Understanding Dermatillomania
Dermatillomania, also known as Excoriation Disorder or Skin-Picking Disorder, is a mental health condition characterised by the repetitive picking of one’s skin, leading to skin lesions and significant distress or impairment in daily functioning. Classified under the category of “Obsessive-Compulsive and Related Disorders” in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), this disorder affects approximately 1.4% to 5.4% of the population, with a higher prevalence in females.
What is Dermatillomania?
Dermatillomania involves the compulsive urge to pick at skin imperfections or perceived flaws, such as scabs, pimples, or insect bites. This behaviour can result in open wounds, scarring, and infections, and can severely impact an individual’s quality of life. The picking may occur on various parts of the body, but the face, arms, and hands are the most commonly affected areas.
Diagnostic Criteria for Dermatillomania (DSM-5)
According to the DSM-5, the following criteria must be met for a diagnosis of Dermatillomania:
- Recurrent skin picking resulting in skin lesions.
- Repeated attempts to decrease or stop skin picking.
- The skin picking causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
- The skin picking is not attributable to the physiological effects of a substance (e.g., cocaine) or another medical condition (e.g., scabies).
- The skin picking is not better explained by symptoms of another mental disorder (e.g., delusions or tactile hallucinations in a psychotic disorder).
Causes of Dermatillomania
The exact cause of Dermatillomania is not fully understood, but it is believed to result from a combination of biological, psychological, and environmental factors. Some potential contributors include:
- Genetics: A family history of obsessive-compulsive disorder (OCD) or related conditions may increase the risk.
- Neurobiology: Imbalances in neurotransmitters like serotonin may play a role.
- Psychological Factors: Anxiety, stress, perfectionism, and body image issues can trigger or exacerbate the condition.
- Environmental Triggers: Stressful life events or trauma can initiate or worsen skin-picking behaviours.
What Does Treatment Look Like?
Effective treatment for Dermatillomania often involves a combination of therapy, medication, and self-help strategies:
- Cognitive-Behavioural Therapy (CBT): This is the most commonly used treatment, particularly a subtype called Habit Reversal Training (HRT). CBT helps individuals recognise the triggers and thoughts that lead to picking and develop healthier coping mechanisms.
- Medication: Selective serotonin reuptake inhibitors (SSRIs), which are commonly used to treat depression and anxiety, may be prescribed to help manage the urge to pick.
- Mindfulness and Relaxation Techniques: These can reduce the anxiety and stress that often precede or accompany skin-picking episodes.
- Support Groups and Foundations: Organisations like the Picking Me Foundation offer resources, support, and advocacy for those affected by Dermatillomania. Founded by Angela Hartlin, a Dermatillomania sufferer herself, the Picking Me Foundation aims to raise awareness, provide education, and connect individuals with the tools and support needed to manage the disorder.
The Role of the Picking Me Foundation
The Picking Me Foundation is a pivotal organisation dedicated to providing support and raising awareness about Dermatillomania. Through education, advocacy, and peer support, the foundation helps individuals feel less isolated in their struggles and encourages them to seek appropriate treatment. The foundation offers a range of resources, including online support groups, educational materials, and outreach programs designed to destigmatise the condition and empower those affected.
Conclusion
Dermatillomania is a challenging condition that requires a compassionate and comprehensive approach to treatment. If you or someone you know is struggling with skin-picking behaviours, it’s essential to seek professional help. The Three Seas Psychology is here to support you with evidence-based treatments tailored to your individual needs. Remember, you’re not alone—resources like the Picking Me Foundation and professional therapeutic interventions can make a significant difference in managing this disorder and improving your quality of life.
