Sometimes referred to as compulsive skin picking, dermatillomania is marked by the overwhelming compulsion to pick at one's own skin. Along with trichotillomania, or compulsive hair pulling, and onychophagia, or nail-biting, dermatillomania falls into a category of impulse control disorders known as body focused repetitive behaviors. Frequently, the urge to pick is so strong that sufferers may cause extensive damage to their skin.
People with this disorder frequently focus on pre-existing lesions on the skin, such as scabs, ingrown hairs, or insect bites. Because of this, they may cause further damage and scarring to the affected area. Many sufferers report that the picking seems to relieve stress or anxiety for the time being.
In some cases, individuals with dermatillomania may be compelled to create surfaces at which to pick. Because of this, this condition is sometimes accompanied by self-injury, or the practice of deliberately inflicting physical harm on oneself. Patients will then pick the resulting scab or wound.
While research in the area of dermatillomania is limited, the condition has been strongly linked to obsessive-compulsive disorder. People who suffer from both dermatillomania and obsessive-compulsive disorder may be very obsessive and ritualistic in their skin-care routines. Patients also frequently report entering a "trance-like" state during episodes of picking.
Many individuals with dermatillomania also suffer from body dysmorphic disorder (BDD), a psychological disorder in which patients experience a distorted body image. People with BDD typically become obsessed with a particular flaw in their appearance, although this flaw is usually non-existent or highly exaggerated by the patient. In this case, patients may feel that picking off scabs and lesions will make them appear more normal.
While the compulsion to pick at one's own skin is extremely overwhelming, some sufferers have found successful treatment through cognitive-behavioral therapy. A psychological practice, cognitive-behavioral therapy focuses on recognizing destructive thoughts and behavior, then re-teaching the brain to cope in less destructive ways. In many cases, cognitive-behavioral therapy is most effective when combined with the use of mood-stabilizing medications.