In Syndromes & Disorders

About Skin Picking Disorder

Millions of people in the world discreetly suffer from skin picking disorder. Specialists refer to the picking skin disorder as other names such as excoriation disorder, dermatillomania, chronic skin picking, pathological skin picking, obsessive skin picking and more. The disease is characterized by the urge and the act of picking one’s skin despite any negative effects that may occur. People with the disorder usually cause severe irreversible tissue damage to the areas that they pick.

What Is Skin Picking Disorder?

Skin picking disorder is a psychological disorder that involves compulsively picking the skin on the face, arms, legs and other areas of the body. Such persons continue to pick at a specific site on the skin until it bleeds and scabs. Skin pickers will remove their scabs every time they reappear. People who suffer from this disorder may not necessarily create the original sore. A blemish such as a mole, mosquito bite or a healing wound may cause the person to get the urge to pick. The imperfection of the wound may cause the desire for the person to get rid of it.

Some chronic skin pickers do create the original sores, and then they aggravate those sores until they have deeply damaged the layers of the skin. Something that starts as a pin sized sore could end up covering a large portion of a sufferer’s skin.

Approximately 32 percent of skin picking occurs in the facial area. The scalp and arms are the second and third most popular picking sites for sufferers. Legs and arms are popular picking sites, as well.

What are the Symptoms of the Picking Skin Disorder?

The main symptom of the chronic skin picking disorder is the inability to resist the urge to pick the skin. Other symptoms that may arise because of the disease are symptoms such as scarring, infection, and pain because of the infected skin.

A person who is consumed with the act of skin picking may miss work, school, sports and other activities because of the overwhelming urge to pick the skin. For example, someone who has just developed a new scab may pick at it for an hour or until he or she removes the scar and causes it to bleed. This activity may take priority over other activities that should be higher on the list.

Obsessive skin picking can eventually cause depression and anxiety. The disease involves a painful cycle that includes destroying the skin, hiding the truth, and then starting the cycle all over again. The appearance of the tissue damage may make a person embarrassed to the point in which that person wears long-sleeved shirts or long pants to hide the scars. A person who has severe skin picking disease may become a hermit inside of his or her home. Such a person could also have a severe case of social anxiety and refuse to go to public functions or spend much time with friends or loved ones.

Who Gets Skin Picking Disorder?

All people of all genders, ages and economical classes are susceptible to developing skin picking disorder. However, studies have shown that the more than 85 percent of chronic skin pickers are women. The largest group of people who are affected by it are between the ages of 15 and 30 years old. The next largest group of people who develop skin picking disorder are between 30 and 50 years old. A small percentage of people over the age of 50 and under the age of 9 develop the disease, as well. Most of the people who suffer from this disorder have been suffering for longer than 10 years. Many skin pickers remember engaging in the activity as they were children.

What Causes Skin Picking Disorder?

Compulsive skin picking can come from a number of factors. One of the most common causes of obsessive skin picking is mental illness. The act of skin picking can be closely related to mental illnesses such as obsessive-compulsive disorder or personality disorders such as borderline personality disorder. Obsessive-compulsive disorder may be caused by a chemical imbalance in the brain. Some of the symptoms of OCD include a need for constant perfection and order. A person who develops a scab on his or her skin has a blemish that must be removed according to the obsessive-compulsive mind. A mole that is not symmetrical on the face may severely bother a person with OCD.

Borderline personality disorder is a condition in which a person has difficulty maintaining emotional equilibrium because of a poor upbringing. The individual never learns to react to situations appropriately and thus may conduct activities such as piercing or picking one’s skin as a way of letting out pain or anger. This type of person may pick up the skin picking disorder as a coping mechanism.

Some people have a predisposition to developing skin-picking disorder. Persons who have relatives with such a disorder are more likely to develop it than people who do not have ill relatives are. One cannot do much when genetics play a factor in disease development other than educating himself or herself fully. Educating oneself early can prevent the illness from coming to the surface.

Stress and Trauma can cause a person to pick his or her skin. A traumatic childhood event such as bullying or abuse may bring forth the urge for an adult to skin pick. The person may have used it as a way of calming down when chaotic things were going on in the home. The adult skin picker will continue to use this method of coping with similar psychological stimuli until he or she learns another method of coping.

Illnesses such as bipolar disorder that directly involve poor impulse control may play a small part in the development of skin picking disorders. A person who has trouble controlling impulses can easily become addicted to destroying his or skin repeatedly.

What to Do About Skin Picking Disorder

Anyone who has a family member who may be suffering from dermatillomania will have to be sensitive about the matter. The person who is doing the skin picking is hurting very badly, and that person is hurting himself or herself even more with the act of picking. A caring family member will want to approach the subject of getting help for skin picking very carefully as not to alienate the sick person. The first step in opening the lines of communication with a skin picker is letting that person know that he or she can trust.

The friend or family member must let the sufferer know that he or she is among loving family members who will support that person in his or her effort to heal. Some skin pickers may deny that they have a problem. An intervention may be necessary in such a case. An intervention is a large gathering between a sick person, his or her family members, and sometimes an intervention specialist.

A person who senses that he or she may have skin picking disorder can contact a psychological specialist, therapist or psychiatrist who can perform a test or two to see if an SPD exists.

How Is Skin Picking Disorder Diagnosed?

The diagnosis of a skin picking disorder would generally involve a series of visual examinations, question and answer sessions, and perhaps apsychiatric test. The doctor will want to know not just if the person has a skin picking disorder, but also what the root cause of the disorder is. If he or she can diagnose the root of the problem, then treating the disease will be easier. Currently, only 70 percent of people who pick their skin ever admit it to another person let alone a professional. Secondly, only 24 percent of people who have the disorder try to stop at all because the urges are so overwhelming. Skin picking is a difficult habit to break. Therefore, a caring specialist will need as much information about the sufferer as possible for a diagnosis.

Speaking with the patient for several sessions can help the psychological specialist to pinpoint the time in the patient’s life when the picking started and the reason that skin picking was chosen as a coping mechanism. A psychiatric evaluation can help the psychiatrist diagnose whether the skin picking illness is a part of another disorder or illnesse such as body dysmorphic disorder.

What Is the Treatment for the Picking Skin Disorder?

The treatment that the acting physician uses to cure a skin picking disorder will depend on the information he or she receives in the test. Some people who have obsessive and compulsive tendencies respond well to drugs that change the levels of serotonin in the brain. Selective serotonin reuptake inhibitors such as Escitalopram can help to balance the serotonin levels and decrease the person’s urges to performe compulsive picking acts.

A Specialist may use cognitive behavioral therapy to treat skin-picking disorder. Cognitive behavioral therapy is a style of therapy that teaches a person to change his or her unhealthy reactions to psychological stimuli with acts that are positive and beneficial. A therapist will try to teach a skin picker to channel his or her energy elsewhere when the urge to pick comes. The person can select from a wide variety of alternative actions such as gum chewing, drawing, painting, watching television, dancing, swimming, watching movies and more. A person with obsessive traits can be retrained to handle a situation differently, develop a new routine, and then become “obsessed” with the new routine. Such treatment involves clever strategies of tricking the patient’s brain to work for him or her.

Acceptance and commitment therapy is another form of treatment that a specialist may use to teat skin picking disorder. This treatment involves the open admission of the problem and a commitment to refrain from conducting the behavior. This means that the sufferer agrees to allow the pain, anxiety and strong urges to flow through him or her without acting on them. ACT therapy requires a strong commitment to oneself and a stubborn determination to beat the disease. Only approximately 1 percent of people who have tried to stop picking have succeeded. The road to recovery is long, but it is not impossible by any means.

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