Skin Picking Disorder
Dermatillomania, often referred to as compulsive skin picking disorder, is a condition in which a person picks at his skin compulsively, sometimes until the skin bleeds. It’s a form of obsessive-compulsive disorder (OCD), which is a type of anxiety disorder. According to the National Institute of Mental Health, about 2.2 million Americans have some form of obsessive-compulsive disorder, but doctors don’t really know how many people are affected by compulsive picking skin disorder because there has been a lack of research on that particular condition to date.
Symptoms of Compulsive Skin Picking Disorder
Symptoms of dermatillomania include picking at the skin and picking at scabs, with the fingers, with tweezers, or with other devices. Symptoms may include swollen areas, areas of reddened skin, scabs, and bleeding. Of course, scars are common, as well. While the arms and face are areas commonly affected by skin picking, all parts of the body can be affected.
Infections can occur if wounds aren’t treated properly, and in some cases, can be severe. Unfortunately, some patients are reluctant to seek treatment for infections caused by skin picking because they feel embarrassed about their disorder.
Causes of Compulsive Skin Picking Disorder
Doctors don’t know exactly what causes compulsive picking skin disorder. In most instances, it’s probably a combination of biological, biochemical, and psychological factors. It is believed that there’s a genetic component to obsessive-compulsive disorders like compulsive skin picking. In some cases, dermatillomania may be caused by an imbalance of neurotransmitters like serotonin in the brain.
People with dermatillomania often suffer from depression and/or anxiety, which may contribute to the condition. Sometimes they suffer from other forms of obsessive-compulsive disorder, as well, such as trichotillomania (compulsive hair pulling). Some people with dermatillomania have a history of abuse or trauma. Some also have issues with poor body image or body dysmorphic disorder, a condition in which people perceive they have some sort of disfiguring flaw in their appearance when they really don’t.
Treatment of Compulsive Skin Picking Disorder
Treatment for compulsive picking skin disorder often includes both medication and counseling. A combination of both is usually most effective, though some people experience good results from just one or the other.
According to the International OCD Foundation, eight antidepressants have been found to be particularly effective at treating obsessive-compulsive disorders, including citalopram (Celexa), clomipramine (Anafranil), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), and venlafaxine (Effexor). It’s believed that these medications help people with dermatillomania and other types of obsessive-compulsive disorders by increasing the amount of serotonin and certain other chemicals in the brain. Some medications work better than others for certain people, so you might have to try a couple different medications before finding one that works well for you.
One type of counseling that has been found to be effective for people with dermatillomania is cognitive behavioral therapy (CBT). CBT helps people change their thoughts, which then leads to changes in behavior. Exposure and response prevention (ERP) therapy is another technique often used to treat obsessive-compulsive disorders like compulsive skin picking. With ERP, a therapist carefully exposes a person to something that typically triggers the urge to pick at their skin while helping him resist the urge. Of course, various techniques for stress management can be taught in therapy, which helps, and many people with anxiety or depression find just having someone supportive and nonjudgmental to talk to helps, too.
In addition to counseling and medication to help stop compulsive skin picking, people with dermatillomania may need medical treatment for wounds that are infected or that aren’t healing properly.