Most people have heard of Trichotillomania, but its counterpart, Dermatillomania, often goes unnoticed. In this article, we shed light on this compulsive condition and how to recognise the symptoms.
I’ve been compulsively picking at my scalp for around 20 years. Not a day goes by where I don’t have sores and scabs hidden under my hair and the scars are the evidence of a lifetime of picking.
As a sufferer of this disorder, it can be frustrating that so little is known about it. It’s not mentioned on many of the psychology blogs, unlike OCD and Trichotillomania (hair-pulling disorder), and very little research has been done on the topic.
What is Dermatillomania?
Dermatillomania is just one of several names used to describe this problem. Sometimes referred to as excoriation disorder or skin-picking disorder, it is a psychological condition that results in repetitive skin picking. It falls within the body-focused repetitive behaviours (BFRBs) category of obsessive-compulsive order. The most common places picked include the scalp, hands, and lips.
Picking at spots or blemishes is common, and there’s a huge difference between doing this and suffering from Dermatillomania. The latter causes long-term skin damage, scarring, and high levels of distress for sufferers. The condition is said to affect 1.4% of the population, the large majority of which are female. There is currently no research to explain why females are more likely to develop the disorder than men, but it’s certainly the case.
The vicious cycle of Dermatillomania is what can make it so bad for its sufferers. The unbearable urge to pick results in painful sores, causing baldness and discomfort. This then creates low self-esteem and guilt, which in fact, results in more picking.
What are the Symptoms of Dermatillomania?
The most obvious symptom of this skin-picking disorder is the constant urge to pick one skin, relieved only by indulging in the self-destructive habit. It’s important to know that similar symptoms can be caused by some medications and substances, and therefore skin-picking would be a side effect, not a compulsive habit.
According to the NHS website, the recognised symptoms of Dermatillomania are:
- The inability to stop picking your skin
- Causing cuts, wounds, and bleeding
- You don’t always realise you are picking
- Unconsciously picking, including during sleep
- Increased skin-picking when anxious or stressed
If you have one or more of these symptoms for a prolonged period, it’s likely that you are suffering from a form of Dermatillomania. The severity of cases can vary greatly, and the level of damage to your skin is the best indicator of how bad your problem is. Most people who suffer from the condition also have other obsessive-compulsive disorders, which may also need treatment.
Living With The Condition
Dermatillomania does not have the same detrimental impact on day-to-day life as other mental health disorders, like depression, for example. People with the condition can live normal lives and their problems can often go unnoticed. This is a bit of a double-edged sword though, as the same discretion that makes it possible to live with can make it isolating.
That said, it’s not enjoyable to live with. You need to pick your skin and it doesn’t matter where you are, what you’re doing, or who you are around. I am constantly aware of the fact that my colleagues must think I’m a little crazy for constantly scratching at my head. I’m aware that I shouldn’t drive with only one hand as the picks my skin. I’m aware that it probably looks like I have lice when I’m using public transport. Despite this, I cannot stop.
One of the worst scenarios for me right now is the inability to go to the hairdressers. I have horrendous sores and bald patches that I would be too ashamed to show to a hairdresser, and it’s likely to be quite painful having my hair done. So this is impacting my confidence, and just further emphasises those feelings of shame.
The most commonly prescribed treatment for this skin-picking disorder is cognitive behaviour therapy (CBT). It’s a specific type of therapy that focuses on why we behave in certain ways and works to re-train the brain into new routines. This is the first course of treatment for many types of OCD and is the least invasive in the sense that it doesn’t require any medication.
The alternative method of treatment is the use of antidepressants, including the likes of Sertraline. The irony of antidepressants is that medical research shows they work, but admittedly doesn’t know how it works. We treat patients with medications that appear to ease symptoms, but we don’t yet understand the chemistry of exactly how this happens.
The results of going down the medication route will be different for every person that does it, but it didn’t work for me. I was prescribed antidepressants for depression and was told it should also help with my obsessive disorder, but it didn’t – although I don’t think it made it any worse, either.