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Compulsive Skin Picking – What Is Dermatillomania?

Dermatillomania, also known as skin picking disorder (SPD), is a serious problem in which an individual picks at their skin to the extent that it causes wounds. Many people don’t have an awareness of this condition but 2% to 3% of the population actually struggles with it.

SPD is considered to be an impulse control disorder that is related to obsessive-compulsive disorder. Occasionally, individuals will also display characteristics of other disorders such as substance abuse, borderline personality disorder or body dysmorphic disorder.

Dermatillomania is most common among teenagers and young adults. Females are more likely to struggle with it than men.

Symptoms of Dermatillomania

Individuals who suffer from dermatillomania may exhibit symptoms like:

  • Skin picking
  • Compulsively rubbing skin
  • Skin scratching
  • Repetitive touching
  • Digging into skin
  • Squeezing skin repetitively

Skin picking is often accompanied by intense emotions and can be done with the fingers or by use of other tools, like tweezers. Most sufferers of SPD focus on a primary area of their body, with the face being the most common.

Effects of Skin Picking Disorder

The skin can become discolored and scarred, with occasional severe episodes of major tissue damage. In rare cases, skin grafting can be required. Infection can also become a problem.

Individuals who suffer from this behavioral issue can experience feelings of guilt and helplessness, along with shame and embarrassment. These feelings come as a result of the physical effects of the disorder and can be cyclical, driving the individual to pick more.

Diagnosis

Although some believe that dermatillomania is the result of another disorder, recent studies and changes in the field of psychology suggest otherwise. A separate category for this area of disorders has been added to the DSM-5.

In order to receive a diagnosis in this category, the person must:

  • Experience some of the symptoms listed above
  • Be under clinical distress or impairment
  • Have symptoms that are not caused by a medical, substance or dermatological condition
  • Have symptoms that cannot be explained by another psychiatric disorder

In order for an accurate diagnosis to be made, help from a medical professional should be sought.

Treatment Options

Evidence shows that treatment is most effective when both pharmacological therapy and behavioral therapy are used in conjunction with one another. Medications that inhibit specific serotonin neurotransmitters are found to help reduce compulsive behaviors and obsessive thoughts. Cognitive behavioral therapy is administered to help the individual understand their behavior patterns and thoughts so they can begin a healthy, guided direction down the path of healing.

 

Resources:

National Institutes of Health: The Recognition and Treatment of Pathological Skin Picking:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2719449/

Mental Health America: Excoriation Disorder (Skin Picking or Dermatillomania):

http://www.mentalhealthamerica.net/conditions/excoriation-disorder-skin-picking-or-dermatillomania

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