If you have developed a habit of picking your skin, you might find you cannot stop. You might even know that what you are doing is harmful and understand its negative effects on your physical appearance, health, and emotional well being, but still find you cannot stop. Those that have this problem – the problem of compulsive skin picking – are likely afflicted with a disorder known medically as dermatillomania. Also known as skin picking disorder, the condition can be serious and it often has characteristics of OCD and other OCD related disorders such as trichotillomania. As much as you want to stop what you are doing, you find that you cannot. Worse yet, you might be experiencing feelings of shame, embarrassment, or alienation and these feelings make it even harder to share with others. You might also feel that others won’t regard your problem as serious – or even a “real” problem at all. All of these problems afflict those with compulsive skin picking. Below is a primer on the disorder and a discussion of its relationship with Obsessive Compulsive Disorder (OCD).
Compulsive skin picking can be defined simply. It is the uncontrollable picking, touching, rubbing, or scratching of the skin. It is often done in an attempt to remove small, often perceived, imperfections and irregularities. The behaviors associated with compulsive skin picking can cause serious damage to the skin. Among the many symptoms of skin picking disorder are discoloration and scarring. In the most serious of cases, severe tissue damage and visible disfigurement are common. Along with the physical symptoms of the disorder come a host of mental and emotional symptoms. Feelings of shame, embarrassment, alienation, and depression often plague those with compulsive skin picking. A feeling of helplessness – from not being able to stop or discuss your problem – can further contribute to an overall feeling of despair. Studies have shown that 11.5% of those afflicted with skin picking disorder have attempted suicide at some point in their lives. The causes of skin picking disorder vary widely. It is often considered closely related to Obsessive Compulsive Disorder. Some researchers see it as a primarily hereditary disorder, much like some cases of OCD. Others see it as a response to feelings of suppressed rage during childhood. The most popular hypothesis on the cause of skin picking disorder is that it is a coping mechanism to deal with feelings of turmoil, arousal, stress, and despair. There is currently no single treatment for compulsive skin picking. Several different treatments are in use with results that vary widely. Perhaps the most effective form of treatment is habit reversal therapy. A number of pharmacological treatments are in the process of being developed.
Compulsive skin picking is closely related to several other compulsive disorders. Chief among these are other Body-Focused Repetitive Behaviors (BFRBs). BFRBs are compulsive disorders in which people can cause harm to themselves or to their physical appearance. Compulsive hair pulling (trichotillomania), severe and obsessive nail biting, and repetitive biting of the inside of the cheeks are all BFRBs as well. BFRBs are themselves closely related to OCD. In fact, some scientists categorize them as symptoms of OCD. However, most researchers make a clear distinction between the two, although they agree they are related. In fact, compulsive skin picking is classified independently in the DSM-V, in the category of "OCD and related disordes". It's official name is Excoriation Disorder. Most BFRBs occur for the same reasons. People with the behavior perform it when they are anxious, afraid, excited, or bored. Some people even feel that such behaviors are pleasurable. Most BFRBs eventually end up negatively affecting a person’s life, whether this is their work or their family and social relationships. All in all, skin picking is a compulsive disorder because it is a behavior that the patient feels like they have to do. They do not feel like they can stop, even though they want to, and often have an incredibly difficult time making changes even when involved in treatments.
As was mentioned several times already, there is a close relationship between compulsive skin picking and Obsessive Compulsive Disorder. Both disorders involve “repetitive engagement in behaviors with diminished control.” Another close similarity between the two is that they often decrease the overall levels of anxiety felt by patients. The primary similarity between the two are the feelings felt by those suffering from them. When the negative actions are performed, the person often knows that what they are doing is painful and self-defeating. Most people experience these feelings even as they perform the compulsive actions. What makes OCD and compulsive skin picking especially confusing for those afflicted is the fact that many people actually find pleasure, comfort, and emotional release in the act despite knowing that it is not healthy. This, in part, influences them to continue the behavior even though they might want to stop. Many of those with OCD believe that it is something to hide because it is not what normal people do. Coupled with public stigma, this is what prevents a large number of sufferers from ever seeking treatment and talking about their problems. Shame is a major component of both compulsive disorders. Unfortunately, tragically, this shame often exacerbates the problem. The shame causes a cycle of self-destruction where the shame causes the behavior and in turn the behavior causes more shame. This marks both those with OCD and compulsive picking disorder. Also of note are the rare instances where people aren’t aware of their compulsive behaviors. There is record of people with both Obsessive Compulsive Disorder and skin picking disorder who are unaware of what they are doing. Oftentimes, they only become aware of the problem when someone else points it out to them.
If you are suffering from compulsive skin picking, it is essential you realize it can be a serious disorder and not just a bad habit that you have formed. For these reasons, it is important to treat it as such and talk to a professional about it as soon as possible. Compulsive disorders are very hard to treat independently without the help of experts.
For more information about Dermatillomania causes and treatment, get the Complete Guide to Picking Disorders today.