Dermatillomania Treatment Options - What Works Today?

Dermatillomania can be a devastating disorder to have. Also known as Compulsive Skin Picking, the disorder is marked by a number of physical conditions such as discoloration, scarring, and severe tissue damage. Yet the emotional and mental damage that is caused by dermatillomania can be far worse to cope with. This damage often manifests itself as:

• Depression
• Anxiety
• Low Self-Esteem
• Emotional and Social Withdrawal

Fortunately, those that are afflicted with dermatillomania have a number of treatment options available to them. These treatments options range from behavioral therapy to medication to alternative holistic care. If you are experiencing the negative effects of dermatillomania, then these treatments can help you stop the disorder at the door.

Professional Help and Behavioral Treatments

Seeking professional help and behavioral treatments is one of the best ways how to stop skin picking. However, it is important to note, right off the bat, that many conventional therapists and psychotherapists do not truly understand the compulsive skin picking disorder. There is even a lower percentage that knows how to effectively treat it. In fact, a large majority of therapists have never even heard of “dermatillomania,” “excoriation” (another name for the disorder), or “compulsive skin picking”. When you visit these therapists to talk about your problem, they don’t treat it as the serious disorder it really is. Instead, they tell you to “just stop it” or they suggest anti-depressants. It has been shown time after time that the most effective dermatillomania treatment is Cognitive Behavioral Therapy (CBT). This treatment can be further subdivided into Habit-Reversal Training (HRT). When seeking professional help, it is essential to select a therapist with extensive experience in both CBT and HRT. Habit-Reversal Therapy is perhaps the most simple dermatillomania treatment to understand. It is focused on making you more aware of your picking patterns. Though some of those with compulsive picking disorder know they are picking every time they pick, there are others that perform the behavior mindlessly, without knowing it. HRT teaches you to be aware of when you are picking and how much you are doing it. A skin picking “log” or “diary” is a key part of HRT. In addition to a skin picking log, HRT encourages patients to utilize “habit blockers.” These are often used in conjunction with a log. At first, they might include things such as comfortable gloves. These provide a barrier between the skin and unconscious picking. As a person progresses, “fidget toys” might be introduced to keep the hands busy during times the picking behavior might otherwise be exhibited. It is also interesting to compare Cognitive Behavioral Therapy with traditional therapies. CBT takes a far more proactive approach to treating dermatillomania. The patient works closely with the therapist to assess the problem and devise active, measurable steps toward alleviation. Furthermore, “homework” assignments are often created so that patients can work on treating their skin picking disorder at home. An offshoot of CBT is known as Mindfulness-Based Cognitive Behavioral Therapy. This form of dermatillomania treatment is concerned with learning to accept the uncomfortable psychological aspects of skin picking disorder to stop the behavior. Mindfulness shows that much of the psychological stress associated with skin picking disorder is not the result of the disorder itself but the result of repeated attempts to stop the disorder and eliminate the uncomfortable thoughts. Mindfulness-Based CBT teaches those suffering from the disorder to be aware of their feelings of depression, anxiety, fear, and stress, and to realize that these are not the problem. The attempt to control and eliminate these feelings is the real problem. The end goal of Mindfulness-Based CBT is to have patients become comfortable with their unpleasant thoughts, feelings, sensations, and urges without responding to them and performing the negative behaviors.

Group Therapy

Group therapy treatments can be essential in how to treat dermatillomania for many people. This treatment is much the same as Cognitive Behavioral Therapy, Habit-Reversal Therapy, and Mindfulness-Based CBT. The big difference is that it takes place in a group setting. Group therapy for skin picking and OCD is much the same as a support group. Members of the group share with each other, assess their problems, and create actionable steps towards alleviation. Though a therapist is present for group therapy, they might not play as active of a role as in independent one-on-one sessions. A big benefit of group therapy is that members can call on other members of the group for help outside of therapy sessions. Exchanging phone numbers is one way to do this. If you are having trouble or need help, there is always someone to call or meet with for support. Another form of group therapy for skin picking disorder is family therapy. Rather than combine a group of people suffering from dermatillomania together, this type of therapy takes a single patient and includes their family at the therapy session. No matter your age, having the support of close family members can greatly help you treat your problem.

