What motivates skin picking disorder?
Both biological and psychological factors appear to contribute to the development and maintenance of this disorder (Grant et al., 2012). Skin picking behaviors are often found in those who have higher levels of emotional impulsivity, and these behaviors might serve as a way for individuals to regulate their emotions.
People may pick out of habit or boredom, and, at times, may not even be aware that they are picking. People may also pick in an attempt to cope with negative emotions (e.g., anxiety, sadness, anger) and/or in response to feelings of mounting stress and tension. While picking, people may feel relief.
Face: An estimated 32% of people with dermatillomania pick at the skin of their face. Legs: Approximately 17% of people with excoriation disorder focus most of their picking on their legs. Scalp: For 22% of those with skin picking disorder, the focus is on the scalp.
Skin picking itself is not indicative of obsessive-compulsive disorder (OCD). Many people engage in skin picking behavior when they have a scab or a pimple, or just pick at their cuticles.
Skin picking may be triggered by anxiety as a way to relieve stress. When it becomes frequent and intense, however, it can become a condition called skin picking disorder or excoriation. People with skin picking disorder do it out of habit and may struggle to control the impulse.
People with ADHD may develop skin picking disorder in response to their hyperactivity or low impulse control.
Skin picking disorder is often linked to sensory processing disorder, and the act of skin picking is referred to as a “sensory seeking behavior.” As a result, one way to help reduce or eliminate your skin picking episodes is to consciously replace skin picking with another form of sensory stimulation.
Skin-picking development has been suggested to be preceded by traumatic life events.
During a time of stress.
Other types of BFRBs include pulling or picking of the hair or nails that damages the body. It is classified in the DSM-V (a compendium of psychiatric diagnoses) as a type of obsessive compulsive disorder because of the compulsive urge to perform repetitive behaviors.
Psychotherapy can help lessen the urge to pick, including medicine. Selective serotonin reuptake inhibitors (SSRIs), other antidepressants, and anti-anxiety medications can help reduce inclinations to pick one's skin. It's easier to pick skin, scars, and scabs when the skin is rough, dry, and cracked.
How do you help someone with skin picking disorder?
- Practice self care. ...
- Remember your partner is a whole person. ...
- Be gentle with shame. ...
- Create a safe space. ...
- Be sensitive to body image issues. ...
- Refer to a dermatologist if you see signs of infection or irritation. ...
- Normalize.
Intermittent and repeated skin picking to relieve tension from itching may “sensitize” the reward system and lead to escalation in reward seeking and repeated stimulation of dopamine release, resulting in restoration of a state of dopamine deficiency as in idiopathic PD.
Putting lotion on my body would be a great alternative to picking, as a self-care activity that involves self-soothing touch.
Excoriation (skin-picking) disorder is treated with a variety of psychotropic medications. Attempts to treat it with a variety of psychotropic medication classes include antipsychotic agents, antianxiety agents, antidepressant agents, topical cortisone agents, and antiepileptic agents.
However, the treatment for hair pulling and skin picking and other BFRB is not the same as for OCD. Medication is often the first line of treatment. Selective Serotonin Reuptake Inhibitors (SSRI) like Prozac, Zoloft, Paxil, and Lexapro offer some symptom relief.
Patients with Autism Spectrum Disorder present with a heterogeneous mix of features beyond the core symptoms of the disorder. These features can be emotional, cognitive or behavioral. Behavioral symptoms often include self-injury, and this may take the form of repetitive skin-picking.
Only fluoxetine (Prozac) has been rigorously studied in hair pulling and skin picking.
The most common cause of picking at the skin is obsessive compulsive disorder (OCD). Some studies suggest that the picking might be similar to a tic-like behavior. It is called tic/OCD disorder. The stimulant medications used to treat ADHD can exacerbate a tic disorder.
Sensory processing problems may differentiate ADHD from normally developing children. However, it does not mean that it is specific to ADHD. The sensory profiles of children with ADHD may be similar to other disabilities such as autism.
- Watching as others move around the room.
- Constantly touching people or objects.
- Being unable to sit still.
- Constantly being on the go.
- Jumping, spinning, or rocking.
- Fidgeting with anything within reach.
- Frequently picking at fingers.
- Taking risks on the playground.
What are sensory seeking behaviors examples?
