Can't You Stop Picking At Your Skin?
Have you ever engaged in or saw someone else engage in: peeling off their lips; or layer of the skin surrounding their nails; or a layer of their ears, or even hands or legs? It might be an underlying indication of excoriation (disorder).
What is Excoriation Disorder?
Excoriation, commonly known as ‘Skin Picking’ is a condition where a person has a tendency to peel their skin off, generally as an outcome of stress. These people pick at regions until they can extract material from the flesh. This may be referred to as “drawing a thread from the skin.”
Less than a century ago, excoriation was included in the Diagnostic and Statistical Manual of Mental Disorders – V (DSM-V), under the category of Obsessive-Compulsive and related disorders. According to the DSM, “Excoriation disorder is characterized by recurrent picking of one’s skin resulting in skin lesions and repeated attempts to decrease or stop skin picking.”
According to the World Health Organization, excoriation (skin-picking) disorder is classified as a mental, behavioral, and neurodevelopmental condition by ICD-10 code F42.4.
What causes Excoriation Disorder?
Clinically referred to as ‘Dermatillomania’, ‘Psychogenic Excoriation’, and ‘Neurotic Excoriation’, Excoriation Disorder is caused due to several reasons. Just one cause cannot be determined. However, there are certain potential causes which include:
- Emotions such as tension, anger, and anxiety are triggers. Not only that but passive activities such as watching television, reading, idleness, and feeling fatigued are also few of the triggers.
- Research has also shown that cerebellum is involved behind the causes of this repetitive behavior. Brain imaging studies have indicated abnormal activities in the gray matter area. Several studies have found differences in the activity of the basal ganglia, insula, and anterior cingulate cortex during executive planning activities and the viewing of emotive images.
- Genetics also play a role. Dermatillomania patients are far more probable to have at least one first-degree member of the family (parent, sibling, or child) who also has the disorder.
How can Skin Picking be classified as Excoriation Disorder?
We can better understand this by noticing the excoriation disorder symptoms that are manifested in the way a person chooses to pick their skin.
- The most typically chosen areas are the face, arms, and hands, however many people select various body regions such as fingernails, cuticles, toenails and so on.
- Picking at healthy skin, small skin abnormalities, infections such as pimples or blisters, or open sores from earlier picking are all possibilities.
- Most excoriation disease patients describe having a primary place of the body where they pick, but they will frequently migrate to other areas of the body to enable their primary picking spot to recover.
- Most people pick use their fingernails, but some use tweezers, needles, or other tools.
- Skin scratching, twisting, lancing, and biting may occur in addition to skin picking.
- Excoriation can cause infections, scarring, and so humiliation and social isolation or covering body parts, wearing long sleeves and so on.
- Skin picking produces clinically significant discomfort or impairment in social, vocational, or other crucial areas of functioning.
- Excoriation disease can persist anywhere from 5 to 21 years if left untreated. However, many experts believe that this condition is a permanent diagnosis.
Treatment for Excoriation Disorder
The prognosis for cure is shockingly bad, except in minor temporary instances provoked by an abrupt stress. The disease tends to grow and decrease with the patient’s living circumstances. Often, however, excoriation disorder can be addressed if the underlying psychiatric condition is controlled. Patients need help but may have difficulties in quitting the behavior of plucking. Without psychological and medical therapy, excoriation disorder seems to be a chronic illness.
There are a variety of options that a person can try to reduce skin picking. The best way to do so is to seek help. A mental health professional will guide you to get over the condition with the help of therapy or medications. The most effective therapeutic approach is Cognitive Behavioral Therapy. Techniques such as talk therapy, group therapy, habit reversal, acceptance and commitment therapy and so on have proved to be useful. Medications involve prescriptions by doctors for antidepressants, anticonvulsants, antipsychotics, and nutraceuticals
Apart from that, people can be taught to be more mindful in several ways such as identifying and resisting the urge to skin pick, asking a friend to point it out to them, or by using other methods like keeping hands busy by squeezing a softball or wearing gloves or even applying moisturizer.
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