The first step in treating dermatillomania, like any other psychological disorder, is to acknowledge thet there is a problem and that you need help to address it. Research on treatment of dermatillomania and other body focused repetitive behaviors (BFRBs) is limited. Although there is no definitive cure, there are a lot of treatment options recommended. Some may not work for you as much as they work for others. The trick is to find something that helps reduce your urge to pull. In this post we will discuss hypnotherapy as a treatment option.
Hypnotherapy is a two way process between the therapist and the client, a professional partnership. People cannot be hypnotised unless he or she agrees and co-operates. What hypnotherapists do is, by definition, therapeutic. Stage hypnosis is very different and is considered as a form of entertainment.
Everyone dealing with compulsive skin picking faces huge challenges of constantly picking their skin. For most dealing with compulsive skin picking, the primary trigger is stress. Stress at work, stress at home – whenever you feel anxiety, fear or worry, you’re more likely to indulge in the compulsive behaviour. Unfortunately, skin picking does nothing to relieve the stress and ultimately just adds to it. A big part of skin picking treatment and tips focuses on learning better ways to handle stress as well as ways to recognize triggers before they happen so you can be more vigilant about actively choosing not to pick your skin.
There are 2 methods of habit reversal for reducing picking - reducing the urge to pick by limiting exposure to the triggers for picking; and resisting the urge to pick by finding alternative actions or tasks that competes with the act of picking.
I am a 24yo female, I have probably gnawed at myself since I was 5!...I Googled "what is it called when you eat your finger skin". And came up with dermatophagia.
WolfBiterGigi is a 24 year-old female who came to the Skinpick.com forum looking for answers and for support. Dermatophagia is considered to be a symptom of dermatillomania or compulsive skin picking, Both dermatophagia and dermatillomania involve compulsions surrounding an individual’s skin. Dermatillomania sufferers will just pick at their skin and will not eat it, whereas dermatophagia sufferers will bite or ingest the picked skin and are often referred to as 'wolf-biters'. Many sufferers of dermatophagia start out with compuslive skin picking. 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 and often also goes hand in hand with another body focused repetitve behavior known as onycophagia or compulive nail biting.
People who have limited knowledge about skin picking often do not consider it as a serious problem. Awareness about excoriation disorder has only recently taken an upsurge with relatively few people knowing that such a condition even existed just a few years ago. Those with it usually feel embarrassed or ashamed to discuss it as many people misunderstand it. People that suffer from dermatillomania exhibit symptoms that include repetitive touching, rubbing, scratching, picking at, and digging into their skin. Some people do this to remove irregularities or perceived imperfections while others do it obsessively for other reasons such as relieving stress or just being bored. The behaviours associated with dermatillomania often result in the discoloration of skin and eventual scarring. Severe tissue damage can even occur in the most serious of cases. This habit is therefore thought to be a form of self-soothing to assuage feelings of extreme anxiety and depression. The question then is, what causes a person to cause pain and unwanted damage to themselves?
Typically, individuals with excoriation disorder find that the disorder interferes with daily life. Hindered by shame, embarrassment, and humiliation, they may take measures to hide the evidence of the disorder by not leaving home, wearing long sleeves and pants even in heat, or covering visible damage to skin with bandages. Activities such as typing may be painful for those who pick at their fingers or hands, or walking for those who pick at the soles of their feet
For many dermatillomania sufferers, the face is a target of compulsive skin picking. This can often result in severe scarring and an in severe cases permanent damage to the appearance of the skin. Dermatillomania is already a disorder that causes the individual immense shame and guilt, but these negative feelings are further perpetuated by the physical consequences of the picking behavior. This can lead to the person avoiding social situations for fear of being harshly judged for their appearance, fears of bullying, or for fear of people asking too many questions about the condition of their skin.
Last month we shared a video about a technology product called Slightly Robot, a device that tracks your hands and vibrates each time you do certain movements. We think this is a great device for developing awareness, an important aspect of Habit Reversal Training (HRT) in Cognitive Behavioral Therapy (CBT). The founders and creators of Slightly robot, Matthew and Joseph Toles graciously took the time to answer some of our questions about Slightly Robot. This is what they had to say:
While body-focused repetitive behaviours (BFRBs) such as excoriation disorder are gaining increased awareness, our knowledge about the disorder is still in its infancy. For example, even though research has found evidence of some plausible causes for compulsive skin picking, there is still no known single definitive cause. Some evidence points to hormonal imbalances, some indicates the cause is neurobiological, while genetic correlation also holds merit. We may not be able to change our genetic make-up, but we certainly can influence our neurobiological processes and our hormone levels through diet. Could what we eat therefore aggravate the urge to pick, or even place us at higher risk for developing a skin picking disorder in the first place?
Methods of cognitive behavioral therapy such as Habit Reversal Training have shown to be effective in the treatment of body-focused repetitive behaviors (BFRBs) such as excoriation disorder and trichotillomania (compulsive hair pulling). Habit Reversal Training is a multicomponent behavioural treatment package originally developed to address a wide variety of repetitive behaviour disorders and has four main components: Awareness Training, development of a competing response, building motivation and generalisation of skills.
There are many different theories about the cause of excoriation disorder, and it may be possible that more than holds true as the theories are often supported by research. One such theory is that it is caused by sensory processing disorder (SPD), whereby the person is sensory seeking. In this instance the person may benefit from self-regulating or sensory tools as a more desirable alternative to skin picking. One such tool found to be effective as a competing response are fidget toys. These are self-regulating tools that can calm or enable individuals to focus. There are a variety of different fidget tools easily accessible online.
This video is from Bethany, a British woman who vlogs as "Freedom, Birdie!" about vegan living and her lifelong struggle with dermatillomania. Also known as "skin picking" or "excoriation disorder" it's a body-focused repetitive behavior classified in the Diagnostic and Statistical Manual (DSM) as related to Obsessive Compulsive Disorder. Patients are unable to resist picking at skin imperfections in an attempt to correct them and often end up causing themselves scarring and damage. Like all body-focused repetitive behaviors it is an impulse disorder - the person is unable to prevent themselves from doing it and may not even be consciously aware of the behavior.
In this video, Bethany talks about having a relapse after being able to keep herself from picking for 180 days - and how she has no clue why she relapsed at this point.
"I've been seduced by the feeling I get, the pay off I get when I pick at my skin."