Why do we pick our skin? Well the reasons vary for everyone. For some it is habitual i.e. not knowing when they are doing it while others consciously do it in response to stress or boredom. No matter what the reason is, it is important to find out what triggers the skin picking so that one can prevent or at least minimize the urge to do it. Being aware as to why you are doing it will help you address the root cause and treat it accordingly.
Many people report that picking is a response to feeling stressed as picking helps reduce that stress. The inability to stop engaging in this behavior despite wanting to is known as compulsive skin picking disorder or excoriation disorder. According to Anxiety UK, a national registered charity:
There are many conditions of the skin that can cause someone to excessively pick or scratch. This does not necessarily mean thy have exoriation or compulsive skin picking disorder. The Diagnostic and Statistical Manual (DSM) cleary defines the criteria required for diagnosis of excoriation disorder. These are:
There are many people on dermatillomania support forums who report to have ADHD, asking if the two disorders are related, and vice versa on ADHD forum. Attention deficit disorder with or without hyperactivity or ADHD, is a disorder typically diagnosed in childhood and is characterized by inattentiveness or hyperactive-impulsivity. Although diagnosis of ADD required the presence of symptoms before the age of 7, it is a disorder that extends into adult life. According to the Diagnostic and Statistical Manual (DSM) the criteria for the diagnosis of ADHD are:
Excoriation Disorder, also known as Dermatilomania or compulsive skin picking disorder is a serious condition that is categorized in the Diagnostic and Statistical Manual (DSM5) as an Obessive-Compulsive and Related disorder (OCD-R). Sufferers compulsively pick at their skin until they cause damage to themselves. Stress and anxiety lead to an increase in picking and this compulsive behavior quickly becomes addictive. In her candid YouTube video about her struggle with the disorder, Lizzie, a 21 year old Dermatilomania sufferer from Newcastle, England opens up and explains this poorly understood disorder and its cause and offers tips for managing it. She admits that
this is a very hard video to make
We talk a lot about raising awareness on this blog. Awareness by those who are afflicted with a body-focused repetitive behavior (BFRB), and awareness from the medical profession and general public. So what's all the fuss about awareness anyway?
Awareness is defined as:
knowledge or perception of a situation or fact.
For people suffering with compulsve skin picking, the words 'beauty' and 'bfrb' used together seems like somewhat of an oxymoron. When you constantly pick your own skin, the last you thing you feel is beautiful. This brings with it immense feelings of guilt and shame for the damage you have caused your own skin. It should therefore come as no surprise that skin picking disorder is big business for the cosmetic and business industry. Not all, but many skin pickers spend large amounts of money on creams and cosmetics to heal faster or to cover up the evidence of their actions. One study hopes to examine this relationship in an effort to see how makeup affects people’s feelings about their BFRB. The Brain and Behavior Lab of Dr. Corey White is interested in learning more about the ways women with Body-Focused Repetitive Behaviors (BFRB’s) use cosmetic products (beauty products for the hair and skin) and how different factors of cosmetic use (time or money spent, number of products used) can be used to predict how severe someone’s BFRB is.
To participate, individuals must be:
click on image to play
We have spoken many a times about the important role bloggers and vloggers play in spreading awareness about skin picking disorder and other body-focused repetitive behaviors. Without awareness many people conitnue to suffer alone and in silence, never reaching out for help, and never receiving the treatment they need. We often feature some of the impactful videos we come across in the virtual community, and this video in particular seems to be making waves. The video was a collaboration between BFRB advocate Nicole Santamorena and Refinery29, an independent fashion and lifestyle online publication in the US. The video was shared on the Refinery29 facebook page on 10 February 2016, achieving 2,591,279 views, 14,766 likes and 7,348 shares by the time of this post being crafted! But what is most inspirational are the comments. As one facebook follower commented:
May compulsive skin pickers report also having a number of other chronic skin conditions such as psoriasis or eczema. It is even thought to be traced back to the onset of skin picking disorder or excoriation disorder for some, while for others the reverse relationship is true, whereby compulsive skin picking worsened the effects of eczema.
I am starting to think that it’s quite likely that the eczema I had on my face for all of my 20s was made worse by me and my habit of picking” – Ellican, skinpick.com forum
However onset is not the same as cause and this is an important distinction to make. Eczema does not cause excoriation disorder, and in severe cases, excessive scratching of the skin is solely attributed to the eczema as opposed to being indicative of a diagnosis of excoriation disorder. In fact one of the criteria for the diagnosis of excoriation disorder as outlined by the Diagnostic and Statistical Manual (DSM5) is that skin picking is not attributable to another medical skin condition such as scabies, eczema, psoriasis, etc. That does not mean however that the two conditions do not occur comorbidly.