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If you constantly pick at wounds and injuries on your skin, you may suffer from dermatillomania. It's a challenging but treatable condition. Here we explain what it is and how to seek help.
What is Dermatillomania?
Dermatillomania is a problem of compulsive repetitive picking at one’s own skin, resulting in damage and wounds. The condition usually occurs in adolescence or young adulthood, but can also occur later in life and the problems are often exacerbated by various forms of stress. Behaviours can lead to feelings of shame that may prevent people from seeking help, but it can be treated.
Causes of dermatillomania
There are several reasons why people can develop dermatillomania. Research shows that both genetic and environmental factors contribute. Dermatillomania is similar to trichotillomania, where hairs are pulled away from the body.
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Dermatillomania diagnosis
To find out if you have dermatillomania, you can answer screening questions to get an idea if you need to seek help. Do you pick, scratch, poke, pick or otherwise damage your skin? Do you do it often? Have you tried not to do it without success? Does it become a problem for you? If you answered yes to these questions, you may want to seek help.
Studies of adults have shown that between 1-5% of people have the diagnosis. According to research, dermatillomania occurs more often in women than men. There are currently no studies on how common it is in children and adolescents, but they do suffer with it. It is also common to have other psychological conditions such as anxiety, depression, dysmorphophobia, obsessive-compulsive disorder, eating disorders and bipolar syndrome with dermatillomania. If you have somatic conditions like scabies or itching, you won’t get a dermatillomania diagnosis.
Dermatillomania and self-harm
Many people who have self-harming behaviours also pick and scratch their body, but their purpose is to hurt themselves, so it is a little different from dermatillomania. Self-harm is not diagnosed as dermatillomania, but it is still important to seek help with treatment for your symptoms.
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Symptoms of dermatillomania
Dermatillomania involves compulsive picking at different parts of the body, such as the face, hands, nails, feet, arms, or upper body. Picking can be done consciously, i.e. there is a ‘need’ to do it, but it is also common to pick without thinking about it. This can lead to sores and injuries that are further picked at. Some of the symptoms of dermatillomania are:
- Picking, scratching, poking, prodding, prodding or damaging the skin.
- Trying to reduce or stop, anffering and/or impairment.
- Anxiety and stress; relief from picking.
- Picking can be unconscious or conscious. Often it does not happen in the presence of others, except family.
- Looking for a particular scab to pick. People also examine, play with, or swallow skin after it has been picked. Picking in the same location can result in skin problems.
- This behaviour can affect daily activities and function. It can also lead to feelings of shame and guilt, as well as social withdrawal.
If you recognise the symptoms of dermatillomania, you may want to seek help. For milder symptoms, we have psychologists at Lavendla who can help you. If you have more severe problems, it is good to seek help through specialist psychiatry. Below you can read more about what treatment for dermatillomania means.
Treatment for dermatillomania
The most effective treatment for dermatillomania is a form of therapy called Habit Reversal Training (HRT). HRT seeks to find alternative behaviours to skin picking. In short, the treatment involves first making the client aware of when they are picking skin (mindfulness training). Then the client is taught an action (countermovement) that is physically incompatible with skin picking (for example, clenching fists). For best results, family members are given information on how to help the client if they pick. In the case of dermatillomania, it is important to follow up the treatment and ensure that the results continue in the long-term.
HRT treatment consists of three parts:
- Consciousness training
- Counter-movement training
- Social support
Dermatillomania is a condition that comes in different degrees of severity: mild, moderate, and severe. For milder problems without great suffering and/or reduced function, treatment with a licensed psychologist or CBT therapist is possible. For more severe problems, specialist psychiatric care is required. Visit your GP for a referral. If you have somatic problems as a result of skin picking, such as infections or other injuries, you can seek help from your GP. In terms of medical treatment with drugs, not enough research has been done.
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Seeking help can change your life
Dermatillomania is something you may need help to overcome. Talking to a licensed psychologist or psychotherapist can help you understand your condition better and learn effective ways to manage it. You are not alone and it is okay to ask for help. Lavendla has qualified therapists and psychologists available to help you break compulsive behaviours.
