Do you sometimes have a habit of picking at a small pimple, spot, or other small area of your skin, whether you're just sitting there, watching TV, or thinking about something? Do you find it hard to stop once you start? Maybe it's even causing a wound or scar on your skin. This can be a little more serious than you think and something to be concerned about. Today we're going to talk about this condition, which is `(Dermatillomania)`, or the disease of picking or scratching the skin.
What is `(Dermatillomania)`? Simply put...
Simply put, `(Dermatillomania)` is a mental health condition. What happens here is that a person compulsively scratches, digs, or breaks their own skin. This can cause skin injuries and scars. This is also called `(Excoriation Disorder)`. This condition falls under the category of `(Obsessive-Compulsive Disorders - OCDs)`. However, this is not exactly the same disease as `(OCD)`, there are slight differences. When this condition causes severe skin scars and wounds, it can have a major impact on a person's mental health, daily life, and quality of life.
Imagine, the word `(Dermatillomania)` (der-ma-til-o-mania) is also made up of three Greek words:
- `Derma`: means 'skin'.
- `Tillo`: means 'to pull' or 'to break/scratch'.
- `Mania`: means 'an excessive behavior or activity'.
What is the difference between `(Dermatillomania)` and `(Obsessive-Compulsive Disorder - OCD)`?
We said that although `(Dermatillomania)` belongs to the category `(OCD)`, there are differences from the specific disease `(OCD)`. Now let's see what they are:
- Obsessions: A person with OCD experiences uncontrollable, unwanted thoughts or urges (called obsessions). However, in Dermatillomania, such obsessions do not occur.
- Feeling of relief: People with dermatolmania feel positive emotions such as relief, happiness, and relief from stress when they pick or scratch their skin. This is not the case with OCD.
- Self-harm: Physical self-harm is rare in OCD, but self-harm, i.e., skin cutting, is very common in Dermatillomania.
Who is affected the most by this situation?
In the past, it was thought that this condition mostly affected women. However, new research has shown that about 55% of people with this condition are women. However, among those seeking treatment for this problem, women are more likely to be affected.
This condition usually starts during puberty , but it can occur at any age. Also, people who have skin conditions like acne or eczema are more likely to develop this condition. This is because skin conditions like these are often the first to cause the skin to itch.
How common is this condition?
Dermatillomania is actually a relatively uncommon condition. It is estimated that about 2% of the population may have it at any given time. About 5.4% of people may experience this condition during their lifetime.
How does this condition affect your body?
Dermatillomania is a condition in which a person picks their skin uncontrollably. For some people, this happens automatically . They may not even realize they are picking. Others do it consciously , but they cannot stop.
Some people scratch the areas of their skin that are rough, like acne, blemishes, or scabs from previous wounds. This scratching can cause new wounds to form, old wounds to resurface, bleed, and cause scarring.
Just think, if this condition gets severe, sometimes the skin is so damaged that there are even cases where surgery like ``Skin grafting'' is required to repair it. If the wound becomes infected, you may also have to take ``antibiotics''.
Very rarely, these wounds can cause infection to spread throughout the body, causing the immune system to overreact. This is called sepsis. This is a medical emergency that can be life-threatening.
Impact on mental health
Often, people with this condition are embarrassed, worried, and deeply saddened by the wounds and scars on their skin. They try to hide them with clothes and makeup. Because of this, they try to stay away from society and be alone. Psychological problems such as anxiety and depression can also occur. Sometimes this can affect relationships at work and with friends.
What are the symptoms of `(Dermatillomania)`?
The main symptom is uncontrollable picking, tearing, or scratching of the skin. Doctors use other words to describe this skin scratching:
- Scratching
- Digging
- Squeezing
- Rubbing
Most often, this is done with the fingertips and nails. However, sometimes the skin is also chewed with the teeth (especially the skin around the lips). Some people may also use sharp objects such as tweezers or pins.
There are two ways to shave the skin.
This process occurs in two main ways: "Automatic" and "Focused".
- Automatic scratching: This often happens without a person even thinking about it. It is sometimes called "scanning." This is because the hand or fingertips are used to find a spot on the skin that feels different than other areas. When they find such a spot, it can become a "targeted scratch."
