Dermatillomania (A 3 point Guide)

This blog provides a detailed and comprehensive guide to Dermatillomania. It will delve into the details of symptoms, causes, and treatment of Dermatillomania.

What Is Dermatillomania?

Dermatillomania or Excoriation disorder commonly referred to as chronic skin picking disorder. It is a mental condition that shows itself as compulsive and repetitive skin picking. It is an impulse control disorder and one of the many body-focused repetitive behaviors (BFRBs) currently categorized in the DSM-5 under the Obsessive-Compulsive Disorders (OCD) and related disorders. Dermatillomania is prevalent in up to 1.4 % of the entire population, and about 75% of them are female. 

Dermatillomania and normal skin picking are different. It is a chronic condition that can result in various tissue damage and cause distress and dysfunction in life.

Excessive and repetitive skin picking can be manifested in the forms of hair pulling, scraping, squeezing, biting, or lancing both damaged and healthy skin from several body parts. People with Dermatillomania often pick at the skins of their lips, face, fingers, hands, arms, and legs. They may use their fingers or other tools like pins or tweezers. They may indulge in this habit for several hours a day, which can even extend for months and years. Dermatillomania can cause visible damage to the skin, and lesions can result in disfigurement, open wounds, discoloration, infections, and scars. 

Dermatillomania is a chronic illness, however, its symptoms may come and go from time to time. People with Dermatillomania may spend hours contemplating this habit of fighting the urge to give in. Depression, anxiety, fear of exposure, shame, and embarrassment about the condition often conceal the skin with clothing, makeup, or by some other way. It can also interfere with the social presence, often leading to uncomfortable relationships with friends and family. Dermatillomania cannot be diagnosed when the symptoms are caused due to other underlying psychiatric or medical conditions. For example, skin picking can often be caused by autoimmune disorders, dermatological infections, opiate withdrawal, or developmental conditions, like autism.

What Are The Symptoms of Dermatillomania?

According to DSM-5, a person with excoriation disorder or Dermatillomania shows the following signs and symptoms:

  • Recurring skin picking may cause skin lesions.
  • Repeated and constant struggle to stop the habit.
  • The condition causes clinically recognized impairment or distress.
  • The symptoms are not due to medical or substance, or any dermatological condition.
  • The symptoms can not be better explained with any other psychiatric condition or disorder.

What Are The Causes of Dermatillomania?

The precise cause of Dermatillomania is yet to be identified. However, evidence shows that there could be a genetic element to Dermatillomania, some people have inherited traits of skin pulling, hair pulling, etc. It is also characterized by higher than usual changes in mood and anxiety disorders. Other factors that may contribute to causing this condition include stress, temperament, and age. Chronic skin behavior also coexists with the start of puberty, and also dermatological issues, like acne. Dermatillomania can also be linked with perfectionism, leading to over-grooming. Or, it can also manifest as a way to avoid stressful situations or release tension that builds up due to frustration, impatience, dissatisfaction, or sometimes boredom.

Things To Try If You Skin Picking Disorder

Things To Do

  • Keep your hand engaged–try to have stress buster toys, softball, or put on gloves.
  • Avoid the triggers that cause you to pick your skin.
  • Challenge yourself and resist your urges to pick skin.
  • Care and Pamper your skin when you are urged to pick your skin–for instance apply hand cream when you feel like biting your nails or picking at your skin.
  • Talk to people and tell them to stop when they see you picking at your skin.
  • Keep the skin clean to prevent infections.

Things Not To Do

  • Don’t grow long nails–trim them regularly.
  • Don’t keep tools like pins and tweezers where you can easily access them.

You Need To See a General Physician if:

  • You are unable to stop yourself from picking at your skin.
  • You are damaging your skin by picking at it, like cuts that don’t heal in a few days.
  • Your skin-picking behavior is causing significant emotional distress or dysfunction in life.

What To Expect From Your Appointment

Your doctor will ask some questions regarding your skin picking behavior and examine your skin. If the doctor thinks your skin needs the intervention of a skin specialist, he’ll refer you to them.

This may involve medication or talking therapy. 

A dermatologist or skin specialist might be referred if your skin has serious damage or other underlying skin problems that are causing the skin picking behavior, like eczema or acne.

What Are The Treatment Options For Dermatillomania?

Research shows that both medication and psychotherapy, such as cognitive-behavioral therapy (CBT) can efficiently reduce symptoms of Dermatillomania.

  • Medication: efficient treatment may include the application of selective serotonin reuptake inhibitors (SSRIs), usually antidepressants which can also help them in reducing obsessive thoughts and compulsive habits.
  • Cognitive Behavioral Therapy or Psychotherapy: Cognitive Behavioral Therapy helps the clients understand their thoughts and patterns of behavior are connected and how they can together reduce this repetitive behavior. Clients can learn in psychotherapy how to stop or manage their intrusive thoughts so that they avoid skin picking. 

Habit reversal training helps by

  • Recognizing and promoting awareness of your skin picking and the triggers.
  • Replace skin picking behavior with less harmful or productive behavior.

Co-Occurring Conditions

Dermatillomania co-occurs with other conditions like obsessive-compulsive disorder (OCD), major depressive disorder, and trichotillomania (hair-pulling). A study shows that 38% of patients with Dermatillomania have co-occurring trichotillomania. 

Other body-focused repetitive behaviors (BFRBs) like nail-biting can also coexist with Dermatillomania.

Conclusion

This blog provided a detailed and comprehensive guide to Dermatillomania. It delved into the details of symptoms, causes, and treatment of Dermatillomania.

Dermatillomania or Excoriation disorder commonly referred to as chronic skin picking disorder. The repeated picking of one’s own skin results in skin lesions and also causes disruption in their life.

If you have this skin-picking condition, let us know in the comments how you manage and cope with this behavior?

Frequently Asked Questions (FAQs): Dermatillomania

Is Dermatillomania a mental illness?

Yes, Dermatillomania is a mental illness closely associated with obsessive-compulsive disorder. Dermatillomania or Excoriation disorder commonly referred to as chronic skin picking disorder. The repeated picking of one’s own skin results in skin lesions and also causes disruption in their life.

What triggers Dermatillomania?

Although there could be a genetic element to Dermatillomania, some people have inherited traits of skin pulling, hair pulling, etc. It is also characterized by higher than usual changes in mood and anxiety disorders.

How do you stop Dermatillomania?

You can try to stop Dermatillomania in some of the following ways:

  1. Keep your hand engaged–try to have stress buster toys, softball, or put on gloves.
  2. Avoid the triggers that cause you to pick your skin.
  3. Challenge yourself and resist your urges to pick skin.
  4. Care and Pamper your skin when you are urged to pick your skin–for instance apply hand cream when you feel like biting your nails or picking at your skin.
  5. Talk to people and tell them to stop when they see you picking at your skin.
  6. Keep the skin clean to prevent infections.

How do I know I have Dermatillomania?

In order to tell if you have Dermatillomania, check if you are habitual of excessive picking, scratching, gouging, or squeezing at an otherwise healthy skin. People with Dermatillomania typically pick at their skin on the face and lips, however, it can be any body part, like scalp, hands, or arms.

References

American Psychiatric Association, Diagnostic and Statistical Manual, Fifth Edition.

https://www.psychologytoday.com/us/conditions/dermatillomania-skin-picking

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