Sephora stores are being overrun with tweens pumping product testers. Eight-year-olds film themselves on “Sephora hauls” and GRMW (get ready with me) videos, applying collagen boosting serums and retinol creams for their nonexistent wrinkles. And party bags are stuffed with face masks and fluffy headbands, instead of glitter and gummy bears.

The rise of Sephora kids is a widely reported issue, but the uptick of children “obsessed” with skincare has some experts concerned about the long-term effects of age-inappropriate products and increased occupation with appearance at such a pivotal age.

A new term has entered the lexicon: “cosmeticorexia”, meaning a preoccupation or fixation with “flawless” skin. Last month when Italian authorities cracked down on big beauty brands for allegedly targeting younger and younger shoppers, they cited cosmeticorexia as a cause for concern. Also in March, a pair of Italian researchers released a paper, based on a study of adult dermatological patients, suggesting that cosmeticorexia “may represent a clinically relevant mental disorder”. They suggest it requires further understanding, tracking, research and potentially treatment.

Associate Prof Giovanni Damiani, the paper’s co-author and a dermatologist and researcher at the University of Milan, had noticed an increase in irritant and allergic contact dermatitis on the faces of eight- to 14-year-old patients in his practice. “They all used similar cosmetics,” says Damiani, including chemical exfoliants such as alpha hydroxy acids and retinoids without appropriate medical prescriptions.

Those patients also displayed worrying behaviours. “Refusing to go out without makeup, for example. The excessive use of cosmetics or watching cosmetic related videos. Switching their interests, basically obliterating everything else,” he says.

Damiani then teamed up with clinical psychologist Alberto Stefana, from the National Institute of Health in Rome, to look into cosmeticorexia (also called “dermorexia”, a term first used by the Guardian columnist Jessica DaFino in her Substack in 2023).

“What interests us, besides the term, is to understand if cosmeticorexia could be regarded, in pre-adolescents, as a risk factor for body dysmorphia,” says Damiani. “Second, if the use of so many cosmetics at a young age could lead to the frequency of contact dermatitis.”

Grace Collinson, a clinical program manager at the Butterfly Foundation, an Australian charity for eating disorders and body image concerns, says there’s been a rise in patients showing “appearance-related distress, particularly amongst young people”. This includes “heightened focus on skin, perceived imperfections, and a strong drive towards ‘flawlessness’,” she says.

However, these patterns of behaviour are occurring at the same time as other broader patterns, such as “high levels of self-scrutiny”, often connected to social media use, “repetitive behaviours such as mirror checking and skin picking”, as well as anxiety, low self-esteem and eating disorders. Cosmeticorexia is not a widely used nor clinically defined term, and it’s not considered an official disorder, but new terms like this can be useful, Collinson says.

“Recognising this condition would lead to better treatment,” Damiani says. He adds that while tweens and teens are at highest risk, “cosmeticorexia could impact any age”.

“It may be helpful for some people to hear a new term that explains their experience,” says Collinson. “It can also help capture emerging cultural phenomena and draw attention to concerning trends, particularly those affecting young people in commercialised beauty spaces.”

The downside, she says, is that non-clinical labels such as cosmeticorexia “may inadvertently medicalise behaviours that, whilst problematic, do not meet criteria for a mental health disorder, or conversely dilute the seriousness of conditions like body dysmorphic disorder”.

In their paper, the Italian researchers likened cosmeticorexia to orthorexia, an extreme obsession with eating healthy food, also not officially classified as a disorder. They also noted similarities to body dysmorphic disorder and obsessive compulsive disorder.

Dr Jasmine Fardouly, a senior lecturer at the University of Sydney’s School of Psychology, says new medicalised terms can add confusion, especially if the symptoms match other known disorders. “If you look at body dysmorphic disorder, it’s often excessive concern, particularly about areas of the face, and it’s common in teenagers and younger people,” she says.

Children “as young as six” report body image concerns, says Fardouly, who researches the impacts of social media on body image and mental health in teenagers.

The influence of influencers

Collinson says the issue is as much of a societal one as it is individual. “The rise of influencer marketing, targeted advertising, and increasingly complex skincare routines, even amongst very young adolescents, has created a landscape where perceived ‘flaws’ are both magnified and monetised.

“Young people are not only learning to fear ageing or ‘imperfect’ skin before it has even begun, but they are being sold the message that they must reach perfection or purchase expensive products to be accepted.”

Fifteen-year-old Erin, from Sydney’s north-west, watches YouTube and TikTok videos about skincare, despite the social media ban in Australia (her accounts haven’t been disabled yet). She buys products based on what influencers recommend, and she’d “never go to school without … makeup and skincare done”.

Her daily routine includes face wash, moisturiser, serum and face mist, and an eye cream at night. She doesn’t believe she has cosmeticorexia, just a normal obsession with makeup and skincare. Which, if the parents of teens the Guardian spoke to are a good guide, checks out. When millennial and gen X parents recalled their own use of alcohol-heavy face pads and apricot facial scrubs in the 1990s, none expressed a serious level of concern about their teen’s passion for peptides or desire to wear makeup.

“I do think that people are more obsessed with skincare and makeup because of social media,” says Erin. “You’ll see get ready with me videos and [young people are] using products they should not be using. You’re not meant to use retinol until you’re older, and they’ll be using all these retinol products.”

Erin doesn’t use retinol, but she does buy high-end beauty products. Her most expensive is $70. “I feel like it’s worth it,” she says.

Not every person who is dissatisfied with their appearance has cosmeticorexia or body image issues, says Fardouly. “We know that over 50% of young people are unhappy with their looks, and up to 90% have at least some level of concern. So being unhappy with your appearance is ‘normal’ to some extent,” she says. “But if it becomes quite excessive, that’s when help-seeking is really important.”

Imagery that focuses on beauty ideals, or puts increasing emphasis on appearance in connection to self-worth, “tends to be harmful regardless of what trend it’s attached to”. “It promotes ideals that are unattainable for most people,” says Fardouly, and that can lead to people internalising those ideals, which is a risk factor for body image concerns.

Dr Deshan Sebaratnam, a dermatologist and associate professor at the University of New South Wales, says anyone can develop body dysmorphic disorder. “It can be males or females, and it can present in different ways,” he says. “We probably all have things that we’d like to change on our bodies, but when it becomes a preoccupation – where it affects your functioning – that might be body dysmorphic disorder.”

Sebaratnam believes the term cosmeticorexia is “a new mutation of an old problem”. He says it seems like “a pop culture term for body dysmorphic disorder”, which he encounters. “It’s very hard to necessarily draw a line in the sand and say [when a request] is within the realm of normal human vanity and an actual problem,” he says.

“People sometimes look things up online and then expect that to be a reality, not appreciating that people have full glam hair and makeup, or filters, AI or Photoshop. All of these things have existed before, but I think now it’s gained steam.”

The Italian researchers are conducting three more medical studies to learn more about cosmeticorexia, the results of which will be published later this year. What they found in the first study, says Damiani, is that those who could be described as having cosmeticorexia “were also highly dependent on social media”. Their first aim is to simply “understand the phenomenon”.

• In Australia, the Butterfly Foundation is at 1800 33 4673. In the UK, find support at the BDD Foundation. In the US, there is body dysmorphic disorder information at the International OCD Foundation.