Common misconceptions about therapy
Many people think therapy is only for ‘serious’ problems or that seeking help is a weakness. These are misconceptions, therapy is a step toward improvement. Lavendla helps make the difficult easier. Simply book an online session with one of the licensed psychologists and therapists listed on our website.
Your next step
If you or someone you know is struggling with compulsive behaviours, it’s a good idea to talk to a professional therapist or psychologist. Lavenla’s therapists and psychologists are experienced professionals and keep your conversations strictly confidential. Don’t be afraid to take that first step.
Living with dermatillomania can be a daily struggle but there is help available. With the right support and tools, you can significantly improve your quality of life. If you are ready to take the plunge, we are here to support you. Book your first session today and start your journey towards a better future.
12 frequently asked questions about dermatillomania
What is dermatillomania?
Dermatillomania is a problem of compulsive repetitive picking at one’s own skin, resulting in injuries and wounds.
How is dermatillomania diagnosed?
A diagnosis of dermatillomania is usually made by a licensed psychologist or psychiatrist through various tests and assessments. This may include questionnaires and clinical interviews.
Is dermatillomania hereditary?
Research shows that dermatillomania may have a genetic component but it is not the only factor. Environment also plays a role, as well as stress and anxiety.
What are the symptoms of dermatillomania?
In dermatillomania, people may compulsively pick at different body parts, such as the face, hands, nails, feet, arms, or upper body. The picking may be conscious, i.e. there is a ‘craving’ to do it. It is also common to jerk or pick without thinking about it.
How is dermatillomania treated?
Treatment can include Habit Reversal Training (HRT). HRT seeks to find alternative behaviours to skin picking and has been shown to be effective.
Is there a cure for dermatillomania?
With the right treatment, symptoms can be managed and quality of life significantly improved. It is important to monitor results over time.
Can children get dermatillomania?
Yes, children and teenagers can be affected. It is important to seek professional help as soon as possible for the best possible treatment outcome.
How common is dermatillomania?
About 1-5% of people have some form of dermatillomania.
Does dermatillomania affect my ability to work?
In severe dermatillomania functional capacity can be affected. However, it is possible to return to normal function with proper treatment.
Is dermatillomania more common in women or men?
Research has shown dermatillomania is more common among women.
Can you have other problems at the same time as dermatillomania?
It is also common to have other psychological conditions such as anxiety, depression, dysmorphophobia, obsessive-compulsive disorder, eating disorders and bipolar syndrome. It is important to have an assessment by a licensed professional.
Where can I go if I need help?
At Lavendla, we have experienced psychologists and therapists who can help alleviate mild symptoms. For more severe symptoms, contact your GP for a referral to a specialist psychiatrist. In an acute mental health crisis, call 111 or visit 111.nhs.uk immediately.
What does treatment for dermatillomania involve?
Seeking help is a big step towards better health, it’s a positive thing to decide to take control of how you feel. Here is an overview of the steps typically involved in CBT treatment.
Step 1: An initial assessment session
The first meeting with your psychologist or therapist is an assessment to review your mental and physical health. You may be asked questions about your life situation, feelings, thoughts and behaviours. You may also be asked to complete assessment forms.
Step 2: Goal setting
This is where you and your therapist set concrete goals for the therapy, both short and long term.
It can define which areas of your life are most affected by your well-being and how you would like to change them.
Step 4: Treatment with different techniques and tools
This is the start of the actual treatment phase, which involves exercises aimed at giving you tools to overcome and work through the problem you are suffering from. Habitual reversal training (HRT) is often used to find alternative behaviours for dermatillomania.
Step 5: Monitoring and evaluation
Treatment is monitored regularly to see how well the therapy is working. If necessary, the treatment plan can be adjusted or renewed.
Step 6: Ending and looking ahead
As the therapy comes to an end, it is time to reflect on the progress made. You will also receive a maintenance plan for how to use the tools and strategies you have learned. It is also important to monitor the results over time.
If you or someone close to you is looking for professional help, don’t hesitate to book a session with one of our licensed psychologists or therapists.
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