Skin picking disorder

Skin-picking is something that is not uncommon and from time-to-time people tend to pick their skins. But it seems to become a problem when it is severe and cannot stop from picking their skin, and it becomes a disorder. "Dermatillomania, also known as excoriation disorder (per the DSM-5) or skin-picking disorder, is a psychological condition that manifests as repetitive, compulsive skin picking. It is one of a category of disorders known as body-focused repetitive behaviors (BFRBs) that are currently classified in the DSM-5 under Obsessive-Compulsive and Related Disorders" (Psychology Today, 2017).

The individual habitually or impulsively picks at their skin. It's common for them to say that they find it difficult to suppress the urge to pick. Although it's uncommon, skin-picking condition is well known. It is regarded as an obsessive compulsive disorder (OCD)-related mental health problem. Although not everyone who has OCD will acquire skin-picking disorder, many persons who have this illness frequently also have OCD.

Symptoms

However, individuals with skin-picking condition could continue to pick at scabs, bumps, pimples, or other skin lesions until they bleed again or become inflamed. The skin surrounding their fingernails and toenails may also be picked at by them. People with the disease may occasionally let the chosen spots to heal before picking them once again. It might be difficult to get out of the habit and impulsive loop. Some of the symptoms of this disorder include:

• Keep picking their skin and cannot stop.
• Their skin may look like cuts, or some of it may look like it's bleeding, and there are bruises on the skin.
• Picking the skin when anxious or stressed
• It may become a habit to a point that the person may not realize their picking at their skin.
• They may attempt to "smooth" or "perfect" moles, freckles, spots, or scars by picking at them.

Causes

Skin-picking disorder is known as a sub-type of OCD. Many people find it difficult to stop picking on their own because of the obsessive need. One's ability to regulate the activity decreases when they pick at their skin more frequently.

Since certain persons appear to have a hereditary propensity for BFRBs like skin picking and hair pulling, in addition to higher than usual rates of mood and anxiety problems in first-degree relatives, there may be a genetic component to excoriation disorder. Age, stress, and a person's disposition all may contribute to the emergence of this illness.

A dermatological condition like acne and the start of puberty frequently coexists with chronic skin plucking habit. Dermatillomania is sometimes linked to perfectionism, which promotes over-grooming. It can also be a coping mechanism for tension brought on by unfavorable feelings including impatience, annoyance, discontent, and even boredom.

Treatment

A combination of treatment and medication is used to treat skin picking condition.

Therapy

In order to treat skin picking, there are two primary types of treatment:

1. Habit reversal training - you receive assistance from the therapist in identifying the circumstances, pressures, and other elements that set off the skin picking. Then, instead of picking at your skin, your therapist can help you find healthier alternatives, like squeezing a rubber ball. Both of these things will keep your hands busy and reduce tension.
2. Stimulus control - the goal of this therapy is to reduce skin picking by altering your surroundings. To assist prevent feeling the skin and obtaining the impulse to pick, you may, for instance, consider donning gloves or bandages. Alternately, if looking in mirrors causes you to pick at acne or imperfections on your face, you can hide them.

Medication

Skin picking disorder is occasionally treated with drugs, however none of them are FDA-approved or have a solid track record in this regard. The class of drugs most thoroughly researched for treating skin picking is the SSRIs (selective serotonin reuptake inhibitors), which include Prozac.

The potential benefits of various anticonvulsant drugs, including Lamictal (lamotrigine), and some dietary supplements, like N-acetyl cysteine, have also been the subject of preliminary investigations. Even the opioid-blocking drug naltrexone has been the subject of investigations.

Summary

As was previously mentioned, a subtype of OCD is skin-picking disorder. Many people find it difficult to stop picking on their own because of the obsessive need. One's ability to regulate the activity decreases when they pick at their skin more frequently. Checking in with the right doctor about this particular issue may be difficult, but in the end it's worth it.

You may go through phases where you pick again, despite the fact that therapy can help you control the symptoms and stop the behaviors. Even after discontinuing the activity for a long time, this might still occur.

Supporting yourself comes before anything else. The moment you accomplish your goals, rejoice. Keep in mind, though, that success might not come easily at first. Don't forget to congratulate yourself on even the little victories, and be kind to yourself if you fall short of a target. Furthermore, it's excellent to achieve the larger good of lessening the symptoms with the appropriate level of support from family and loved ones.

References:

Shaw, G. (2014). Skin Picking Disorder (Excoriation). [online] WebMD. Available at: https://www.webmd.com/mental-health/skin-picking-disorder [Accessed: 18 Jul. 2023].

Psychology Today (2017). Dermatillomania (Skin Picking) | Psychology Today. [online] Psychology Today. Available at: https://www.psychologytoday.com/us/conditions/dermatillomania-skin-picking [Accessed: 18 Jul. 2023].

Holland, K. (2017). Excoriation (Skin Picking) Disorder: What Is It? [online] Healthline. Available at: https://www.healthline.com/health/skin-disorders/excoriation#coping-and-support [Accessed: 18 Jul. 2023].

NHS (2021). Skin picking disorder. [online] nhs.uk. Available at: https://www.nhs.uk/mental-health/conditions/skin-picking-disorder/ [Accessed: 18 Jul. 2023].