Dermatillomania, also known as Skin Picking Disorder, is diagnosed when a person picks their skin repetitively to the point of causing temporary or permanent damage. This damage may include bleeding, bruising, and scabbing, and can lead to infections and/or significant scarring.
Like OCD and other OCD Spectrum disorders, dermatillomania can take many forms. The face is often the primary location of picking, but people may pick any part of the body and they may or may not target blemishes, freckles, moles or bumps. Usually individuals use their fingernails, but they may also use tweezers or pins or other objects. Some people even use their teeth and bite the inside of their mouth or tongue.
Other factors that tend to vary widely are the precursors and the duration. Prior to picking, some individuals report experiencing high levels of stress and tension, or they feel the incredible urge as if to scratch a persistent itch. Sometimes people report not even being aware that they have begun to pick. They may “wake up” once a picking session is well underway. Once a session is completed, people usually report a sense of relief, much like those who have straight OCD feel when they engage in compulsive behavior. However, the relief is often followed by regret and renewed commitments to stop.
Melissa treats individuals with Dermatillomania with a combination of individual and group therapy. She has found that Cognitive-Behavioral Therapy (CBT) and Habit Reversal Training (HRT) are key components, but that individual therapy also provides the opportunity to address underlying stressors and issues that create the state of tension in the first place.
Acceptance and Commitment Therapy (ACT) is a form of Mindfulness based CBT that helps people identify their values before employing an increased tolerance of feeling states in order to continue to move, in spite of their discomfort, in the direction of those values. Group therapy is a perfect format for teaching skills such as cognitive restructuring, mindfulness and how to use habit blockers. This is particularly helpful with Dermatillomania because the experience of not being alone with this often confusing and isolating disorder can be extremely supportive.