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Dermatillomania and Addiction

Dermatillomania, also known as excoriation disorder, is a severe mental health condition involving uncontrollable, repeated skin picking. The DSM-5-TR classifies it as a type of obsessive-compulsive disorder that shares similarities with nail biting and hair pulling. People with dermatillomania may find they can’t quit the habit, despite wanting to.  

Why Do People Pick at Their Skin?

At first glance, dermatillomania may seem like nothing more than a bad habit. However, researchers believe there are genetic and physiological components to the disorder. For example, scientists have identified a correlation between structural brain changes and compulsive skin picking.

Excoriation tends to begin as a completely unconscious behavior; even when the resulting injuries are impossible to overlook, people may be unaware of when they are picking at their skin.

There is also a connection between dermatillomania and abuse of specific drugs, including heroin and methamphetamine.

  • Heroin: Heroin can cause an itching sensation throughout the legs, arms, face and torso. A powerful compulsion to scratch at your skin can open wounds, and picking at the scabs will prevent them from healing.
  • Meth: Ongoing meth abuse can cause people to hallucinate the sensation of bugs crawling under their skin. Many meth users develop skin sores from picking and scratching at the imagined insects.

Is Dermatillomania Self-Harm?

Self-harm, officially known as non-suicidal self-injury, is a psychological disorder that causes people to deliberately cut, bruise, scratch or burn themselves. It is an unhealthy coping mechanism that helps people find temporary relief from powerful emotions. Though compulsive skin picking can cause physical injuries, it is not a self-harm disorder. While self-harm and borderline personality disorder often go hand in hand, compulsive skin picking relates more closely to anxiety and OCD than BPD.

People with excoriation disorder start picking at their skin because they feel compelled, not because they have an underlying condition like psoriasis or eczema. However, over time, picking can result in infections, scars and thick or rough skin that mimics a skin ailment. These issues can cause shame and worsen existing low self-esteem.

Skin picking can be time-consuming and cause people to overlook their personal and professional responsibilities. They may also miss appointments because they are acutely embarrassed by their sores and scars and don’t want others to see them. The chronic stress may make the compulsion worse and predispose skin pickers to depression, suicide and substance use disorders.

How to Find Help for Skin Picking

Usually, people who pick have a strong desire to be free of the compulsive behavior, but don’t know how to stop. That isn’t due to a lack of willpower – instead, it is because they must uncover the underlying psychological issues causing the urge. Techniques such as cognitive behavioral therapy and specific anti-anxiety medications are the most effective ways to address excoriation disorder. It may also be necessary to enter residential treatment for co-occurring addiction.  

At Vista Taos, we provide holistic programming tailored to our clients’ unique needs. Our master’s-level clinicians uphold high standards of care in a therapeutically rich environment. To learn more about recovering in New Mexico, contact us today.

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