As with any condition of the body or mind, dermatillomania does not discriminate. Celebrities are often heralded by fans as being perfect and untouchable. Yet, celebrities also experience the trials and tribulations of human emotion, and are also vulnerable to stress and anxiety. Unfortunately conditions like dermatillomania evoke feelings of shame and embarrassment in the person challenged by it, and is therefore not a condition that is publicized, especially by those in the limelight. However, in 2012, a well known singer-songwriter became one of the first celebrities to publicly admit to having dermatillomania.
One of the first and greatest hurdles to overcome to successfully be skin-pick free is to open up to someone who cares and to seek help and support. So imagine the courage it must take to stand up in from of hundreds of people, in front of a camera, and admit that you are a skin-picker. In this video clip, a brave woman named Caroline does just that.
Not only does she admit to being a skin-picker, but she also describes her skin-picking habits in detail and gives an emotional account of how skin-picking has impacted her life socially and academically. She describes the journey that so many with dermatillomania can relate to, in which the shame and guilt of her skin-picking habits drove her to engage in other destructive behaviours such as drug abuse. She describes a life spiraling out of control and failed attempts at managing her condition with therapy and support groups.
Dermatillomania or excoriation (skin picking) disorder is not a very well known condition, primarily because the behaviours that manifests in this disorder are not often shared by people who engage in them. As a skin-picker you are often riddled with shame and guilt about your behaviour, covering up the ‘evidence’ to protect your closely guarded humiliating secret. Ironically the secrecy often isolates you from those you care about and, ironically, prevents you from receiving the much needed support and help you need to overcome it.
Onychophagia is a behavioral disorder characterized by compulsive nail biting. It is categorized with other disorders such as skin picking disorder (aka dermatillomania or excoriation disorder) and hair pulling disorder (trichotillomania) under the umbrella term body-focused repetitive behaviors (BFRB). These are compulsive habits that are automatic in nature and in its mildest forms are not perceived as socially unacceptable and therefore often not recognized by the individual as a clinical problem. Of the BFRBs, compulsive nail biting is the most socially accepted habits, viewed as simply a ‘nervous habit’. It is also commonly occurring in childhood with frequency tending to decrease by adulthood. However, the behaviour is known to intensify or persist through adulthood, and the severity of onychophagia can range from a very mild presentation to behaviours that are so severe that physiological complications occur.
The Trichotillomania Learning Centre (TLC) was initially aimed at providing support to people with thrichotillomania (hair pulling disorder). However as TLC has grown it has come to recognised the links between trichotillomania and other conditions such as skin-picking disorder (SPD) which are classified as body-focussed repetitive behaviours (BFRB). They have since evolved into a prolific organization in the support of education, awareness and research into the cause and treatment of all BFRBs including skin picking. However, since skin picking, also known as dermatillomania or excoriation disorder, is still a growing community, resources and support to the skin-picking community is not at the same level as programs focused on hair pulling. As such TLC are conducting a survey to understand needs of the skin-picking community to guide them in creating and improving programs that will benefit those suffering from skin-picking disorder.
There has been disagreement in the medical fraternity about the classification of skin-picking disorder (SPD) with some grouping it with obsessive compulsive disorders (OCD), while others categorising it as a body-focussed repetitive behaviour (BFRB). One might question what the importance is of classifying the skin-picking disorder into any specific category when they are all so similar. The importance lies in the advancement of knowledge and understanding of the causes and developing guidance of treatment of the condition. There are distinct clinical differences in the presentation of obsessive compulsive disorders and the underlying causes, and those of BFRBs. As such, there are also differences in the treatment approaches that are most effective within each category of disorder. In a recent 2012 internet study comparing the rates of problematic BFRBs in individuals with SPD, it was found that skin-picking disorder is associated with body-focussed repetitive behaviours.
Dermatilloma is a skin-picking disorder that not only leads to skin damage, but the severity of the behaviour is directly proportional to the social and emotional distress experienced by the person who engages in the behaviour. Anyone with a skin-picking disorder will testify to the shame and embarrassment the condition causes. People with dermatillomania (official term: excoriation disorder) often suffer in silence, unaware of how common the condition actually is. The explosion of web-based technology has given millions of people suffering from dermatillomania access to information and enabled individuals to seek support anonymously.
Dermatillomania or skin-picking disorder manifests in many forms. Common areas that are the focus of skin picking include the face, arms, neck, and scalp. Skin-picking disorder is part of a cluster of disorders known as Body-Focussed Repetitive Behaviour (BFRB). When dermatillomania presents as an obsessive-compulsive scalp-picking behaviour, it can often be confused with another BFRB called trichotillomania. Trichotillomania is a hair-pulling disorder, which leads to hair loss and sometimes baldness. However, scalp-picking is motivated specifically by the person’s urge to pick at the skin of the scalp, whereas hair-pulling is the urge to pull the hair out of the scalp.
Cosmetics brand Dermablend Professional recently launched an advertising campaign on YouTube called the Camo Confession Campaign. The cosmetics industry is often slated for being superficial and encouraging women and girls to strive for the unrealistic ideal of perfection. Dermablend Professional hopes to challenge this view with the Camo Confession ad campaign. The campaign kicks off with a young model named Cassandra removing her make-up and sharing her personal story of shame and ridicule as a young teenager because of her terrible facial acne. Even though she is talking about acne, we thought the heart of the story is something that many who suffer with skin-picking disorder can relate to.