- Focused: This involves "targeting" the skin in a specific area. This can be done for hours. This type of scratching is the most intense and causes the most damage to the skin.
Where in the body does this happen?
Most often, skin abrasions occur in places that are easily accessible:
- Head: face, skull, neck.
- Hands: fingers, palms, forearms.
- Legs: thighs, calves, feet, toes.
What are the reasons for this situation?
The exact cause of `(Dermatillomania)` is not yet known. However, experts believe that several factors may contribute to it:
- Genetics: People with Dermatillomania are more likely to have a close family member (i.e. a parent, sibling, or child) who also has the condition.
- Changes in brain structure: It has been shown that people with dermatotillomania have certain changes in the structure of the parts of the brain that control how habits are formed and how they learn.
- Stress, Anxiety, or Other Conditions: Dermatillomania may be a coping mechanism used to deal with other problems or mental conditions. Or it may be due to boredom or other problems.
Other conditions that may occur with `(Dermatillomania)`
People with `(Dermatillomania)` are more likely to have other mental or medical conditions. Some of them are:
- OCD or other conditions related to OCD, such as hair pulling (trichotillomania) or nail biting (onychophagia).
- Depression.
- Anxiety disorders.
- `(Bipolar disorder)`.
- `(Prader-Willi syndrome)`.
Is this contagious?
No, `(Dermatillomania)` is not a contagious condition. It is not spread from one person to another.
How to recognize this?
When diagnosing `(Dermatillomania)`, your doctor will physically examine you to see if you have any symptoms of the condition. They will also ask you questions about your medical history, lifestyle, and behaviors that may be associated with the condition. Laboratory tests may help rule out other conditions, but they are not usually needed to confirm the diagnosis.
To recognize this condition, all five of the following must be met:
1. Frequently or continuously scratching/breaking the skin.
2. I have tried several times to stop or reduce the sagging skin.
3. Feelings like shame and anxiety have had a negative impact on your daily activities and social life.
4. The skin-scratching behavior is not caused by another medical condition (for example, a skin disease such as scabies) or by drugs (recreational or prescription).
5. Skin picking behavior is not caused by another mental condition (for example, ``Body Dysmorphic Disorder`` - that is, thinking negatively about one's appearance and picking at one's skin to correct it).
What kind of tests are done to diagnose this?
Medical tests for this condition are often done to rule out other medical conditions. Your doctor will explain to you exactly what tests are needed for your specific condition and why.
How is Dermatillomania treated? Is there a cure for it?
Dermatillomania is usually treated with a combination of medication and psychotherapy . Research has shown that a combination of both is more effective than either treatment alone.
Medications
The medications that doctors most often prescribe to treat this condition are:
- Antidepressants: The most commonly used of these are the Selective Serotonin Reuptake Inhibitors (SSRIs).
- Anticonvulsants: Lamotrigine is a medication that helps with uncontrolled muscle movements. Research has shown that it helps some people with dermatotillomania.
- Antipsychotics: These medications help by changing the chemical balance in the brain. These medications are commonly used to treat many conditions, including dementia, bipolar disorder, and schizophrenia. Researchers are also investigating how they might help conditions like dermatillomania.
- Nutraceuticals: These are nutritional products that can help treat medical or psychological conditions. For dermatolism, the amino acid supplement N-acetylcysteine has been found to help reduce the urge to pick at the skin.
Psychotherapy `(Therapies)`
Counseling can treat this condition in different ways, depending on the counseling method used.
- Habit Reversal Therapy: This method makes you more aware of your behavior and activity patterns. By doing so, it teaches you to break habits, such as skin picking.
- Group therapy and peer support: People with dermatotillomania may benefit from specialized group therapy or support groups.
- Cognitive Behavioral Therapy (CBT): This method teaches coping techniques and strategies that help change behaviors.
- Acceptance and Commitment Therapy: This therapy helps people accept the negative emotions that lead to behaviors like skin picking and helps them change those behaviors. Mindfulness and other positive coping techniques also have a place here.
Other treatments for `(Dermatillomania)`
People with severe damage to the skin or underlying tissue may need additional medical treatment and care. Your doctor will be best able to explain the treatments they recommend (such as surgery, skin grafting, or antibiotics).
