Treatments for People with a Skin Picking Disorder: Dermotillomania

Dermotillomania, also known as skin picking, can become extremely dangerous if left untreated. Dermotillomania is not just pulling a scab from a wound; it is a disorder in which people with it will pick at their skin with their fingernails or other instruments.

This condition is often associated with high levels of anxiety and severe depression. The cause is unknown but the ramifications of untreated skin picking could lead to needing surgery to fix a severe picking of the skin, stitches for larger areas of picked skin, antibiotics and dressings for infected areas that have been picked, and a worsening of the disorder.

What is Dermotillomania

Simply put dermotillomania is when a person picks at their skin for no apparent reason. The skin picking is not normal and can lead to a multitude of problems as listed above. Research has found that dermotillomania is closely related to trichotillomania-a hair pulling disorder. As in trichotillomania the person is often not aware they are picking at their skin until the episode is over, sometimes they pick at their skin due to boredom, from being stressed, scared and depressed. This disorder is not necessarily curable but is treatable. The issue for many skin pickers is that they are embarrassed about their condition and to add insult to injury not many physicians are knowledgeable about skin picking disorders.

What Psychological Treatments are Available for Skin Picking

Most likely the two most common forms of psychological treatment would include cognitive behavioral therapy in addition to habit reversal therapy. These two therapies will teach the skin picker how to pick up on what may be causing them to have the urge to pick at their skin and to find healthy alternatives to doing so. It will also give the person with dermotillomania the opportunity to discuss environmental, home, and other factors that cause them to have stress or anxiety. These sessions with a trained psychologist are generally very helpful for those with the skin picking disorder. Research has found that greater success in stopping someone from picking at their skin or at least reduce the skin picking is with a combination of psychotherapy and psychopharmacology.

Medications for People with Dermotillomania

Regardless of whether a person with the skin picking disorder is depressed because they pick or pick because they are depressed, a prescription of anti-depressant medication that has SSRIs in it will help them. The SSRIs in anti-depressants will help to give the skin picker a better sense of wellbeing and should help with depression and also help with anxiety and stressors in their life.

Anti-anxiety medication is also often prescribed to people with skin picking disorders because the reduction of anxiety could possibly reduce the picking. The most common forms of anti-anxiety medications for skin pickers are ones such as Xanax, Klonopin, and Ativan.

Some people with the skin picking disorder do well with only one form of treatment while other benefit greatly from having both sets of treatment done simultaneously.

Skin picking is not something a person does to mutilate their body. Just as with trichotillomania it is an impossible urge for the picker to pick and only with the right treatment can they ever begin to stop unintentionally hurting themselves. If you know someone with a skin picking disorder you should be sensitive to their disorder because this is not something they want to do. In fact, most clinical findings report that the person with dermotillomania is extremely ashamed and filled with guilt for doing this to themselves. The picking of the skin is not a habit; it is a psychological disorder that the person has no control over until a psychologist teaches them how to control the disorder.

Resources:

Skin Picking
http://www.psychnet-uk.com/dsm_iv/skin_picking.htm

Compulsive Skin Picking Treatment
http://www.skinpick.com/treatment

Skin Picking - Dermatillomania
http://www.skinpick.com/dermatillomania-information

Skin Picking Disorder Fact Sheet.pdf (application/pdf Object)
http://www.ocfoundation.org/uploadedFiles/MainContent/Find_Help/Skin%20Picking%20Disorder%20Fact%20Sheet.pdf

Compulsive Skin Picking - Dermatillomania
http://www.brainphysics.com/skin-picking.php

Dermatillomania - Wikipedia, the free encyclopedia
http://en.wikipedia.org/wiki/Skin_picking

Signs & Symptoms | What Is Skin Picking?
http://www.trich.org/about/skin-signs-symptoms.html