Dermatillomania is a disorder that involves recurring and impulsive picking of the skin which often results to impairments of the skin. This impulse control disorder is also known as pathologic skin picking, neurogenic excoriation, and compulsive skin picking. This is commonly associated with obsessive-compulsive disorder (OCD), although some experts say that it is more related to substance abuse disorder. This is because dermatillomania may give pleasure and may decrease the feelings of anxiety of a person with the disorder.

Indications

Those who are afflicted by dermatillomania predominantly exhibit skin picking while they are stressed out, tense, or anxious. Most pick at their skin when they feel that there is something wrong with their skin or when they note some skin irregularities or blemishes. Some may even find skin picking to release their tension. They typically pick at the skin on their face, fingers, toes, lips, chest, stomach, arms, legs, or even their scalp. Scars are commonly seen on these parts of the body.

Due to constant compulsive skin picking, these people are at risk of skin infections. This is specifically true when their fingers or the tools they use in skin picking are not clean. They are also vulnerable to tissue damage. Actually, some people with dermatillomania have inflamed, bleeding, or calloused skin. In addition there are several patients who have systemic infection, or septicemia as an unwanted effect of dermatillomania.

Individuals with dermatillomania also have problems with low self-esteem, guilt, and distress. These intense thoughts may even lead to further self-harm. In fact, there are several people who have this disorder who have suicidal tendencies.

Causes

Experts say that there are many theories explaining the probable cause of dermatillomania. One of these theories states that dermatillomania is a way for a person to cope with intense anxiety and stress. Meanwhile, another hypothesis explains that it is a way of repressing a person's rage against his parents who might be perceived as expecting absolute obedience from that person.

There are also recent surveys on pathologic skin picking. Based on these studies, excessive amounts of dopamine in the body or intake of drugs that further increase the level of dopamine can lead to that impulse of picking at the skin. However, this behavior is controlled when drugs that prevent the effect of dopamine are taken.

Other experiments, nevertheless, show that people with dermatillomania have lessened motor-inhibitory control than others who don't have the dysfunction; even though both groups have the similar opportunity to think about a number of things at the same time or jump from thinking of one concept to another. Which means that some brain pathways responsible for controlling movements and behavior in pathologic skin pickers may be affected.

With these concepts, it can be deduced that not all skin pickers have skin disorders before they've dermatillomania. An additional belief that all skin pickers have a psychosis is also debunked.

Treatment

There's absence of proof on how dermatillomania is to be treated. The fact is, now, there is no drug created specifically to take care of this problem. However, some interventions for other ailments like OCD and panic disorders could also be used for people with dermatillomania. Selective serotonin reuptake inhibitors (SSRI), which are usually used as pharmacological intervention for OCD, plus some drugs that are used in cocaine addiction may be used for compulsive skin pickers. Additionally it is said that an anti-epileptic drug called Topiramate may also be used. However ,, it is strongly advised to seek help from a psychiatrist before taking any medication.

Non-pharmacological interventions can also serve as cure for dermatillomania. Common behavioral treatments include cognitive behavioral therapy (CBT) and acceptance-enhanced behavior therapy. Habit reversal training, where the affected person is aided to become more alert to his issue, could also be used as treatment. In fact, some people are suggested to keep skin picking logs that allows them to enhance their degree of awareness on what they're doing and preferably, enable them to deal with it. Some articles introduced mindfulness-based cognitive therapy as the second way of addressing dermatillomania, which allows the person to learn to recognize his problem and accept it, even though the behaviour is unpleasant.