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What is skin picking disorder? -

Skin picking disorder, also known as dermatillomania and excoriation disorder, is when a person compulsively picks their skin.

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What is skin picking disorder? -

This is not a casual type of skin picking, but rather a compulsive behavior that often leads to injuries and scarring.

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What is skin picking disorder? -

Skin picking is related to obsessive-compulsive disorder (OCD), but there are a few differences. One of them is the absence of obsessions (uncontrollable thoughts or urges) These don’t happen with skin picking disorder.

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Differences between dermatillomania and OCD -

Skin picking is associated with a sense of relief and positive emotions, which is something that doesn’t usually happen to the same extent with OCD.

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Differences between dermatillomania and OCD -

Self-injury is common in people with skin-picking disorder, whereas OCD rarely involves any type of self-damage.

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Who’s at risk? -

It’s estimated that the condition affects both males and females, but the percentage of women affected by it is believed to be higher.

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Who’s at risk? -

People with acne or eczema are more likely to develop skin-picking disorder. The condition often develops during adolescence, but adults may develop it too.

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How common is it? -

Dermatillomania is pretty rare. In the US alone, it’s estimated to affect between 1.4 and 5.4% of adults.

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How does it affect the body? -

People with the condition may or may not be aware that they are picking their skin. The behavior is compulsive and often cannot be stopped. This can result in bleeding, scarring, and even infection of wounds.

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How does it affect mental health? -

People with the condition may feel embarrassed of the injuries and scars, and try to hide them by covering them with clothes and makeup. This shame may lead to more anxiety in people’s social lives.

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Most affected areas -

The areas most affected by skin picking disorder are the head (face, neck, scalp), the arms (including hands and fingers), and legs (from thighs to toes).

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Types of skin picking: automatic picking -

This is when the person is not even aware that they are picking their skin. This often happens while performing other activities (e.g. reading, driving, watching TV, etc.). This is believed to be a form of self-stimulation.

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Types of skin picking: focused picking -

Urges to pick the skin in a specific area is called focused picking. This is believed to be a form of fighting boredom and/or feelings of discomfort.

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Causes -

Dermatillomania doesn’t have any specific causes, but there are a few factors that play a role in the development of skin-picking disorder.

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Causes: genetics -

One of these factors is genetics. In which case, often there is one first-degree family member with the condition.

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Causes: changes in brain structure -

The brain structure in areas that control learning and habit formation are more likely to be different in people with the condition.

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Causes: mental health -

Dermatillomania is sometimes used as a coping mechanism associated with other mental health issues, and used as a form of emotional regulation (e.g. dealing with boredom, stress, anxiety, etc.).

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Causes: mental health -

People with skin-picking disorder may also suffer from other OCD-related disorders, including hair-pulling (trichotillomania) or nail-biting (onychophagia).

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Causes: mental health -

Anxiety disorders, as well as depression, bipolar disorder, and Prader-Willi syndrome, are among the most common mental health issues associated with dermatillomania sufferers.

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Diagnosis -

Most people pick their skin at some point (e.g. dry skin, pimples, etc.) but doing so for an ongoing period and repeatedly, is one of the main signs that a person may suffer from skin-picking disorder.

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Diagnosis -

Another clear symptom is the inability to stop doing it, despite trying multiple times to change the behavior. As are signs of lesions and any reported impact on the individual’s life (e.g. shame, social isolation, etc.)

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Diagnosis -

Ruling out other possible causes is also important. The behavior must not be triggered by other skin conditions, the use of drugs (both prescription and recreational), or by other mental health conditions such as body dysmorphic disorder.

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Treatment -

Treatment usually involves both medications and therapy. Medications used in such cases may include antidepressants, anticonvulsants, and antipsychotics.

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Treatment -

Nutraceuticals, such as the amino acid N-acetylcysteine, may also help control urges.

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Treatment -

In addition to medication, some form of psychotherapy is usually recommended. This may include, but is not limited to, habit reversal therapy, cognitive behavioral therapy (CBT), and acceptance and commitment therapy. 

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Treatment -

People with dermatillomania may also benefit from group therapy and peer support.

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Prevention -

Because dermatillomania is a mental health condition with a number of possible causes, it’s not possible to prevent.

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Living with it -

If you suffer from skin picking disorder, there are a few things you can do, including avoiding triggers. The behavior is often triggered by certain settings or situations. If you are aware of these, try to avoid them.

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Living with it -

Picking behaviors are less likely to occur if your hands are busy (e.g. using a fidget device). Wearing gloves and/or clothes that cover parts of the skin usually picked on, can also be a way to avoid further damage.

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Outlook -

The urge to pick the skin may be present throughout one’s entire life, but with treatment, it’s possible to reduce the number of episodes. It’s important to address the underlying causes of dermatillomania.

Sources: (Cleveland Clinic) (Mental Health America) (Picking Me Foundation) (WebMD)

See also: The most common things that cause anxiety

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