What are the complications/side effects of the treatment?
Possible side effects and complications depend on the severity of the condition, your personal situation, and other factors. Your doctor is the best source of information about what to expect or what to be careful of, as he or she can provide information tailored to your specific situation.
How can I take care of myself and manage my symptoms?
Dermatillomania is not something you should diagnose yourself. A trained, experienced mental health counselor should determine whether you have Dermatillomania or another condition. It is also not a good idea to treat it yourself. Medications, counseling, and other treatments require a doctor's prescription or guidance.
How soon will I feel better after treatment?
Your doctor can tell you more about what you can expect during your treatment and what can help you through the process. Because recovery time and how long it takes for you to feel better depend on many factors. Your doctor can take all of these factors into account and tell you what to expect.
How can I reduce or prevent the risk of this condition occurring?
Although `(Dermatillomania)` is a mental health condition, experts still don't know exactly what causes it. This means that it is unpredictable and cannot be prevented. There is no way to reduce the risk of developing it.
What should I expect if I have this condition?
Dermatillomania is not a very serious or dangerous condition. The main risk of this condition is the open sores. They can become infected due to constant scratching or damage. Although this condition is not directly dangerous, it can have a serious negative impact on your quality of life and overall well-being.
Because people with dermatotillomania are often embarrassed or anxious, many people avoid seeking treatment. Avoiding or delaying treatment increases the risk of permanent scarring and other mental health problems.
How long does `(Dermatillomania)` last?
Dermatillomania is considered a lifelong condition because of the risk of relapse . However, people with the condition can go into remission - meaning they no longer feel the urge to pick their skin or can abstain from it for long periods of time, sometimes indefinitely.
What is the outlook for this situation?
The outlook for this condition depends on how severe it is and other factors. Most people with this condition do not experience any serious physical effects. However , without treatment, many people with this condition suffer from psychological effects such as anxiety, shame, or worry.
How do I take care of myself? (More tips)
If you have `(Dermatillomania)`, it is very important to see a doctor (or several doctors, depending on your specific needs) who is trained and experienced in treating this condition. They can give you the best guidance for your care and tell you what you can do to improve your condition.
In general, you should do these things:
- Be honest about your condition. Dermatillomania is a mental health condition that affects your mind and behavior. Just as you would see a doctor for an ear infection or heart disease, you should see a doctor for mental health conditions like Dermatillomania. They can help treat the physical and mental effects of your condition.
- See your doctor(s) as recommended. This is especially important for counseling sessions, mental health appointments, and any other care you may need.
- Take your medication if prescribed. Avoid acting on your urges to scratch your skin. Medication can make a big difference.
- If possible, avoid triggers. People with dermatolism often pick at their skin in specific situations or circumstances. Avoiding those triggers can make a big difference.
- Eliminate opportunities to scratch. People with dermatotillomania may benefit from fidget devices or other activities that keep their hands busy and help them avoid scratching. Other ways to avoid scratching include wearing socks or wearing clothing that prevents scratching.
When should I go to an emergency room (ETU) ?
People with `(Dermatillomania)` usually do not need emergency medical treatment unless they have suffered serious injuries due to the condition. You should seek medical attention if you are bleeding heavily or have signs of infection. Signs of infection, including life-threatening conditions such as `(Sepsis),` include:
- Swelling, redness, or other color changes around the wound.
- Rapid heartbeat or breathing.
- Fever or chills.
- Confusion or delirium.
- Dizziness or fainting due to low blood pressure.
Finally, what to remember (Take-Home Message)
Dermatillomania is a mental health condition that can have a big impact on your life. Feelings of shame, anxiety, and guilt are common. But you are not alone. Seeing a doctor can help you overcome these feelings and get treatment for the condition. Doctors have special training and experience in treating these conditions and their effects. They can also help you feel comfortable getting the treatment you need.
With treatment, many people can control or overcome this condition. This means that you can focus on the things you want to do in life instead of worrying about what people will see or think about you. So, if you have these symptoms, please seek medical advice.
` Dermatillomania, Skin picking, Excoriation disorder, Compulsive skin picking, Mental health, OCD related, Skin damage, Skin picking, Skin breaking, Mental health, Skin diseases
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