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Treating Dermatillomania, a Skin Picking Disorder

Dermatillomania, Skin Picking

Dermatillomania is an obsessive compulsive disorder where a person has an intense urge and need to pick at their own skin. Dermatillomania is a disorder that consists of body focused repetitive behavior. Dermatillomania is also known as “obsessive skin picking”. For people with Dermatillomania, the urge to pick at their own skin is so strong that often damage is done to the skin that doesn’t heal correctly or it leaves scars. The picking usually begins with a mole, scab, or imperfection in the skin. Picking at their skin is a stress release and a coping mechanism for those with Dermatillomania. Dermatillomania patients will typically use their fingernails to pick at their skin, but tweezers, pins, teeth and other sharp instruments are used as well.

People with Dermatillomania mainly pick their skin at the face, scalp, arms, back, chest, hand, arms and feet. Those who suffer from Dermatillomania often feel shame and are embarrassed by their behavior and they will try to hide the evidence of their disorder. They will use makeup to cover up their scars and scabs, wear long sleeved shirts and pants even in the summer months.

In some patients, Dermatillomania may be a symptom of body dysmorphic disorder. People with body dysmorphic disorder have an obsessive preoccupation with a real or imagined physical defect on their body.

There is not a lot of research or information on Dermatillomania so it can be hard for patients to find the proper treatment, support and help they need. Currently there are no medications specifically FDA approved for Dermatillomania. Medications used to treat Dermatillomania are also used to treat many obsessive compulsive disorders and anxiety related disorders. Never try any medications without first consulting a physician.

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Antidepressants are often used to treat people with Dermatillomania and obsessive compulsive disorder. The antidepressants work by affecting levels of serotonin in the brain; therefore, improving the patient’s mood. Antidepressants also work for these patients by diminishing obsessive thoughts and diminishing the need to continue performing their repetitive behaviors. Commonly prescribed antidepressants are Prozac (fluoxetine), Anafranil (clomipramine), Zoloft (sertraline), Paxil (paroxetine), and Lexapro (escitalopram). It can take up to 12 weeks to relieve OCD and Dermatillomania symptoms once antidepressant treatment begins.

Cognitive Behavior Therapy

Cognitive Behavior Therapy is also used to treat Dermatillomania. Cognitive Behavior Therapy is a form of psychotherapy that helps the patient seek out why they are picking at their own skin. The patient will journal the emotional state they are in when they start picking their skin or feel the urge to pick and what factors triggered their urge to pick. With the help of a therapist, the patient will learn how to deal with their stress and triggers and how to redirect their emotions in a positive fashion. Patients are taught relaxation skills as a way to control their compulsive urge to pick their skin.

The key to Dermatillomania patients getting well is to consistently take their medications and to continue with therapy. Giving up on either one too soon can cause old behaviors to return. Recovery is an ongoing process that takes time, dedication and a willingness to get well.