Medication and Pharmacological Treatments

Taking medication is another common way how to stop skin picking. Though it is not the most common or effective method of treating dermatillomania, it can be helpful. The number one thing to note about pharmacological treatments is that there is no one medication that helps everybody. People respond differently to all types of medication. Medication is most often used to lessen the feelings associated with skin picking. For instance, the medication can be used to lessen the feelings and sensations of pleasure that skin picking provides people with the disorder. When used alongside behavioral treatments, this can help the patient respond to behavioral or habit-reversing techniques that they might not have been able to learn otherwise. Selective Serotonin Reuptake Inhibitors (SSRIs) are one of the most common pharmacological treatments for compulsive skin picking disorder. SSRIs are often used to treat OCD. Though they are often prescribed, there are not yet any clinical studies that show they are effective at treating the disorder. Doxepin, clomipramine, naltrexone, pimozide, and olanzapine have all been shown to be potentially effective at reducing the picking behavior. Medications for skin picking disorder are not solely focused on prevention of picking. In fact, the majority of them target the causes behind skin picking, depression, anxiety, and stress. For this reason, many doctors prescribe a number of different anti-depressants to patients with dermatillomania. Most of these medications need to be used on a daily basis. A small number of them are only used in extreme situations, where skin picking has been triggered by particular feelings or events. Finally, a variety of anti-itching medications and creams are prescribed to treat people with dermatillomania. Some people with the disorder pick at their skin because it actually itches. These medications prevent the itchy feeling and thus hope to prevent picking. Some medications are also used to prevent and reduce skin conditions like eczema and acne. As these are often some of the initial causes of skin picking disorder, this type of medication can be very effective, especially when combined with professional Cognitive Behavioral Therapy.

Alternative and Holistic Treatment Methods

There are a number of alternative and holistic treatment methods for skin picking. It is important to state that these methods are not backed up or approved by the majority of scientists. However, some people have experienced success with them. At the same time, it is mostly advisable not to rely solely on these treatment methods. You should combine them with Cognitive Behavioral Therapy and possibly medication for the best affects. One of the most common alternative home remedies for skin picking disorder is diet. A change in the diet can introduce essential nutrients into your body that a) prevent itching and b) lessen the risk of depression, anxiety, and stress. A change in the diet can likewise eliminate certain foods and chemicals from your diet that could be having negative affects on itching and your mental state. Focus on eliminating processed foods from your diet as these contain several unhealthy chemicals and preservatives. You should also reduce the amount of sugars and fats that you eat. Including foods that are rich in vitamin A, zinc, and magnesium can all help with skin picking. Meditation is an alternative remedy that has been shown to be highly effective in treating dermatillomania. Meditation increases mindfulness so that you are more aware of and at ease with your body. It can significantly reduce stress. For these reasons, meditation can be a great way to help treat skin picking. 5 minutes of mediation per day will give you a fair share of calming benefits. Additional meditation at times of high stress or anxiety can thwart their negative effects and prevent you from falling back on picking your skin. In some cases, hypnosis has been shown to help treat skin picking. Though it is not an instant cure, it can be added to a treatment program with great results. In many ways, hypnosis, whether from a trained professional or self-hypnosis, is like meditation. It produces a calming and relaxing state that can greatly help reduce stress. Hypnosis can also help in reversing skin picking habits and protect you from skin picking triggers and stressors. Seek the guidance of a professional to learn the best hypnosis techniques. There are a host of other “alternative” methods of dermatillomania treatment although many of these aren’t worth discussing here. These are treatments that have been shown almost definitively not to work. They include fads, “miracle cures,” and the like. In other words, a large portion of them are “scams,” aimed at making money and not actually helping people. You are better off sticking to alternative and holistic treatment methods like dieting, meditation, and hypnosis rather than pay big money for these.

Help, Support, and Coping

As discussed above, an essential component of how to treat skin picking is help and support. Joining a skin picking support group is an excellent way to stay connected with others and receive emotional help in times of distress. Being involved in such a group is the number one way to cope with skin picking, both during other treatment processes and after treatment. Joining such a group can help you cope by showing you that you are not alone when fighting your compulsive disorder. Dermatillomania support groups can be easily found online. If there is not a brick and mortar meeting in your area, there are plenty of online groups that are nearly as effective.

Maintenance Treatments and Relapse Prevention

Because skin picking is such a difficult disorder to tame, maintenance treatment is essential. Staying on top of your game is the key to preventing a relapse. Unfortunately, relapses are all too common in people with skin picking disorder. Regularly visiting both a doctor and a therapist can greatly improve your chances of not relapsing. A doctor can check out how you are doing physically and assess your general health. A therapist can talk to you about your disorder, see how you are doing, and advise additional treatments if necessary. It is actually a great idea to visit with your therapist on a regular basis to prevent relapse altogether. You should do this even after you have stopped picking your skin. Finally, the support groups discussed several times already are a phenomenal way of providing maintenance treatment and preventing relapse. They give you the tools that you need to keep skin picking disorder under control. Such a group acts as a support line if you feel yourself nearing relapse.

How to Treat Dermatillomania

As you can see, there are a large number of different ways that dermatillomania can be treated. You can choose to use any of the treatments above individually or combine two or more of them together. The best way to figure out which treatment is right for you is to visit a professional. Make sure to find a doctor or therapist with experience in both CBT and dermatillomania for the absolute best results possible.