantly seeking the next procedure or product.'
Both practitioners believe social media has a lot to answer for when it comes to perpetuating unrealistic skincare goals.
'Education is really important,' Ryan says. 'Especially for teenage girls, and boys. What they are seeing on social media, filtered, AI images, that isn't real.'
The rise of so-called 'Sephora kids', where girls appear to be turning to expensive skincare products at an increasingly young age, has been the topic of much conversation in the media over the past year.
Professor Caitriona Ryan: 'Healthy skin habits and an interest in skincare can be empowering, but there are people who see imperfections that aren't there."
For Ryan, the concern is less about the products damaging young children's skin barriers and more about 'that preoccupation starting so young'.
'It's a culture we need to turn around,' she says. 'I worry about nine and 10-year-olds being so focused on their appearance at such a young age.'
Breen believes she may already be seeing the impact in her clinic.
'My clients who are 45, 50, upwards, are not obsessed with their skin. It's the girls who are in their 20s and 30s who are obsessed,' she says.
'Yesterday, I had a client who had three little pimples on her chin, a hormonal breakout, and she was obsessing about it being full-blown acne.'
Emotional distress
Clinical psychologist Malie Coyne says identifying whether your obsession with skincare has gone too far is about the degree to which it's impacting your daily life.
'Is there any emotional distress around minor or imagined flaws that might lead to avoidance of social situations? Are there compulsive behaviours like mirror checking and picking skin? Is your self-worth directly tied to how your skin looks?'
When I look at my relationship with my skin, it can be hard to work out whether I am just engaging in self-care — our skin is an organ, shouldn't I care for it to the best of my ability? — or whether I am obsessing over small imperfections due to our society's increasing obsession with 'flawless', poreless skin.
Clinical psychologist Malie Coyne: 'Compassion focused therapy [designed to reduce self-criticism and shame] suggests we have three emotional circles — drive, threat, and soothing."
Coyne suggests we think about what drives our motivation: 'Compassion focused therapy [designed to reduce self-criticism and shame] suggests we have three emotional circles — drive, threat, and soothing. Is your drive to engage in skincare coming from a place of threat, where you feel, if I don't get that microneedling, if I don't get that Botox, that means my skin won't look at its best, and I won't be at my best, and I'm not good enough.
'When something comes from a soothing place, it's more like, I have an hour off on Tuesday, and I really love getting a facial, so I'm going to go ahead and get that because I know I'm going to feel good afterwards. And it's not about feeling less good than other people.
'If you didn't get those treatments or procedures, would you be OK?'
For parents who might be concerned about their children's relationship to skincare, Coyne advises having a gentle conversation with them about where their interest in their skin has come from.
'My daughters are 11 and 13. I know what they're being fed on social media — what every woman gets fed — you're not good enough, and you should try this product in order to be better,' she says.
'Watch out for deeper signs of distress — if they're spending a lot of time looking in the mirror, avoiding photos, or expressing dissatisfaction with their face or overall appearance. At that stage, it might be time to bring them to a mental health professional.'
Achievable goals
Breen, who works with a roster of celebrity and influencer clients, says it's important not to compare our own skin to what we see on social media.
'When I'm doing videos to the camera [for social media], even when I'm not using a filter... that isn't how I really look. If you look at my skin up close, you can see the imperfections, pigmentation, pores,' she says.
'There is no such thing as perfect skin. We're setting ourselves up for a standard that's impossible to reach. Skin is full of texture and character, and we need to embrace that more.
'One of the nice things about my job is to be able to say to someone, don't worry about that, that is not an issue.'
While something may seem like a minor imperfection to others, Breen says addressing it can make an individual feel better about themselves: 'I had a client the other day who had a little growth on her nose, a little red dot, and her doctor dismissed it and said, 'it's nothing to worry about'. But she felt like Rudolph. I just did a little bit of diathermy [a deep heat therapy] and got rid of it.
'It's about seeking out a professional who has the compassion and the understanding to know whether something is an issue, that's the key.'
This is me
Looking back at my younger years, I recognise some of the red flags Coyne identified. I feel empathy for the girl who gave up swimming, the teen who wouldn't get in the selfie, the college student who dreaded nights out because she wasn't comfortable in her skin.
At 27, I am developing a healthier relationship with my skin. I see the facials and supplements as part of my self-care regimen, but when I have a breakout, I don't let it stop me from living my life.
I have been helped in large part by following positive skin influencers like Izzie Rodgers and Sophie Dove, who embrace skincare and make-up without covering their blemishes or using filters.
Inspired by their impact, I recently sat for a photoshoot without any make-up. It was terrifying, and it's taken me a year to look at them without shame. Today, they are printed alongside this piece. It's my battle cry against a world that keeps telling me I am not enough as I am.
Izzie Rodgers (@izzierodgers)
Sophie Dove (@skinwithsoph)
Institute of Dermatologists (@instituteofdermatologists)