Dermatillomania

Dermatillomania is when you are unable to stop touching, picking or scratching at your skin.

Recognised as one of several body-focused repetitive behaviours (BFRB), it is a mental health condition, which may need professional treatment if self-help techniques do not work for you.

It is also known as skin picking disorder or excoriation disorder.

If you pick at your skin repetitively, causing damage, you could have dermatillomania.

Sometimes the skin picking may be concentrated in one area, or you may find yourself picking at the skin on different areas of your body. It is usually a chronic (long-term) condition.

The symptoms to look out for include:

Obsessive, compulsive picking, scratching, or digging at your skin with your fingers, nails, scissors or other implements
Picking at your face, lips, scalp, arms and legs, back, stomach, chest, shoulders (these are the most common areas)
Picking your skin without realising
The urge to pick your skin is increased when you are stressed or anxious
The picking causes bleeding or damage to your skin, even scars
Picking several times a day - some people can spend hours picking at their skin
It may get in the way of your personal, work or social life

As we have mentioned, dermatillomania is a BFRB mental health condition and can be related to obsessive compulsive disorder (OCD).

This condition has also been linked to body dysmorphic disorder, which is when you have an unrealistic view of your body. The compulsion to pick at the skin to ‘smooth out’ perceived imperfections is a part of this. Likewise, it is similar to trichotillomania, which is the compulsion to pull at your hair.

It is thought that the compulsion to pick at your skin can be triggered by certain things, including:

After a rash, injury or skin infection which causes your skin to scab over or dry out, you may pick at the area, causing more damage, leading to more picking, which then turns into a habit
Stress
Anxiety
Boredom
The desire to have smooth, perfect skin
Negative emotions

If you have a skin picking disorder, you may also have other obsessive-compulsive disorders. If this is the case, these will each need to be assessed and treated individually.

To determine if you have dermatillomania, a GP will need to discuss the symptoms you have and go through the things that cause your urges to pick your skin.

If you are causing damage to your skin by picking it, or if you are finding that it is disrupting your day-to-day life, it is a good idea to speak to a GP for help and advice.

If they suspect you have the condition, you may be referred to a specialist, who can work with you on a treatment plan.

The most common treatments for dermatillomania are talking therapies or medications.

Talking therapies for dermatillomania

Cognitive behavioural therapy (CBT) is most commonly recommended, and habit reversal training in particular.

Habit reversal training helps you to identify what causes you to pick at your skin - whether that’s stress, boredom or something else - and then the specialist will help you change your behaviour patterns and replace it with something else.

Medications for dermatillomania

Medications used to treat dermatillomania are SSRIs (selective serotonin reuptake inhibitors). These types of antidepressants have shown some success in dealing with compulsions. A doctor will usually refer you to a specialist before these medications are prescribed.

There may be another underlying reason that you are picking at your skin, such as eczema or other skin conditions. If this is the case the doctor will be able to prescribe treatment, which should help alleviate the picking.

There are techniques you can try to prevent yourself from picking at your skin, but if these do not work, you may need professional help. This includes:

Avoiding triggers or situations when you know you are prone to pick at your skin, such as being stressed.
Try distraction techniques, and try to keep your hands busy.
When you feel the urge to pick, try another behaviour instead - fidget toys will come in handy here.
Keep your nails trimmed as short as possible to make it more difficult to pick at your skin.
Speak to family and friends – it is nothing to be embarrassed about. They could help you recognise when you are picking to see if there are any patterns in your behaviour.

If these techniques don’t work, chat to a doctor.

At Push Doctor, you can see a GP online 365 days a year. Our caring doctors can listen to your symptoms to find out more about your behaviour and take a look at the affected areas of skin. They may refer you to a specialist for a diagnosis and treatment plan.

What is dermatillomania?

What are the symptoms of dermatillomania?

What are the causes of dermatillomania?

How is dermatillomania diagnosed?

Treatments for dermatillomania

Self-help for dermatillomania

How can Push Doctor help?

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