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Dermatillomania (Skin Picking)

Dermatillomania, also known as skin-picking disorder, is a psychiatric condition characterized by the repetitive and compulsive urge to pick at one's skin, leading to skin lesions and tissue damage.

What is Dermatillomania (Skin Picking)?

Dermatillomania, also known as skin-picking disorder, is a psychiatric condition characterized by the repetitive and compulsive urge to pick at one’s skin, leading to skin lesions and tissue damage.

Individuals with dermatillomania find it challenging to resist the impulse to pick, scratch, or dig into their skin, often resulting in open sores, scabs, and scars. The act of skin picking typically provides a sense of relief or gratification, but this is commonly followed by feelings of guilt, shame, or distress. The behavior can become a habitual and compulsive response to stress, anxiety, boredom, or other emotional triggers.

The exact cause of dermatillomania is not well-defined but similar to trichotillomania (hair-pulling disorder), it is believed to involve a combination of genetic, biological, and environmental factors.

Dermatillomania can affect various parts of the body, with common target areas including the face, arms, hands, and other exposed skin. The consequences of dermatillomania extend beyond the physical damage to the skin. Social isolation, decreased self-esteem, and difficulties in interpersonal relationships can result from the visible signs of skin picking. Individuals may attempt to conceal their skin lesions with clothing or makeup, further contributing to distress.

Treatment for Dermatillomania (Skin Picking)

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) empowers you to identify and change the thoughts and behaviors contributing to dermatillomania. In a supportive and collaborative environment, our experienced therapists help you obtain freedom from dermatillomania.

Building Coping Strategies: Through CBT, we work together to build a toolkit of practical strategies. This includes recognizing triggers, challenging negative thoughts, and finding alternative behaviors to replace skin picking.

Empowering Change: CBT isn’t just about managing symptoms – it’s about reclaiming control over your life. By fostering self-awareness and providing effective tools, we empower you to break free from the cycle of dermatillomania.

Medication

Medication can play a supportive role in managing symptoms and enhancing the effectiveness of CBT for dermatillomania.

  1. Selective Serotonin Reuptake Inhibitors (SSRIs): SSRIs are commonly prescribed to address underlying mood and anxiety issues associated with trichotillomania. 
  2. N-acetylcysteine (NAC): NAC is a promising supplement that has shown effectiveness in reducing hair-pulling symptoms. It is believed to work by modulating glutamate levels in the brain, affecting the impulsive behaviors associated with trichotillomania.

Integrating CBT + Medication

Our approach involves a careful integration of CBT and medication, depending on patient preferences and clinical need, to address both the biological and psychological aspects of dermatillomania.

  1. Collaborative Treatment Planning: Our experienced team works collaboratively to create an individualized treatment plan that assists you in meeting your treatment goals as effectively and rapidly as possible.  
  2. Patient Empowerment: We believe in empowering you with comprehensive information about dermatillomania treatment options, allowing you to make informed decisions about your treatment journey. 
  3. Monitoring Progress: Regular monitoring and adjustments to your treatment plan are made based on your response and progress. This ensures you are obtaining maximum benefits from the time and energy you are putting into the dermatillomania treatment process.  
  4. Ongoing Support:  We offer ongoing support and adjustments to your treatment plan as needed, ensuring a comprehensive and personalized approach to your path to healing.

Your Unique Path to Freedom From Dermatillomania

Our goal is to create a treatment plan that aligns with your needs and preferences, recognizing that each individual’s journey is unique.

What are the symptoms of Dermatillomania (Skin Picking)?

Dermatillomania, manifests through a distinct set of symptoms that encompass both the physical act of picking and the psychological consequences.

The characteristic symptom involves recurrent, uncontrollable urges to pick at one’s own skin. This behavior extends beyond normal grooming and can lead to the removal of healthy skin, resulting in lesions, scabs, and open wounds.
Individuals with dermatillomania often intensely focus on perceived imperfections or irregularities in their skin. This preoccupation may drive the urge to engage in skin picking as a means of attempting to correct or perfect the skin, despite the negative consequences.
Many affected individuals recognize the harmful nature of their skin-picking behavior and make repeated, unsuccessful attempts to stop or reduce the frequency.
Dermatillomania results in visible physical consequences, including scarring, tissue damage, and potential infection. Chronic skin picking can lead to long-term skin issues, exacerbating the initial concerns and contributing to a cycle of distress.

Individuals with dermatillomania often experience significant psychological distress, including feelings of guilt, shame, and embarrassment. The preoccupation with skin imperfections and the inability to control the picking behavior can contribute to diminished self-esteem and negatively impact overall quality of life.

FAQs about Dermatillomania (Skin Picking)

Dermatillomania, also known as excoriation disorder, involves compulsive skin picking. It can be linked to anxiety, stress, or a desire for perfection. Factors like genetics, brain chemistry, and environmental influences may contribute.

CBT for skin picking and and other BFRBs entail:

  1. Learning to observe behavior and catch it in action before too much time has passed.
  2. Engaging in a replacement behavior to ride out the initial moments of the urge to engage in the behavior.
  3. Increase in self compassion and acceptance to reduce the guilt and other negative emotions that often accompany one’s struggle to move past BFRBs.

While a dermatologist primarily deals with skin conditions, they may not specialize in treating the underlying psychological aspects of dermatillomania. Mental health professionals, such as therapists, psychologists or psychiatrists, are more suitable for addressing the compulsive behavior and providing appropriate therapy or interventions. It’s advisable to consult both a dermatologist and a mental health professional for comprehensive care.

Yes, dermatillomania, officially known as excoriation disorder, is a diagnosable mental health condition. A qualified mental health professional, such as a therapist, psychologist or psychiatrist, can assess and diagnose dermatillomania based on specific criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Avoid making comments that may trivialize or dismiss their struggles, such as saying "Just stop picking" or "It's not a big deal." Instead, offer support and encouragement, and suggest seeking professional help. Be understanding and patient, as individuals with dermatillomania often face challenges in managing their behavior.

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