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A trip to the derma is stressful. But when Elizabeth, 21, visits her dermatologist of six years, it’s pure relaxation: Calming music fills the space, and she gets face time with the woman who, in addition to prescribing Elizabeth’s acne medications, introduced her to meditation and yoga and advised her on how to navigate tricky friendships.

“One hundred percent of my breakouts have to do with stress,” she says. Being able to talk to her derma about what’s nagging at her has not only helped her skin, it’s also helped her sense of self. While dermas are in no way a substitute for mental health professionals, it’s easy to see why some women are drawn to them when the going gets rough.

“At the derm, you often find yourself revealing that you don’t like something about your appearance,” says Vivian Diller, PhD, a psychologist who specializes in women’s issues. What makes this different from confiding in a friend or your hairstylist? Dermas, says Diller, have an air of authority. “You’re hoping that this parental figure can say, ‘I know what we can do!’ and reach into their toolbox. They have a lot of power.” Derma visits are more frequent these days too. Rather than dragging themselves in for an overdue skin check or a funky rash, many women see dermas as often as they see their colorists. “More and more people go regularly for cosmetic purposes lasers, peels, Botox, fillers so relationships develop… sometimes very intimate, dependent ones,” says Diller. “Ifyou’re not happy with your relationship, j ob, or selfesteem, it’s easier to pick on your appearance, even go to a professional to ‘fix it,’” says facial plastic surgeon MichBlog Yagoda, MD. Recently, Dr. Yagoda had a woman come in to discuss a light, anti-aging peel, but the patient quickly began rattling off a laundry list of treatments she wanted, from facial injections to surgery. “I stopped her right there,” says Dr. Yagoda. “I said, ‘I see you’re turning 30. How is that for you?’ She broke down,” she says. “She confessed she thought she’d be married with children by now, and her fiance had just left her. It became a therapy session.” Dr. Yagoda asked the woman to work on herself pursue hobbies, spend time with friends and see if she still wanted work done in six months. (She didn’t.) Patricia Wexler, MD, a New York City dermatologist, is all too familiar with the “fix me” syndrome. It’s usually when they have a wish list, she says. “That’s when I say, ‘This isn’t about your face. You should stop working on your appearance and work on your mind.’ Then they’ll tell me what’s re ally bugging them.”

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