Dermatillomania and Dermatophagia

A young YouTuber who goes by the name of MilkPunk posted a video describing dermatillomania and dermatophagia as these are both disorders she struggles with. It takes great courage to publicly talk about these types of disorders as it can be a source of great shame and embarrassment. In the video MilkPunk tries to explain what the disorders are and the difference between them.

What’s the difference?

Both disorders are classified as body-focussed repetitive behaviors (BFRBs) because they are characterized by the irresistible urge to act upon one’s own body in a way that causes damage. In the case of these two disorders, the target area is the skin. The key difference is in the type of behavior the person is compelled to engage in. Dermatillomania, now known as excoriation disorder, is the repetitive picking, pulling or scratching of the skin. Individuals with compulsive skin picking disorder generally use their fingers, nails, and in some instances implements such as tweezers or pins to pick at the skin. Any part of the body can be a target. Some people pick at pimples and acne, while others tend to pull at scabs or scratch at areas of the skin that feels ‘bumpy’. Continuous picking eventually leads to scarring, which reinforces feelings of shame the individual experiences. Dermatophagia on the other hand, involves the compulsion to bite into the skin. Although not as common as skin picking, there are many who do engage in this kind of behavior. Generally the target of dermatophagia is the fingers, particularly areas around the nails.

What’s the big deal?

You may be wondering, but what is the big deal? Many people pop their pimples, bite their nails or the cuticles and flaky skin around it. Isn’t it just a bad habit? Well there certainly are many who engage in this behavior when nervous or stressed but are not considered as having a clinical disorder. The key feature of dermatillomania and dermatophagia is that the person desperately wants to stop doing it, but is unable to despite the negative impact it starts having on their functioning and the damage it causes. People who constantly bite the skin around the nails end up with discoloration, scarring and bleeding fingers. The constant exchange of bacteria between mouth and fingers, as well as having open wounds, can cause skin infections. Even worse, constant biting can result in tissue damage. Similarly with skin picking, constant picking, sometimes even digging into the skin can cause irreparable tissue damage and scarring, and in severe cases can also cause infection.

Identifying the problem is key

There is help available, but many people suffer in silence because 1) they are not aware it is a clinically recognized disorder, or 2) the shame and guilt about the behavior stops them from seeking help. However it is important to seek help. This website provides lots of helpful tips and resources, and you can also find more information about available treatment from the Trichotillomania Learning Centre (TLC).