Impulse Control Disorders Dermatillomania

Dermatillomania, or chronic skin picking, (CSP) is the practice of repetitively rubbing, touching, scratching and picking at one’s skin. Very often the face is the main target, but any part of the body can be a site for skin picking. People with dermatillomania commonly believe they’re scratching away skin blemishes.

Although dermatillomania is different from self-mutilating behaviors like cutting or burning the skin, it can have serious consequences. Compulsive skin picking can lead to:

  • Bleeding
  • Bruising
  • Infections
  • Scarring
  • Skin damage.

Dermatillomania: Background and Characteristics

Chronic skin picking has been observed in animals, leading some researchers to suggest that dermatillomania stems from a genetic grooming impulse.

A variety of emotional states are associated with dermatillomania. Some people develop a skin picking habit because they find it soothing. Others do so because they’re seeking stimulation. Still others pick their skin because they’re trying to be “perfect” and they think their skin is flawed.

Dermatillomania is considered an impulse control disorder, and is usually diagnosed on the basis of the following characteristics:

  • An inability to resist picking at real or imagined blemishes
  • Growing interference with daily life
  • Growing tension before skin picking, for some
  • Relief after skin picking, for some
  • Scarring, or noticeable sores.

Some people feel such shame and remorse because of their dermatillomania that they limit their personal and professional activities to hide the results of their skin picking.

The OCD Dermatillomania Connection

Although it is not the same as obsessive compulsive disorder, dermatillomania has much in common with OCD.

According to HealthCentral.com, almost half of those diagnosed with OCD may have dermatillomania, as well (2008). Depression and anxiety are also related disorders.

Dermatillomania is considered a body-focused repetitive behavior (BFRR), like compulsive hair-pulling (trichotillomania), chronic nail-biting (onychophagia) or biting the insides of your cheeks (dermatophagia).

Dermatillomania Treatment Options

Skin picking can be a symptom of other conditions such as autism, an autoimmune disorder, dermatological disease, substance abuse or psychosis. These must be ruled out before dermatillomania treatment begins.

The options for dermatillomania treatment include:

  • Competing response: Providing dermatillomania patients with alternatives to picking, like knitting or another activity that keeps their hands busy
  • Habit Reversal Training: Teaching patients coping strategies through a comprehensive approach to dermatillomania
  • Self-Monitoring: Helping patients stop skin picking by building awareness of their habit
  • Stimulus Control: Helping patients recognize and avoid their skin-picking triggers.

Some medications have been helpful in treating skin picking, including selective serotonin reuptake inhibitors (SSRIs) and medications used to treat alcohol abuse.

Resources

BrainPhysics.com. (2010). Dermatillomania: Compulsive skin picking. Retrieved July 16, 2010, from http://www.brainphysics.com/skin-picking.php.

Kennard, J. (2008). Skin picking: A sign of deeper problems. Retrieved July 16, 2010, from http://www.healthcentral.com/anxiety/c/1950/47842/picking-problems.

Trichotillomania Learning Center. (2007). What is chronic skin picking? Retrieved July 16, 2010, from http://www.trich.org.