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Conducting research with adolescents living with appearancealtering conditions or injuries is a growing area. Current literature highlights the psychosocial consequences of living with an altered appearance and the lack of high-quality evidence-based interventions.1 With up to one-third of those living with an altered appearance struggling with issues such as socialising, selfconfidence or body image, 2 engagement in appearance research can be confronting. Recruitment is further complicated when participants are patients from a tertiary hospital as there are additional environmental factors to consider. Currently, there is a dearth of literature that discusses the challenges of conducting appearance-related research. This article discusses the experiences of recruiting adolescents for research that explored the psychosocial consequences of living with a condition or injury that alters appearance. The paper discusses complexities associated with conducting appearance-based research in a paediatric tertiary hospital and offers recommendations. The authors emphasise the importance of patient involvement, sensitivity and privacy eliciting appearance discussion and utilising creative, non-traditional methodology when designing appearance projects. Methods Study designThe research involved two studies: (i) qualitative interviews exploring the psychosocial impact of living with a condition or injury that alters appearance and (ii) acceptability testing of a new online intervention designed to target appearance-related distress. Qualitative semi-structured interviews explored gaps and barriers in appearance-related care, experiences and preferences for support to treat the psychosocial consequences of an altered appearance. The acceptability study tested the cultural suitability of a British online psychosocial intervention 3 that combines cognitive behavioural therapy and social skills training to target appearance-related distress. Adolescents were given access to the website for at least 2 weeks, followed by a semi-structured interview that explored the intervention's acceptability to Australian users. Interviews were audio-recorded, conducted face to face or online (e.g. Skype) and lasted at least 40 min. Interviews were conducted by a female chief investigator (CI), transcribed verbatim and coded by at least two independent coders. Qualitative interview data were analysed using thematic analysis and acceptability data were analysed using content analysis. ParticipantsThirty-six adolescents consented to at least one of the studies. A final 25 participants (n = 14 for qualitative interviews and n = 11 for acceptability study) were recruited. Adolescents aged between 12 and 17 (M = 15.12, standard deviation = 1.54, 22 females and three males) were purposively recruited from specialities including paediatric surgery, burns, plastics and reconstructive, vascular malformations, epidermolysis bullosa and maxillofacial from Australia's largest specialist paediatric hospital. The CI approached patients face to face at outpa...