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Dermatillomania, which is also called a compulsive skin picking, is a psychological disorder that leads to the damage of skin. The face is usually the main object for the patients suffering from the disorder but dermatillomania may involve almost each part of the body. It is a way of self- mutilation. The disease is quite serious, because patients suffering from it may experience bruises, infections, bleeding, scarring, and even cause permanent damages to their skin. Such behavior is often unconscious, and it appears quite difficult for the patients, which experience compulsion, to stop themselves (Hyman and Pedrick, 2010).
Causes of Dermatillomania
Probably, the source of dermatillomania is a blend of environmental and biological factors. Most animals experience excessive scratching and skin picking. In addition, it is a common knowledge that grooming is one of their typical behaviors. However, engaging in obsessive grooming leads to appearing of patches and bald spots of missing hair, which can increase stress even more.
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Dermatillomania and OCD
Dermatillomania is often recognized in the patients suffering from OCD, obsessive uncontrollable disorder. In addition, almost a quarter of the patients with this disorder also have dermatillomania. A quarter of patients suffering from dysmorphia have CSP. The disorder tends to be transmitted genetically. The main reasons, which lead to developing of dermatillomania, are mentioned further.
Self-Soothing
During the periods of stress, most patients feel an urge to soothe themselves, and they normally feel better after picking themselves. Dermatillomania usually has a relaxing effect on the body systems.
Stimulation
During the periods of low activity, dermatillomania provides people with a required stimulation of their nervous systems. Thus, it keeps them alert and helps avoid a distractive condition.
Perfectionism
Patients who suffer from dermatillomania can check their appearance in the mirror a lot of times, examining their bodies for the slightest irregularity. They usually hope to achieve a perfect look. However, they become even worse despite of their picking efforts. As a result, much harm is caused to the skin due to unrelenting thoroughness (Shahrokh, 2011).
Dermatillomania leads to a self-perpetuating cycle. It may result into anxiety and shame, which might lead to additional picking. The common behaviors of the patients suffering from compulsive self-mutilations are not harmful, though they can turn to extremes. Skin pick (dermatillomania), skin bites (dermatophagia), hair pull-off (trichotillomania), and nail bites (onychophagia) are the main aspects of the same issue (Shahrokh, 2011).
Treatment for Dermatillomania
Dermatillomania can become unavoidable and might interfere with work, relationships, and life in general. Unawareness of this problem and mistreatment of this actual disorder are common among people who really suffer from it. Patients with CSP might feel insane, get out of control, and become entirely helpless concerning their dangerous condition. Fortunately, the disorder responds well to the behavioral therapy and medication.
Medication
The medicines used while treating dermatillomania are the same as those used for the OCD patients. Medications that alleviate skin picking are to be taken during a couple of weeks before the effect will be reached. However, in some cases, the medicines might not work as expected. Usually, 65% of patients get a positive result. The treatment must not be considered as a solution on their own problems, but as an element of help in a form of therapy sessions (Shahrokh, 2011).
Therapy
Cognitive-behavioral therapy is identified as a way of treating dermatillomania and other related disorders. The therapy involves several different procedures outlined below.
Habits Reverse Training. This is a 4 step process that teaches the patients on how to loosen up, breathe, feel centered, or take muscle reaction exercises. Habit Reversal Training includes stimulus control, individual monitoring and social assistance.
Self-Monitoring.The therapyhelps the patients with dermatillomania become aware of their actions. As their behavior is often involuntary, awareness improves by keeping a record of all picking patterns. The process of recording these instances interrupts the procedure and therefore, reduces the picking (DeAngelo, 2011).
Stimulus Control. This is a behavioral form of treatment that assists patients to identify, eliminate, change the environment’s causal factors and avoid moods or situations that trigger dermatillomania. The objective is to control the triggers and develop the new learned links between the patients’ urges and alternatives (non-destructing behaviors). For instance, if picking occurs while lonely, the patient will be expected to spend more time with others. If picking occurs in front of the mirror, the patient may be requested to cover the mirrors at the place of residence, though most of the patients resist this therapeutic measure (Grant and Potenza, 2011).
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Competing Response. This is a method intended to give the patients a substitute to picking, which may involve knitting, beading, fidget toys, or other activities that keep hands busy. The above mentioned techniques are provisional ways of assisting the patients to resist their urge of picking. When the urge disappears, these methods become less significant. The duration taken eliminates the behavioral patterns depending on the extent the patient has had the disorder and how thorough the patients are in defying the urges. Though the therapy usually takes from 10 to 12 weeks, sometimes it may take even twelve months to get rid of the obsessive behavior (Hyman and Pedrick, 2010).