Examples of Sensory Seeking Behaviors
Dumping toy bins rummaging through them aimlessly. Chewing on objects or clothing. Rubbing against walls or furniture and bumping into people. Loves spinning in circles, amusement rides, and is constantly moving.
Compulsive self-injurious behavior (SIB), including hair pulling, nail biting, skin picking (SP), and scratching, is habitual, repetitively occurs, and is frequently observed as a comorbid condition in various psychiatric disorders, such as borderline personality disorder (BPD), post-traumatic stress, depressive, ...
Skin-picking development has been suggested to be preceded by traumatic life events. Dissociative symptoms have been reported as experienced by skin-picking sufferers during picking episodes.
Frequent picking can irritate existing sores and even cause new ones to form. This can cause additional scabbing and lead to scarring. This continued picking can develop into a condition called skin-picking disorder, or excoriation. People with this disorder pick at their skin out of habit or impulse.
While dermatillomania can be triggered by negative emotions such as anxiety, it isn't always; boredom, for example, is just as common a trigger. What's more, any pain caused by skin-picking is rarely the intention; instead, the behaviors often are experienced as soothing or relaxing, at least in the moment.
Skin picking can be triggered by emotional components such as anxiety, boredom, or tension. Pain in not reported to accompany these actions. Often a sense of relief, gratification, and pleasure is achieved following the skin picking.
- Play to your strengths. Identify your signature strengths and the impact you can have by using them on a daily basis. “ ...
- Be willing to experiment. Avoid the risk of routine by shaking things up. ...
- Tap into purpose.
Get therapy
This type of CBT includes more of the stimulus control techniques described above, as well as habit reversal training, in which individuals are taught to engage in a harmless motor behavior (like clenching one's fists) for one minute when triggered to pick.
Excoriation (skin-picking) disorder (SPD) is a relatively common psychiatric condition whose neurobiological basis is unknown.
Selective Serotonin Reuptake Inhibitors (SSRIs)
Several studies have examined SSRIs in treating trichotillomania and skin picking. The SSRIs include: fluoxetine (Prozac), fluvoxamine (Luvox), sertraline (Zoloft), citalopram (Celexa), escitalopram (Lexapro), and paroxetine (Paxil).
References
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5353026/
- https://anxietyinstitute.com/what-we-treat/ocd-and-related-behaviors/skin-picking-excoriation-disorder/
- https://iocdf.org/about-ocd/related-disorders/skin-picking-disorder/
- https://www.medicalnewstoday.com/articles/325925
- https://neuro.psychiatryonline.org/doi/10.1176/appi.neuropsych.15100250
- https://www.southshorehealth.org/wellness/blog/sensory-seeking-in-children-how-to-treat-sensory-seeking-behavior
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8326802/
- https://www.therecoveryvillage.com/mental-health/excoriation/excoriation-statistics/
- https://courage-counseling.com/15-dos-donts-significant-others-people-struggle-skin-picking-trichotillomania/
- https://emedicine.medscape.com/article/1122042-medication
- https://www.kleinmd.com/blog/stop-picking-neurotic-excoriations-and-how-to-break-the-habit
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4837383/
- https://bfrb.org/articles/list-of-strategies-for-skin-picking
- https://www.psychologytoday.com/us/conditions/dermatillomania-skin-picking
- https://www.frontiersin.org/articles/10.3389/fpsyt.2021.698543/full
- https://bfrb.org/articles/medications-for-body-focused-repetitive-behaviors
- https://www.fastcompany.com/40573806/how-to-trick-your-brain-into-not-getting-bored
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5379223/
- https://www.webmd.com/mental-health/skin-picking-disorder
- https://www.thetemper.com/skin-picking-disorder/
- https://www.additudemag.com/is-her-adhd-medication-making-my-daughter-pick-at-her-skin/
- https://winterparkcounseling.com/hair-pulling-skin-picking-disorders/
- https://www.health.harvard.edu/blog/picking-your-skin-learn-four-tips-to-break-the-habit-2018112815447
- https://www.treatmyocd.com/blog/skin-picking-sign-of-ocd
- https://www.healthline.com/health/skin-disorders/excoriation
- https://www.medicinenet.com/is_picking_at_your_skin_a_symptom_of_anxiety/article.htm
- https://www.brainbalancecenters.com/blog/sensory-integration-ideas-for-a-sensory-seeker
- https://tpcjournal.nbcc.org/excoriation-disorder-assessment-diagnosis-and-treatment/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3149116/