Dermatillomania or Skin Picking Disorder
Compulsive Behavioral Signs, Symptoms, Treatment and Diagnosis
Nov 15, 2009
Compulsive skin picking (CSP) – known by the medical term dermatillomania – is an unconscious, repetitive psychological behavior that results in the mutilation of healthy skin. Other terms that relate to this condition are chronic skin picking, pathological skin picking, neurotic excoriation and acne excoriee. Though not formally listed in the Diagnostic and Statistical Manual (DSM-IV), CSP is considered a type of obsessive compulsive disorder (OCD).
In most cases, dermatillomania affects the healthy skin on an individual's face, but can involve other areas of the body such as the arms, legs, torso and scalp. Left untreated, this disorder can impact not only psychological health, but physical health as well – resulting in scarring, infection and permanent disfigurement.
Skin picking is most commonly seen in women, and typically begins during teenage years. In most cases, it begins as a conscious way to deal with tension, eventually becoming an unconscious impulse-control disorder.
Signs and Symptoms of Compulsive Skin Picking
This condition causes an individual to pick skin with fingers, fingernails, tweezers, needles and other objects. In many cases these symptoms are the result of an individual picking or scratching the same area repeatedly. Individuals affected tend to hide signs and symptoms of CSP because of the associated psychological embarrassment. Several signs an individual may have CSP are:
- scarring
- excessive scabbing
- callusing
- scratching or picking at skin
- bleeding or swelling of skin
- picking scabs
- picking acne
- wearing long sleeves, pants and scarves to hide signs of self-mutilation
Associated Psychological Conditions
Dermatillomania is a psychological condition usually triggered by situations causing increased tension, anxiety or stress. However, the individual is often unaware of the trigger or response. Also this condition tends to accompany other psychological conditions, including but not limited to:
- obsessive compulsive disorder (OCD)
- body dysmorphic disorder (BDD)
- mood disorders – depression or bipolar disorder
- anxiety disorders
If a compulsive skin picking disorder is suspected, only a licensed physician or mental heath professional can make a proper diagnosis and provide proper treatment.
Misdiagnosis of Dermatillomania
The lack of classification and understanding of CSP can result in a misdiagnosis. Several physical and psychological disorders display similar symptoms, including but not limited to:
- depression
- bipolar disorder
- multiple sclerosis (MS)
- Lyme disease
- Chronic Fatigue Syndrome
Treatment of Compulsive Skin Picking
Once proper diagnosis is made by a qualified health professional, CSP can be treated through medication and psychotherapy. Individuals are often unaware of triggers and picking behavior and psychotherapy can aid in behavior modification through:
- cognitive behavioral therapy (CBT) – helps individuals realize how the thought process forms and translates into feelings and behaviors.
- habit reversal training (HRT) – makes an individual aware of unconscious behaviors, recognize triggers and modifies behavioral patterns.
Living with Compulsive Skin Picking Disorder
Dealing with dermatillomania first requires an individual to admit there is a potential mental or physical health problem and to seek appropriate treatment by a licensed health care professional. Diagnosis requires a through physical and psychological evaluation and successful treatment will be based on individual signs, symptoms and personal needs.
Sources:
Dermatillomania: Compulsive Skin Picking – BrainPhysics Mental Health Resource
Compulsive Skin Picking – OCD Center of Los Angeles
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