It’s not unusual for people to pick at their skin from time to time – this is a common behavior. But if you notice that picking at your skin is constant or find that you can’t stop doing it even if you try, you might have skin picking disorder called dermatillomania. Are you picking at a scab, or more commonly the skin around your fingernails, until it causes sores, bleeding, or scars? Read on. There are ways your doctor might be able to help you.
When Skin Picking Goes Too Far
Dermatillomania can start as early as adolescence – usually between ages 13 and 15 – and may continue into adulthood if no corrective action is taken.
People with dermatillomania tend to pick not only at normal skin irregularities, such as pimples, calluses, or scabs, but also at healthy skin, creating even more lesions, scabs, and scarring which, in turn, starts the cycle all over again. Skin picking disorder can also manifest itself in adults, and when it does it tends to show up between ages 30 and 45. Regardless of when it starts, dermatillomania is related to obsessive-compulsive disorder and not only causes damage, like scarring and potential infection, to the skin, but also can be detrimental to a person’s self-image, and the scarring and lesions can make those who bear them uncomfortable in public.
Determining You have Skin Picking Disorder
As with any condition, don’t try to self-diagnose dermatillomania. That determination needs to be made by a trained health professional familiar with its symptoms and triggers. If you think you might have skin picking disorder, talk to your doctor or a therapist. Some symptoms you might look for, and your doctor might ask you about, are:
- Noticeable scars from picking at your skin.
- Picking at your skin taking up a significant amount of your time.
- Having feelings of guilt or shame that come from not being able stop picking at your skin.
- Scarring or picking are stopping you from doing things socially or make you uncomfortable in a social setting.
A healthcare professional will determine if the symptoms are causing you significant stress, whether they’re caused by a substance, medical, or dermatological disorder, and whether a psychiatric disorder might be the cause.
Treatment Options for Skin Picking Disorder
There are typically two different paths of treatment used in helping someone with skin picking disorder. Your doctor might recommend either or a combination of both depending on the severity of the disorder and how well you respond to treatment. One treatment path is therapy – typically either cognitive-behavioral therapy (CBT) or acceptance and commitment therapy (ACT). CBT involves helping people understand how their thoughts and behavior can influence their actions even if they don’t realize it and focuses on recognizing and then changing those thoughts and behaviors. ACT is a similar type of therapy. It teaches people to accept their reactions to stimulus and pay attention to when they’re reacting – in this case, be present when you’re picking at your skin instead of doing it mindlessly – and then substitute the harmful behavior with a healthier one. The other treatment path involves prescribing medication that can help reduce obsessive thoughts and compulsive behaviors.
Dr. Ogunmakin is a board-certified Dermatology specialist at Kelsey-Seybold’s Tanglewood Clinic. She cares for patients of all ages, and her clinical interests include skin of color, hair loss, medical dermatology, dermatologic surgery, and laser and cosmetic surgery.