This will come as no surprise to skin pickers, but research indicates that there is a connection between mind and skin. Our skin is the largest organ of the body is designed to protect us from the outside world, regulate what is happening on the inside such as body temperature, and provides us with a complex communication network both inside and outside our bodies. Through the skin we are able to integrate environmental cues and transmit intrinsic conditions to the outside world. Research has shown that stimuli received in the skin can influence the immune, endocrine, and nervous systems at both the local and central levels. It is through recognition of these research findings that a new discipline called psychodermatology has emerged. Dermatologists are recognizing that protecting the skin from aging and disease is a two-fold process that involves addressing both internal and external factors. Some of the frequently treated conditions are include trichotillomania and excoriation disorder.
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There is no universally accepted classification of psychodermatological diseases. However the most commonly used classification excludes psychiatric disorders with dermatological symptoms such as trichotillomania and excoriation disorder. However, people who compulsively pick their skin often report that the presence of imperfections such as acne, scarring or scabs is a major trigger to the behavior. Many describe the act of rubbing the fingers across the skin to feel for bumps and that this then sets in motion an irresistable urgency to pick at the area. Since conditions of the skin are precipitated or exacerbated by psychological stress, this implies that during times of heightened emotional stress our skin will be more likely to present with these triggering imperfections. Studies show that our emotions, particularly stressful ones, can unleash a torrent of free radicals and stress hormones such as cortisol that not only age our skin but can also cause a wide range of allergic and inflammatory skin ailments.
Excoriation disorder is characterized by a paradox of emotions, with feelings of release and pleasure reported during the act of picking, but quickly followed with feelings of intense shame and guilt. While picking is believed to be a maladaptive response to stress and anxiety, succumbing to the urge to pick in itself can be distressing and anxiety-provoking for the individual, which in turn can have a negative impact on the skin's ability to heal and repair thereby setting in motion a negative cycle. Psychodermatology employs a combination of psychological and pharmacological approaches to help the skin regain health, whilst at the same time breaking this cycle by addressing the underlying emotional factors our skin is reposnding to. Some of the techniques used include relaxation, meditation, hypnosis and self-hypnosis, psychotropic medications, biofeedback, and focused psychotherapy.