Dermatillomania skin picking disorder causes

Everything you need to know about dermatillomania – from causes of the skin picking disorder to treatments

8th April 2024 | Author: Victoria Woollaston-Webber

Dermatillomania is a skin picking disorder that can cause people to uncontrollably pick at the skin on their fingers, lips, face and more. Here are its causes and treatment options


Many of us can relate to the occasional urge to pick at a scab or squeeze a spot – there’s a reason why pimple popping videos are so popular and garner millions of millions of views.

However for some, this occasional skin picking can turn into a compulsion known as dermatillomania; a chronic mental health condition that can have a profound impact on a person’s life, leading to social isolation, decreased self-esteem, and even physical complications.

Often going unnoticed, dermatillomania is surprisingly prevalent, according to dermatology consultations. Around 2% of people are said to have these compulsions, which means millions of people worldwide struggle with this condition.

This guide explains more about dermatillomania, from its potential causes and triggers and how to get help.


What is dermatillomania?

Dermatillomania causes and treatmentKairyu7/Wikimedia Commons

Dermatillomania, also known as an excoriation disorder, is a chronic condition characterised by uncontrollable picking at the skin.

It’s not too dissimilar to trichotillomania, which is a condition where people incessantly pick at their hair and pull out their eyelashes and eyebrows.

Dermatillomania goes way beyond picking at a spot or removing a scab. Instead, it’s a relentless urge to pick at any perceived imperfection – real or imagined. This can include moles, freckles and scabs, but can also see sufferers picking at healthy skin.

It can be mild, and involve simply picking at the skin on your fingers and around your fingernails (this is the most common form), or it can be more extreme and involve picking at your scalp, face, body, lips, fingers, hands and more.

The picking habits can be driven by a number of triggers – we explain more below – but regardless of the trigger, the picking can often lead to significant damage, scarring, and even infections.

The repetitive nature of dermatillomania can also become a source of shame, which can see picking being done in private with people hiding the wounds. This can lead to social isolation and a decline in overall well-being.

This relentless picking disrupts the skin’s natural healing process, leading to scarring and an increased risk of infection.

FURTHER READING: Trichotillomania: What is trich, what causes it, and is there a trichotillomania treatment that works?What stress does to your skin and hair – and how to reduce and combat it


What Causes Dermatillomania?

The exact cause of dermatillomania remains unknown, but it’s likely a combination of factors. Some theories suggest a link to underlying mental health conditions like anxiety, depression, or OCD.

Others point to neurochemical imbalances that contribute to compulsive behaviors. Existing skin conditions like eczema or acne can also act as triggers.

  • Underlying mental health conditions: Anxiety, depression, and OCD are often linked to dermatillomania. The repetitive picking can become a way to cope with negative emotions or intrusive thoughts. The picking might offer temporary relief from anxiety, but the damage to the skin can make the anxiety worse and lead to further picking, creating a vicious cycle.
  • Stress: Heightened stress can be a significant trigger for picking. Stressful events or periods of chronic stress can exacerbate the urge to pick as a means of coping. Read more in our What stress does to your skin and hair guide.
  • Boredom: Picking can become a way to fill empty time or self-soothe. The repetitive motions and sensory feedback from picking can provide a temporary distraction, but ultimately lead to negative consequences.
  • Existing skin conditions: Acne, eczema, or psoriasis can create a focus on the skin and a desire to “fix” the imperfections. Blemishes or irritated skin can trigger picking behaviour, even if it makes the underlying condition worse.
  • Genetics: Some research suggests people can be genetically predisposed to dermatillomania. If a close family member has the condition, you may be at a slightly higher risk of developing it yourself.

These triggers can create a cycle of negative reinforcement and feed into one another.

For example, an existing condition can lead to picking, which then becomes a temporary relief from anxiety or boredom but, in doing so, results in damage to the skin which can  the resulting can worsen the skin condition, or the anxiety and lead to further picking. This cycle can be difficult to break without professional help.


How to Treat Dermatillomania

How to get rid of acne scars fast and naturallyShutterstock

Dermatillomania can be treated and there are several approaches to help manage the compulsive picking behaviour and promote healing. However, it depends on the causes and triggers so these should be used as a guide only.

If you’re worried about your own picking behaviour, or you think a loved one might be suffering from dermatillomania, the following common treatment strategies may help:

Self-Help

While not a cure, introducing a number of self-help techniques can help. Especially for mild cases. These techniques can be used to identify triggers and develop healthier coping mechanisms to replace picking.

  • Identify triggers: Keep a journal to help pinpoint situations, emotions, or even specific times of day when you’re most likely to pick your skin. Once you recognise your triggers, you can find strategies to avoid them or manage the urge.
  • Distraction techniques: When the urge to pick strikes, distract yourself with another activity that keeps your hands occupied. This could be fidget toys, stress balls, or squeezing a soft object. Anything that helps redirect your focus and give you a sensory outlet can help manage the urges.
  • Protective measures: Wearing gloves, keeping your nails trimmed, or covering blemishes with bandages can create physical barriers that make picking more difficult.

Therapy

Cognitive Behavioral Therapy (CBT) is a form of psychotherapy that has been shown to help treat dermatillomania, as well as other compulsive conditions. CBT helps you identify negative thought patterns and behaviours in order to then develop healthier coping mechanisms. Through techniques like habit reversal training, you can learn to replace picking with alternative behaviours like relaxation techniques, meditation or deep breathing exercises.

Medication

In some cases, medication can be used instead of, or alongside therapy and self-help techniques to manage any underlying mental health conditions that might be triggering or contributing to dermatillomania. Antidepressants or anti-anxiety medications, for example, can help regulate your mood and reduce the urge to pick. Or they can at least give you some mental clarity to seek help or engage in the self-help techniques listed above.

Treating dermatillomania is a journey, not a quick fix.

If you suspect you or someone you know might be struggling with dermatillomania, get professional help from a GP, mental health specialist or even a a dermatologist. They’ll be able to better guide you towards a personalised treatment plan.

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