It used to be that only fashion magazines, using rail-thin models and sophisticated photo editing technology, set unrealistic ideals for normal people. But now, anyone with a smartphone can electronically airbrush themselves to look impossibly perfect in photos. This easy access to photo-shopped and filtered versions of oneself or one’s friends can, according to a new editorial by a group of dermatologists and cosmetic surgeons on the faculty at the Boston University School of Medicine, set the stage for serious body image issues.

“Today, with apps like Snapchat and Facetune, that same level of perfection is accessible to everyone,” the authors write. “Now, it is not just celebrities propagating beauty standards: it is a classmate, a coworker, or a friend,”

“…Those enhanced selfies often present an unattainable look and are blurring the line of reality and fantasy for these patients.”

They're calling it “snapchat dysphoria,” a new take on the mental health disorder known as body dysmorphic disorder (BDD). People with body dysmorphia tend to focus on a particular body part, which they may try to minimize or cover up. Seeking out plastic surgery is also a common characteristic of BDD. With snapchat dysmorphia, patients seek out cosmetic surgery to look not like than idols or supermodels, but like “filtered versions of themselves…. This is an alarming trend,” they write, “because those filtered selfies often present an unattainable look and are blurring the line of reality and fantasy for these patients.”

According to the paper, 55 percent of plastic surgeons now say their patients are requesting surgery to improve their appearance in selfies, which is a rise from 42 percent in 2015.

Plastic surgery in these cases can ultimately worsen BDD rather than help treat it, the authors say. Instead, they recommend psychological interventions including cognitive behavioral therapy (CBT) and/or psychiatric ones, like antidepressants.

They also point out that snapchat dysphoria can be particularly dramatic in teens, who are more susceptible and may “more severely internalize” the impossible beauty standard that photo editing can offer.

“Filtered selfies can make people lose touch with reality, creating the expectation that we are supposed to look perfectly primped all the time,” said study author, Neelam Vashi, in a statement. “This can be especially harmful for teens and those with BDD, and it is important for providers to understand the implications of social media on body image to better treat and counsel our patients.”

Too much time online isn’t good for teens' or adults'mental health. But some online behaviors are more harmful than others. If you have kids who use these apps, keep talking to them about how unrealistic, and indeed damaging, the images can be. And if you need more help, finding a sensitive psychologist or therapist is always a good idea.

The paper was published as a JAMA Facial Plastic Surgery Viewpoint.