Research conducted during the pandemic shows that millions of people are dealing with "Zoom dysmorphia," or a feeling of unhappiness or dissatisfaction about their looks exacerbated by looking at themselves on camera all day.
New research shows that as people return to school, work and other in-person events, that concern about their looks is still lingering, even when the cameras are turned off.
Dr. Arianne Shadi Kourosh, a dermatologist and the director of Community Health at Massachusetts General Hospital, who led the team that conducted both the original research and the new survey, said that over 70% of the 7,295 participants in the new survey expressed "feeling anxiety" about their in-person appearance.
"There was a significant percentage that, when they were asked about their reasons for the anxiety, cited their self-consciousness about their appearance," Kourosh said. "When we asked follow up questions about that, the top reasons were concerns (about) weight gain, skin discoloration, acne and wrinkles."
The new research attributes many of these concerns to "increased hours spent on videoconferencing" and the use of tools like filters to alter appearance. Kourosh said that respondents who spent more time on social media and more frequently used photo-editing tools or filters had "great anxiety" about their appearances.
Sierra Gordon, who is starting her first year of college in-person at U.C. Santa Barbara, said that she's worried about returning to in-person learning for exactly those reasons.
"It's going back to everybody seeing your whole body, and there comes the body issues and worry about confidence and stuff like that," Gordon told TODAY. "People being able to see me from all angles and directions, even when I don't like certain angles or directions of my physical self."
Dr. Janis Whitlock, a psychologist specializing in adolescent and young adult mental health, resilience and well-being, said that for young people who are worried about returning to in-person events, it can help to slowly return to regular activities by hanging out with close friends or engaging in hobbies.
"Over the pandemic, we did see increases of body image anxiety," said Whitlock. "All of the studies that have come out looking at that relationship have shown very similar things, and that is that people did struggle. ... I do believe we'll have more students with body issues heading back in the fall, for sure."
In addition to spending time with friends, Whitlock recommends making space for family time. If a child seems to need extra support during the transition back to in-person learning or other activities, Whitlock recommends seeking out a mental health professional.
Jessica Stern, a clinical psychologist at NYU Langone Health, offered some advice for those who may be feeling some anxiety about their appearance as they return to in-person events. To start, keep everything in perspective.
"Something that can be really helpful to remember is that this past year and a half has been a little bit strange and we've been getting a lot more visible feedback about the way we look than we are typically used to," Stern said. "Keeping that standard and understanding in mind can be helpful to recognize that ... statistically we are more likely to notice things about ourselves that we didn't notice (before)."
Understanding that that our perceptions of ourselves have "shifted" can be helpful, and can help you avoid comparing yourself to others.
"Lots of people have been watching themselves virtually, much more extensively than they used to, and have been taking feedback about themselves and experiencing their looks in a different way than they have before, and that's OK," Stern said. "If you're noticing that you're feeling harder about yourself in a way that's impacting you, you can seek out professional help if it seems like that would be helpful."
If, like Gordon, you're worried about people being able to see you from all angles instead of from a carefully-curated video screen, Stern said it can help to remember how you went about life before the pandemic.
"People have been receiving much more feedback about their physical appearance and their body language and their facial expressions than they were ever used to. Once you start to almost become dependent on that feedback, it can feel really bizarre not to have (it)," Stern said. "What can be helpful is if you can connect to the previous standard as best as possible and remember that once upon a time, you were doing a wonderful job functioning in the world without that feedback, and that we as human beings don't typically have that feedback."
Most important, Stern said, is to be gentle on yourself and remember that this is a period of transition for almost the entire world.
"Learning some self-compassion can be helpful for you, to learn to embrace the things that are strong about you, beautiful about you, and giving yourself a little bit of space to appreciate the things that you like about yourself, because there might be a tendency to lean toward the things that you don't like about yourself," she said.
Kourosh said that even after conducting the original research, she was surprised to see how many people were still worried about their appearance while returning to in-person activities.
"I thought that people would be much more eager to return to in-person, and so I think seeing this feeling of hesitancy or anxiety in well over the majority of the study population made me realize that certain aspects of the pandemic have made an impact on us in ways that may be lasting or take longer than we realized to return to normal," Kourosh said. "We may need to make a special effort to understand these effects and to become aware of them and to take active measures to heal from them."
However, Kourosh said that she hopes the research will make people realize that they aren't alone as they cope with these feelings.
"I think one of the most eye-opening lessons in doing the work, even last year, was realizing that the issue was much broader than we realized and was experienced by different people of all backgrounds and walks of life," Kourosh said. "Many people came to learn that they were not the only one, they were not alone in having this experience, and I think this was reassuring for people because they were suffering from this phenomenon and thought that it was just them."
"I think it was important to raise awareness around it, and explain that there was actually a reason for what they were experiencing," Kourosh continued. "And that they weren't alone."