How to get rid of dermatillomania?

Dermatillomania—Overview

Dermatillomania, also known as excoriation disorder or skinpicking disorder, is characterized by compulsive picking at one's skin, which causes tissue damage, infections, and scarring. It belongs to the OCD spectrum. Psychotic Dermatillomania (Excoriation Disorder) causes bodily injury. DSM-5 classifies it as Obsessive–Compulsive and Related Disorders.

Symptoms

• Excessive picking of the skin, scabs, acne, or perceived flaws.
• Sores, bleeding, scars, infections.
• Distress: guilt, humiliation, anxiety, or low quality of life.

Causes

• Multifactorial causes: Genetic predisposition.
• Mental issues such as OCD, stress, and anxiety also play a significant role.
• Environmental factors such as boredom, stress, and sensory cravings also play a significant role.

Impact

• Physical health risks: infections, delayed wound healing, permanent scars.
• This can lead to heightened feelings of anxiety, despair, and social isolation.

Options for Management and Treatment

• CBT: Especially Habit Reversal Training (HRT), which helps people identify triggers and replace picking with better habits.
• In difficult situations, SSRIs and other psychiatric drugs may be administered.
• Lifestyle tips: Trim nails.
• Consider using stress balls or fidgets.
• Bandaging afflicted areas.
• Relaxation and mindfulness.

Risks and Factors

• Delayed diagnosis: Embarrassment causes many to hide symptoms, exacerbating damage.
• It frequently co-occurs with OCD, anxiety, and depression.
• Need for expert help: Self-management typically requires psychiatric or psychological support.

What therapist treats dermatillomania?

Skin-picking disorder, dermatillomania, is best treated by clinical psychologists or psychiatrists who specialize in OCD and similar disorders. CBT, particularly HRT, is the best method. Dermatologists may treat skin damage, although psychologists and psychiatrists are usually the main therapists.

Therapist Types: Those who treat dermatomania

1. Clinical psychologists

• CBT and HRT psychotherapy are recommended.
• Help patients recognise triggers, learn coping skills, and adopt better picking habits.
• Relapse prevention and long-term behaviour change.

2. Psychiatrists

• Medical mental health specialists.
• Recognise excoriation disorder, administer SSRIs and N-acetylcysteine, and coordinate care.
• They are recommended for treating severe depression, anxiety, and OCD.

3. Dermatologists

• Treat skin-picking injuries, infections, and scars.
• Give wound care, topical therapies, and cosmetic recommendations.
• Best for: Skin care and psychotherapy.

4. Specialised BFRB Therapists

• BFRB therapists treat trichotillomania and dermatillomania.
• Focus: Customized CBT, mindfulness, and acceptance therapies.
• Ideal for: Specialised patients.

Important Considerations

• Psychologists, psychiatrists, and dermatologists work best together for therapy, medicine, and skin health.
• Early intervention reduces scarring and psychological anguish.
• Online therapy: BetterHelp and PsychologyHelp match patients with dermatillomania-trained therapists.

How prevalent is dermatillomania?

Dermatillomania (excoriation condition) affects 1.4%–5.4% of the population, more than many realize. Shame and embarrassment lead individuals to conceal their symptoms, resulting in underdiagnosis of the condition.

Epidemiology and prevalence

• 1.4%–5.4% of individuals develop dermatillomania, according to studies.
• Gender differences: Women are more affected, although men are too.
• It usually starts in youth or early adulthood, around the time acne or skin changes are widespread.
• Underreporting: Many cases are overlooked because people perceive it as a “bad habit” rather than a mental illness.

Why It's Missed

• Patients may avoid care owing to stigma and guilt regarding visible scars or wounds.
• Overlap with other disorders: OCD, anxiety, sadness, and body dysmorphic disorder sometimes disguise its presence.
• Mental illness is sometimes misdiagnosed as dermatological.

Co-occurrence with other conditions

• OCD is compulsive.
• Body-centered repetitive behaviors (BFRBs) include trichotillomania.
• Depression and anxiety: High comorbidity increases disease burden.

Can dermatillomania be cured?

Dermatillomania (excoriation disorder) is a chronic mental illness whose "cure" is rarely mentioned. Instead, professionals discuss management, treatment, and rehabilitation. With the correct therapy, medicine, and lifestyle changes, many patients improve and even go into remission.

Treatment Prospects

Why “cure” is challenging

• Dermatillomania, like OCD and trichotillomania, is a body-focused repetitive activity.
• Symptoms fluctuate with stress, surroundings, and mood.
• Relapses are possible; therapy can greatly reduce severity and frequency.

