Dermatillomania

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Disfiguration of the distal and proximal joints of the middle and little fingers.
Markings on arms due to skin picking with the fingernails.

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Dermatillomania (also known as compulsive skin picking or CSP) is an obsessive compulsive disorder characterized by the repeated urge to pick at one's own skin, often to the extent that damage is caused.

Sufferers of dermatillomania find skin picking to be stress relieving or gratifying rather than painful.

Habits of dermatillomania sufferers

Episodes of skin picking are often preceded or accompanied by moments of tension, anxiety, stress, or paranoia. During these moments, there is commonly a compulsive urge to pick, bite, itch, or scratch at a surface or region of the body.

The regions most commonly affected by this are the face, back, scalp, chest and extremities such as the hands, feet, and arms. Symptoms most commonly expressed in these areas are swelling, scarring, and callusing due to damage to the affected region's epidermis.

In the face of these symptoms, most sufferers feel and recognize a need to stop the process but are physically and mentally unable without aid. Additionally, the development of said symptoms is very similar to the expression of trichotillomania, or the compulsive pulling of hair from the body.

Often dermatillomania sufferers find that their disorder intereferes with daily life. Plagued by shame, embarrassment, and humiliation, they will take measures to hide their disorder by not leaving the home, wearing long sleeves and pants in summer, and heavy make-up use for coverage.

Causes and treatments

The inability to control the urge to pick is similar to trichotillomania.[1] Recent research suggests that, like trichotillomania, dermatillomania may be an impulse control disorder. This is part of the obsessive compulsive disorder spectrum.[2]

Some sufferers feel that "picking off" pimples or skin abnormalities may rid them of these flaws and help them look more "normal." They feel the pimples they have are not like those of others, but abnormal. In these cases, skin picking may be a symptom of body dysmorphic disorder.[3]

Few mental health practitioners have studied the disease, as many of these cases go unreported, but some individuals have found relief through cognitive-behavioral therapy. Hypnosis and self-hypnosis and meditation have also proven useful for some patients.[citation needed] They are also sometimes prescribed medications, such as those prescribed for obsessive compulsive disorder.

In some cases, removing the major "abnormalities" in the skin may be of some use, particularly if the problem is confined to a particular area such as the feet. In this case, applying a solution consisting of 3% or less of hydrogen peroxide and bandaging the area tightly for several hours will allow most of the dead skin to slough away, leaving a relatively smooth surface that may be protected by a physical barrier from picking for the few days until healing is complete. Solutions of 10% hydrogen peroxide or greater can significantly damage skin.

Synonyms

  • compulsive skin picking
  • skin picking
  • acne excoriee (from French)
  • chronic skin picking
  • excoriated acne
  • neurotic excoriation
  • psychogenic excoriation
  • self injurious skin picking
  • obsessive skin picking
  • skin picking disorder
  • psychodermotosis

Hyponyms

  • compulsive face picking
  • skin picking
  • scalp picking
  • Cheek biting
  • Finger Picking

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