A brief history of skin picking disorder

Annette Pasternek is an authority on the subject of compulsive skin picking disorder. In a recent video, she takes a look at the history of body focused repetitive behaviors (BFRBs)in science, as detailed the BPM (BFRB Precision Medicine Initiative) brochure of the TLC Foundation for BFRBs. If you prefer reading, here is a summary of her video:

History of Skin Picking Disorder in Science

• 750 B.C in the lliad, Agamemnon is literatures first trich-strer, “ whensoever to the ships he glanced… then rent he many a lock clean forth from his head.
• 400 B.C Hippocrates treat first documented case of skin picking in a woman who “groped about, scratching and plugging out hair” he tells the other healers to note whether he plugs his hair ,picks at his skin or weeps.
• 1602 in Shakespeare’s “Troilus and Cressida” Cressida grieves : “ tear my bright hair andscratch my praised cheeks, crack my clear voice with sobs and breaking my heart.
• 1893 french dermatologist, Francois Hallopeau conducts the first major scientific report of trichotillomania also coining the term.
• 1890s-1930s Sigmund Feud develops and practices psychoanalysis- the dorminant form of psychological treatment of time.
• 1920s worldwide, 33 articles are published highlighting hair pulling, nail biting, and skin picking , linking them to possible  causes: sexual perversion, personality disorder and hysteria. First “Cure” to trichotillomania is reported- cutting the hair short.
• 1997 the first medication study of skin picking disorder conducted by Daphne Simeon, M.D and D.R Stein; it finds fluoxetine effective in double blind test of fluoxetine (Prozac) vs. Placebo
• Dr. Keuthen establishes link between trichotillomania and menstrual cycle; study has not yet been expanded on.
• 1998 scientific journal CNS Spectrums devoted issue to trichotillomania, edited byDrs. Keuthen and O’Sullivan, and including a plethora of featured articles by Dr. Stien
• 2001 Dr. Keuthen and Christon published help for hair pullers self help book for audults with trichotillomania
• 2002 Scientific journal behavior modification releases special issue devoted to trichotillomania edited by Doug Woods and features articles that coins the term body focused repetitive behaviors
• 2002 first case studies of congnitive behavior therapy are done by T Deckessbach, P.H.D Dr. Keuthen and colleagues  at Massachusetts General Hospital.
• 2000 TLC begins its annual research grants program to fund BFRB research
• 2008 Dr. Woods and Michael Twohig P.H.D, publish treatment manual that combines habit reversal training with acceptance and commitment therapy techniques
• 2009 first epidemiological study of skin picking disorder is published by Stephania Hayes, reporting that 62.7% of people engage in some degree of skin picking and 5.4 % would meet clinical criteria for skin picking disorder ( which was still not formally acknowledged as mental illness)
• 2009 Dr. Grant conducts successful study on N-acetyl cysteine (NAC), a dietary supplement that modulates a neurotransmitter called glutamate, in adults with trichotillomania.
• 2016 Drs. Grant Woods and Stein serve on the obsessive Compulsive and related disorders workgroup to refine classification and diagnosis of trichotillomania and skin picking worldwide in the International Classification of Diseases (ICD-11)
• 2016 In Dr Grants study of NAC for skin picking disorder, 47% of patients are much or very much improved after 12 weeks of treatment.
• 2016 The trichotillomania learning center celebrates its 25th birthday with a relaunch as the TLC Foundation for Body-Focused Repetitive Behaviors, a name that better represents all the members of the BFRB community.