Treatments Based on Evidence

1. Psychotherapy

• CBT helps discover triggers and change mental habits.
• Habit Reversal Training (HRT): Addresses impulses and promotes healthy habits.
• ACT decreases compulsive plucking and builds discomfort tolerance.

2. Drug

• Some SSRIs lessen compulsive cravings.
• Some research has demonstrated that N-acetylcysteine (NAC) reduces BFRB symptoms.
• Medication is generally used with therapy.

3. Dermacare

• Wounds, scars, and infections become less embarrassing and painful when treated.
• Bandages and barrier creams minimize picking.

4. Manage Yourself

• Keep nails short.
• Use stress balls or fidget toys.
• Practice mindfulness and reduce stress.
• Cover sensitive areas with clothing or bandages.

Test for skin picking

To better understand your symptoms, take a free online self-assessment exam for dermatillomania (skin-picking disorder). These tests are screening tools and do not replace a professional diagnosis.

Recommended Online Skin-Picking Disorder Tests

1. SkinPick.com Dermatillomania Test

• The test utilizes a validated scale-based questionnaire, such as the Skin Picking Scale-Revised and Milwaukee Inventory.
• The test identifies the symptoms and severity of excoriation disorder.
• Review your 7-day behavior.
• Available from SkinPick.com

2. Online Dermatillomania Quiz

• Complete clinical self-assessment.
• Skin-picking frequency, intensity, and effects are assessed.
• This information should only serve as a guide.
• It is not a substitute for seeking medical advice.
• Online Dermatillomania Test Toolkit

3. Dermatillomania OCD Screening MantraCare

• The survey is simple and provides immediate results.
• Screens for compulsive skin-picking and its effects on daily life.
• Connects therapists if needed.
• MantraCare OCD Dermatillomania Test

These tests measure

• The MantraCare OCD Dermatillomania Test measures the frequency of picking (never, rarely, sometimes, often, or always).
• The tests distinguish between minor scratches and the level of harm caused by wounds or scars.
• Ineffective attempts to stop.
• The condition can cause distress, embarrassment, and disruption to daily life.

Vital Considerations

• Autotests aren't diagnostic. It is important to determine whether your symptoms are indicative of dermatillomania.
• Professional assessment is crucial. A psychologist or psychiatrist can diagnose and treat.
• Early intervention is important. Assistance can prevent scarring, infections, and emotional distress.

Dermatillomania therapy

The video is about tips to avoid skin picking.

Skin-picking condition can be treated with psychotherapy, medicine, and dermatology. The most successful treatment is Cognitive Behavioral Therapy (CBT) with Habit Reversal Training (HRT), often combined with SSRIs or N-acetylcysteine, wound care, and lifestyle changes.

Main Treatment Methods

1. First-line psychotherapy

• CBT helps patients discover triggers and change cognitive patterns.
• Habit Reversal Training (HRT): Addresses impulses and promotes healthy habits.
• ACT decreases compulsive plucking and builds discomfort tolerance.
• Body-focused repetitive behaviours such as trichotillomania and dermatillomania necessitate specialized BFRB treatment.

2. Adjunctive medication

• Reduce anxiety and obsessive cravings with SSRIs.
• N-acetylcysteine (NAC), an amino acid supplement, reduces compulsive picking in studies.
• Sometimes antipsychotics or glutamatergic medications are used in resistant patients.
• 3. Dermacare
• Initial treatment: wound care, antiseptics, and infection surveillance.
• Permanent skin repair: Hydroquinone for pigmentation, silicone for scars.
• Prevention: Bandages, barrier creams, and safety gear.

Risks and Factors

• Stress might trigger relapse; therapy helps maintain remission.
• Side effects of SSRIs include nausea, sleep disturbances, and sexual dysfunction.
• Patients delay therapy owing to embarrassment; education and support groups lessen isolation.
• Mental illness is often misdiagnosed as dermatological.

Also, read https://www.medicoverhospitals.in/diseases/skin-picking-disorder/.

A Key Note

• Although treatable, dermatillomania is rarely “curable.”
• A psychologist for treatment, a psychiatrist for medicine, and a dermatologist for skin care get the best results.
• Early intervention reduces scarring and psychological anguish.

Conclusion

Dermatillomania, or excoriation disorder, is a mental illness that causes excessive skin-picking and physical and emotional suffering. Though commonly mistaken for a "bad habit," it is part of the body-focused repetitive behaviours (BFRBs) continuum, strongly connected to OCD and trichotillomania. Dermatillomania is serious, curable, and common. Early detection, destigmatization, and multidisciplinary care are crucial for rehabilitation. Patients should know they have support and effective treatment.