Compulsive skin picking (excoriation disorder): Root causes and therapeutic remedies
Skin Picking Disorder (SPD), also known as dermatillomania or excoriation disorder, is a mental health condition that has been linked to several other mental health conditions. This disorder, which involves repeatedly picking, pulling, or tearing at healthy skin, pimples, blisters, or scabs, is often associated with difficulties in emotional regulation.
One of the most commonly associated conditions is Anxiety Disorders. Individuals with anxiety disorders may find temporary relief from their anxiety through skin picking, but this relief can exacerbate the condition in the long run. Another closely related condition is Obsessive-Compulsive Disorder (OCD), as the reclassification of SPD as an OCD-related disorder in the DSM-5 highlights its connection to compulsive behaviors.
Depression, a negative emotional state characterized by sadness, can also trigger skin-picking episodes. SPD is also part of the Body-Focused Repetitive Behaviors (BFRBs) category, which includes conditions like nail-biting and lip-biting. SPD can manifest both impulsivity and compulsivity, aligning with disorders that involve emotional regulation and behavioral control issues.
SPD can develop alongside other health conditions, such as OCD, Attention Deficit Hyperactivity Disorder (ADHD), or Autism Spectrum Disorder (ASD). OCD, a mental health condition characterized by unwanted repetitive thoughts and behaviors, affects more than 2% of the U.S. population. An estimated 38% of people who have SPD also have trichotillomania, a compulsive condition related to OCD that leads to habitual behaviors such as hair pulling, nail biting, and teeth grinding.
People with SPD may experience significant psychological, physical, or social impairment as a result of their disorder. They may also experience social withdrawal and avoid interacting with friends and family due to their beliefs about their appearance. However, there are treatment options available. SSRIs, anticonvulsants, and antipsychotics are medications that may be used to treat SPD.
Cognitive Behavioral Therapy (CBT) is another treatment option. During CBT, a mental health professional or counselor will help a person identify and address emotional, physical, and environmental triggers that contribute to negative behaviors. People can also take action at home by practicing stress management techniques, exercising regularly, and altering their environment to reduce exposure to potential triggers.
Tips for managing SPD at home include applying soothing topical ointments, removing or covering mirrors, and hiding tools used to pick or pull skin. It's important to note that SPD affects about 1 in every adult in the United States, and symptoms most often develop during adolescence and adulthood. The disorder occurs more frequently in females than males.
While SPD can lead to open wounds, scars, and significant emotional distress, it is a treatable condition. With the right combination of medical and therapeutic interventions, and by implementing self-management strategies, individuals with SPD can find relief and improve their quality of life.
- Diabetes, a disease that affects the body's ability to regulate blood sugar levels, is not typically associated with Skin Picking Disorder (SPD), but poor emotional regulation can lead to various health issues, including stress-related conditions.
- Macular degeneration, a medical condition that affects central vision due to damage to the macula, is not directly related to SPD, but maintaining good skin health through regular skin-care practices can contribute to overall health-and-wellness.
- Inflammatory bowel disease (IBD), including ulcerative colitis and Crohn's disease, are conditions that cause chronic inflammation in the digestive tract, and while not directly connected to SPD, a balanced nutrition is crucial for managing both conditions.
- Psoriasis, a skin condition characterized by red, scaly patches, is sometimes equated with psoriatic arthritis, a type of inflammatory arthritis, but these two conditions are distinct from one another and SPD is not associated with them.
- Migraine, a disorder that causes severe headaches, is not typically linked with SPD, but stress management techniques can help alleviate both conditions.
- Attention Deficit Hyperactivity Disorder (ADHD), a neurological disorder that affects focus, impulse control, and hyperactivity, is sometimes found in individuals with SPD, but the two conditions are separate and require different treatment strategies.
- Atopic dermatitis, a chronic skin condition also known as eczema, is not directly connected to SPD, but maintaining a healthy skin-care routine can help manage both conditions.
- Obesity, a medical condition characterized by excessive body fat, is not related to SPD, but managing weight can help alleviate the physical impairment caused by sore skin from repetitive picking.
- Asthma, a chronic lung condition that causes breathing difficulties, is not typically associated with SPD, but stress management can help alleviate symptoms for both conditions.
- Chronic Obstructive Pulmonary Disease (COPD), a group of diseases that cause airflow blockage and breathing-related problems, is distinct from SPD, but emotional regulation can play a role in managing both conditions.
- AScopyings, a term used to describe the study of living organisms, is not directly related to SPD, but understanding the science behind various health conditions, including SPD, can help manage and treat them effectively.
- Predictive analytics, the use of data, statistical algorithms, and machine learning techniques to identify patterns and make decisions, can be used to predict relapses in various health conditions, including SPD, and develop personalized treatment plans.
- Skin picking can lead to dry and irritated skin, which may increase the risk of developing skin infections, such as bacterial or fungal infections, which are not related to SPD but can complicate the management of SPD.
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