Dermatillomania is a skin-picking disorder most closely-associated with OCD. It can also be referred to as excoriation disorder.
This condition is classified as an impulse control disorder and a body-focused repetitive behavior (BFRB). It is one of the many BFRBs experienced by someone suffering from OCD.
Dermatillomania affects approximately 1 percent of the population, and about 75% of those affected are women. This condition is different from the normal picking of skin. This disorder is identified by chronic skin-picking that can eventually result in tissue damage.
The behavior can escalate to the point where a victim will squeeze, cut, bite, or even scrape both dead and healthy skin from different parts of the body. The face, hands, fingers, arms, and legs are areas that are often targeted by the victims. Sufferers will use their fingers, but may often use tools like pins, tweezers, razors, nail clippers, etc.
People suffering from the disorder can be preoccupied with the thought of picking their skin for hours. They may even spend a large part of their day fighting their urge to pick, but eventually giving in.
Eventually the tissue damage and scarring from the disorder can become so bad that it starts to affect a person’s relationships with family and friends. Sufferers of dermatillomania start to feel stress, anxiety, or embarrassment about their condition. This leads to attempts to cover up their condition with makeup, clothes, or other means and can lead to awkward social interactions.
Symptoms of Dermatillomania
The skin picking occurs so often that skin lesions become a common symptom of the disorder. People suffering from the disorder will make repeated attempts to stop picking without any success.
Many individuals suffering from dermatillomania begin to feel helpless. They start to feel a loss of self-control or shame. They can even be so affected by the disorder that it impairs their normal functioning.
This behavior is never conducted in public. Because of the shame and embarrassment associated with the disorder, sufferers typically wait until they are alone to indulge in the behavior.
What Causes Dermatillomania?
Experts believe that the disorder may be genetic. This is because other BFRBs, like hair pulling and skin picking, have been linked back to relatives. Age, individual personality, and stress also play a role in the development of the disorder.
The condition also appears to be linked to the beginning of puberty, and may also develop if a person suffers from acne. It can also be brought on by personality traits like perfectionism, or it can used as a coping mechanism. Many times, teens and adults alike, can resort to skin picking as a way to process negative emotions like boredom, impatience, dissatisfaction, or boredom.
It can be difficult for medical professionals to diagnose dertamillomania. The symptoms of the condition are closely related to general skin picking. It can be challenging for a doctor to determine if a patient’s skin picking behavior is, in fact, chronic.
This diagnosis is typically made by a dermatologist rather than a mental health professional.
As mentioned before, one of the symptoms of the disorder is repeated attempts to stop. These attempts to quit without help are typically unsuccessful, but shame and embarrassment from the disorder stop sufferers from seeking professional help.
Less than 20% of people suffering from Dermatillomania seek help. Psychologists have seen treatments like cognitive behavioral therapy, habit reversal therapy, and acceptance and commitment therapy work for the ones that do seek help.
There are no medications prescribed specially to help with dermatillomania, but medical professionals may prescribe certain antidepressants or neutraceuticals. In more extreme cases, a patient may need antibiotics to treat infections or they may need to undergo surgery to repair severe skin damage.
The antidepressant medications are serotonin reuptake inhibitors (SSRIs) that are typically prescribed to handle the patient’s OCD as a whole. These medications can be effective in treating the symptoms of dermatillomania specifically as well.
In addition to therapy, or medication, there are some behavioral changes someone can attempt to stop the behavior. The idea is that someone suffering from dermatillomania can possibly beat the disorder by substituting their skin picking with another, more healthy habit.
One of the ways to do this is to keep your hands busy. If you start to feel the urge to pick your skin, squeeze a softball, baseball, or other object you can hold in the palm of your hand. It may even be a good idea to put on gloves or band-aids to prevent yourself from picking or scratching your skin. Especially if you’ve already started to experience lesions or tissue damage in a particular area.
Another tip is to pay close attention to when and where you are most likely to pick your fingers. Is there a certain area of the house or certain time of day where you are more likely to pick? Pay close attention to your mood, or certain social situations as well. Being mindful in this way will help you to identify your triggers, and help you to be better prepared for the urge to pick your skin.
Each time you feel the urge to pick your skin, try to resist for longer. As you gradually increase the amount of time you can resist the urge to pick, you may eventually overcome the urge to pick entirely.
You can also turn your urge to pick into an opportunity to care for your skin. When the urge to pick comes on, replace it with a habit of applying moisturizer or clipping/filing your nails.
Tell other people when you’re picking. If friends and family are conscious of your habit, and they know it bothers you, they will be able to point it out and tell you to stop if you start to do it subconsciously.
Keeping your skin clean, as to not get it infected, can also go a long way in helping with the disorder as well.
Choosing The Right Treatment Center
Luckily, there are a number of treatment centers around the country that specialize in this area. They are experts at dealing with compulsive disorders like dermatillomania and OCD.
When seeking treatment it’s important to call and verify the center’s experience with this disorder. In fact, this is good practice no matter what disorder you are seeking treatment for. The type of center you choose will also depend largely on your insurance coverage. Check with your insurance provider to see what centers near you can treat dermatillomania. Once you have a list of reputable centers in the local area, and see which ones you are covered for.