What Everybody Must Know About Dermatillomania
Dermatillomania is a disorder that involves recurring and impulsive picking of the skin which often results to impairments of the skin. This impulse control disorder is also known as pathologic skin picking, neurogenic excoriation, and compulsive skin picking. This is commonly associated with obsessive-compulsive disorder (OCD), although some experts say that it is more related to substance abuse disorder. This is because dermatillomania may give pleasure and may decrease the feelings of anxiety of a person with the disorder.
People who suffer from dermatillomania primarily exhibit skin picking when they are stressed, tense, or anxious. Most pick at their skin when they feel that there is something wrong with their skin or when they note some skin irregularities or blemishes. Some may even find skin picking as a way to release their tension. They typically pick at the skin on their face, fingers, toes, lips, chest, stomach, arms, legs, or even their scalp. Scars are usually seen on these body parts.
Because of constant compulsive skin picking, these people are at risk of skin infections. This is especially true when their fingers or the tools they use in skin picking are not clean. They are also prone to tissue damage. In fact, some patients with dermatillomania have swollen, bleeding, or calloused skin. There are also a few patients who have systemic infection, or septicemia as a complication of dermatillomania.
People with dermatillomania also suffer from low self-esteem, guilt, and embarrassment. These intense emotions may even lead to further self-harm. In fact, there are some people with this disorder who have suicidal tendencies.
Experts say that there are many theories explaining the probable cause of dermatillomania. One of these theories states that dermatillomania is a way for a person to cope with intense anxiety and stress. Meanwhile, another hypothesis explains that it is a way of repressing a person’s rage against his parents who might be perceived as expecting absolute obedience from that person.
There are also recent studies on pathologic skin picking. According to these studies, excessive amounts of dopamine in the body or intake of drugs that further increase the amount of dopamine may lead to that impulse of picking at the skin. On the other hand, this behavior is controlled when drugs that inhibit the effect of dopamine are taken.
Other studies, on the other hand, show that people with dermatillomania have decreased motor-inhibitory control compared to those who do not have the disorder; although both groups have the same ability to think about a number of things at the same time or jump from thinking of one concept to another. This means that some brain pathways responsible for controlling movement and behavior in pathologic skin pickers may be affected.
With all these theories, it can be deduced that not all skin pickers have skin disorders before they have dermatillomania. Another belief that all skin pickers have a psychosis is also debunked.
There is lack of evidence on how dermatillomania is to be treated. In fact, at present, there is no drug specifically designed to treat this disorder. However, some interventions for other disorders like OCD and anxiety disorders may also be used for people with dermatillomania. Selective serotonin reuptake inhibitors (SSRI), which are typically used as pharmacological intervention for OCD, and some drugs that are used in cocaine addiction may be used for compulsive skin pickers. It is also said that an anti-epileptic drug named Topiramate may also be used. Then again, it is strongly advised to seek help from a psychiatrist before taking any medication.
Non-pharmacological interventions may also serve as treatment for dermatillomania. Typical behavioral interventions include cognitive behavioral therapy (CBT) and acceptance-enhanced behavior therapy. Habit reversal training, in which the patient is assisted to become more aware of his condition, may also be used as intervention. In fact, some patients are advised to keep skin picking logs in order for them to increase their level of awareness on what they are doing and hopefully, enable them to control it. Some articles presented mindfulness-based cognitive therapy as another way of treating dermatillomania, which allows the patient to learn to recognize his condition and accept it, despite the fact that the behavior is unpleasant.
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