As cosmetic procedures surge worldwide and beauty content increasingly dominates social media, a new study from the Hebrew University of Jerusalem suggests that for some women, cosmetic treatments may begin to resemble compulsive or addiction-like behaviour.
The research was led by Dr Vera Skvirsky alongside Dr Uri Lifshin, Dr Dvora Shmulewitz, and Professor Mario Mikulincer from the Hebrew University Department of Psychology and the Israel Center for Addiction and Mental Health. Published in the Journal of Health Psychology, the study surveyed 1,614 Israeli women aged between 25 and 71, making it one of the largest general population investigations to date into the psychological patterns associated with repeated cosmetic treatments. Unlike earlier research, which often focused on patients already attending cosmetic clinics, this study drew on the general population.
The findings arrive amid a sharp global increase in cosmetic procedures, which international estimates cited in the paper suggest rose by roughly 40% between 2019 and 2023.
Among women who had undergone cosmetic procedures, 20% met the threshold for moderate to severe risk of addiction-like cosmetic procedure use during their lifetime, and more than 15% reported active symptoms within the past year. Across the full sample, nearly 9% of women showed moderate to severe signs of problematic cosmetic procedure use.
To assess this, researchers adapted a tool originally based on the Diagnostic and Statistical Manual of Mental Disorders criteria for substance-related disorders. Participants were asked questions typically associated with addiction, including whether they had unsuccessfully tried to stop undergoing cosmetic procedures, felt compelled to continue despite negative consequences, or experienced cravings related to treatments.
Addiction-like patterns were most strongly associated with the combination of low body esteem and problematic social media use. Women with lower body esteem were significantly more likely to report these patterns, particularly when paired with high levels of problematic or excessive social media behaviour, and were especially vulnerable if they also struggled with dissatisfaction about their appearance.
Smaller associations were also observed between addiction-like cosmetic procedure use and lower feminist attitudes, lower attachment security, and more negative attitudes towards ageing, though these relationships were less consistent once multiple factors were analysed together.
The researchers stressed that the study does not find cosmetic procedures to be inherently harmful. “Cosmetic procedures have become deeply normalised in many societies, and for many people they may be a positive experience,” they said. “But our findings suggest that for a meaningful minority, the behaviour may begin to resemble other compulsive patterns we see in addiction research, especially when low body esteem and problematic social media use are involved.”
They also cautioned that the study was cross-sectional, meaning it cannot determine cause-and-effect relationships. It remains unclear whether problematic social media use contributes to addiction-like cosmetic behaviour, whether cosmetic procedures themselves influence body image and online engagement, or whether other psychological factors drive both.
Clinicians say the study highlights the need for screening in cosmetic settings, with questions about motivations, previous procedures, and emotional responses potentially helping to identify those at risk before patterns escalate. Mental health professionals may also consider integrating discussions about cosmetic procedure habits into therapy for body image concerns.
While the study focused on Israeli women, researchers suggest the patterns may apply more broadly in societies with high social media penetration and normalised cosmetic enhancement. Further longitudinal studies are needed to explore causality and potential interventions.
The paper, titled “Prevalence of addictive use of cosmetic procedures and risk factors among Israeli women,” is available in the Journal of Health Psychology.