Excoriation disorder

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

File:Dermatillomania fingers.jpg

Disfiguration of the distal and proximal joints of the middle and little fingers.

Sufferers of dermatillomania find skin picking to be stress relieving or gratifying, though it can still be painful as it would be for anyone else.

Habits of dermatillomania sufferers

Episodes of skin picking are often preceded or accompanied by moments of tension, anxiety, stress, or paranoia and sedentary actions, such as sitting on a computer. 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,stomach, 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, many 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 interferes 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. The disorder is typically found among females more than males.

Causes and treatments

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

In some animal models, it has been shown that animals that who excessively pull their hairs have more endorphin receptors in their brain than animals who do not. Endorphin receptors enable endorphins to have an effect on the brain. If this is true for humans, people who are particularly compulsive about their repetitive habits may have more endorphin receptors in their brain as well. This may explain why sufferers get more enjoyment out of picking their scabs than others.

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, self-hypnosis and meditation have also proven useful for some patients. They are also sometimes prescribed medications, such as those prescribed for obsessive compulsive disorder. Artificial fingernails (acrylic or gel) have been found to be very useful in stopping the picking behaviour.

Synonyms

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

Hyponyms

• Compulsive face picking
• Skin picking
• Scalp picking
• Cheek biting
• Finger Picking

See also

• Dermatophagia
• Morgellons
• Onychophagia
• Trichotillomania

External links

• SPOM! Stop Picking on Me! Site for Compulsive Skin Pickers
• Los Angeles Body Dysmorphic Disorder & Body Image Clinic: Compulsive Skin Picking
• OCD Center of Los Angeles: Compulsive Skin Picking
• Dr. Grossbart: How to Stop Compulsive Skin Picking and Scratching
• Dermatillomania Support
• Dermatillomania Center - Information About Dermatillomania