Skin Picking (Dermatillomania)

Skin Picking (Dermatillomania) see Self Harm:  Compulsive skin picking is a body-focused repetitive behavior that results in the destruction of one's skin. The face is oftentimes a primary target but other areas of the body can be involved i.e. finger/toe cuticles, or pulling out hair. It is a form of self-mutilation/self-harming that can vary in degrees of severity including consequences of bleeding, bruises, infections, scarring or permanent skin damage. This behavior often is unconscious; as an individual may be unaware he or she is engaging in skin picking, it is difficult to interrupt. It can take on a self-perpetuating cycle; individuals engage in the behavior, experience consequences including guilt and shame which is uncomfortable and therefore leads to a repeat of this cycle.

When skin picking is done in a compulsive manner it is referred to as dermatillomania and has been classified as a form of an impulse control disorder. There is a high co-morbidity of skin picking in individuals that have obsessive compulsive disorder, body dysmorphic disorder and trichotillomania. Skin picking also has been found to be present in individuals with anxiety disorders and eating disorders and utilized as a means of regulating emotions to promote self-soothing and distractions (in maladaptive manners). Therefore, use of DBT has been effective in developing effective means of coping and promoting emotional regulation, distress tolerance skills and mindfulness skills. Antidepressant medications have also been found to be helpful for treating this condition and co-morbid emotions i.e. depression and anxiety. The most effective treatment typically involves a combination of psychotropic medications combined with a CBT based form of treatment.

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