Which disorder involves distress from compulsively seeking reassurance about appearance?

The disorder characterized by significant distress from compulsively seeking reassurance about one's appearance is Body Dysmorphic Disorder. This condition involves a preoccupation with perceived flaws or defects in physical appearance, which may not be noticeable to others. Individuals with Body Dysmorphic Disorder often engage in repetitive behaviors, such as seeking reassurance from others about their appearance, constantly checking mirrors, or excessively grooming themselves. The reassurance seeking can provide only temporary relief and typically leads to increased anxiety and distress.

In contrast, Hoarding Disorder primarily involves persistent difficulty discarding or parting with possessions due to a perceived need to save them, rather than issues related to body image. Trichotillomania refers to the compulsive urge to pull out one’s hair, and Excoriation Disorder involves skin picking, often resulting in skin lesions and distress. Neither of these disorders primarily focuses on concerns regarding appearance in the way described in the question.