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TheHayleyDoll 02-25-2012 05:24 AM

Dermatillomania - Skin Picking
Ever since I was in my early teens (around the time I developed Body Dysmorphic Disorder) I have had a crazy compulsion with skin picking (particularly, my lips, scalp, and skin/nails on my fingers). Apparently a 1/4 of people with BDD have this problem. It started off with striving to look perfect. If I felt my nails were uneven, I'd bite them down to nothing. If I saw any dry skin on my lips, I'd pick it off and would pick until I felt they were smooth. If I felt any bumps on my scalp, I'd pick them until they bled. If I had acne, I'd pick it off.

I told myself this was normal. "So many people bite their nails", "It's probably just a nervous twitch type thing" - but it had nothing to do with being nervous. Even though I don't struggle with BDD like I used to, I kept the habit. It's become something I do without consciously thinking about it. My husband hates it, and sometimes he grabs my hand and holds it so I stop, but it causes me to get extremely agitated and I usually end up yelling at him. I know he's trying to help, but the withdrawal causes the "butterflies in the stomach" feeling and makes me unable to think about anything other than "when will he let go so I can continue what I was doing?" If it's my lips I was picking at though, I just end up chewing them, because he can't stop me from doing that.

Right now I just stopped to pick/bite my fingers(or nails). Actually, since I started this thread post, I've stopped at least half a dozen times for about a minute or two each time. Sometimes these sessions can last for nearly an hour straight. O_O

Does anyone else have this sort of compulsive behaviour?

AaronShadows 02-25-2012 03:50 PM

I'm always chewing the skin around the corners of my nails, or just nomming on my nails altogether.

Miranda_ 02-25-2012 08:30 PM

I do that sometimes, usually when stressed; back when I used to self harm, I'd often worry at the cuts so they'd take ages to heal.

belladoggy 02-26-2012 03:51 AM

I will never shave my head because of all the scars that could be seen. I wonder if I have a form of what you described....I've been obsessed with scratching at my scalp or any bumps in my ears since I was at least five...nervous habit. I do it when I get incredibly bored, anxious, or angry/agitated, and half the time I don't even know I'm doing it. It doesn't hurt (I mean it probably should when the scratching leads to bleeding) but I also feel a weird sense of satisfaction when I finally get what ever spot I digging at to smooth out, even if that means it bleeds. I'm ashamed of it, of course, but my doctor always said it was part of my OCD (it's a compulsion and I guess I am obsessed with it), but what you described sounds closer to what actually happens. Except I don't bite my nails.

TheHayleyDoll 02-26-2012 03:55 PM

People with it don't have to have all the different types. And quite a few people with OCD have it as well. I know how you feel bella about not even realizing you're doing it or that feeling of satisfaction when it's smooth, regardless of the damage you've done to yourself.

It's because of that feeling that they generally treat it like a substance abuse problem, not a neurological disorder.

From wikipedia page (the important stuff):

Dermatillomania (also known as neurotic excoriation, pathologic skin picking (PSP), compulsive skin picking (CSP) or psychogenic excoriation[1][2]) is an impulse control disorder characterized by the repeated urge to pick at one's own skin, often to the extent that damage is caused. Research has suggested that the urge to pick is similar to an obsessive compulsive disorder but others have argued that for some the condition is more akin to substance abuse disorder. The two main strategies for treating this condition are pharmacological and behavioral intervention.

Research has also suggested that dermatillomania may be thought of as a type of obsessive compulsive disorder (OCD).[4] Dermatillomania and OCD are similar in that they both involve "repetitive engagement in behaviors with diminished control" and also both generally decrease anxiety.[2]
Nevertheless, Odlaug and Grant have suggested that dermatillomania is more akin to substance abuse disorder than OCD.[2] They argue that dermatillomania differs from OCD in the following fundamental ways: (1) there is a much greater share of females with dermatillomania; (2) dermatillomania may be inherently pleasurable whereas OCD is not; (3) the treatments that are generally effective for patients with OCD, (i. e., SSRIs and exposure therapy) are not as successful in patients with dermatillomania; and (4) unlike OCD, picking the skin is rarely driven by obsessive thoughts. Odlaug and Grant have recognized the following similarities between individuals with dermatillomania and patients with addictions: (1) a compulsion to engage in the negative behavior despite knowledge of the harm; (2) a lack of control over the problematic behavior; (3) a strong urge to engage in the behavior prior to engagement; and (4) a feeling of pleasure while engaging in the behavior or a feeling of relief or reduced anxiety after engaging in the behavior.[2] One study that supported the addiction theory of picking found that 79% of patients with dermatillomania reported a pleasurable feeling when picking.[2]

The region most commonly picked is the face,[4][2] but other frequent locations include the arms, legs, back, gums, lips, shoulders, scalp, stomach, chest, and extremities such as the fingernails, cuticles, and toenails.[2] Most patients with dermatillomania report having a primary area of the body that they focus their picking on, but they will often move to other areas of the body to allow their primary picking area to heal.

Those individuals that have dermatillomania along with other diagnosed conditions report differing motivations for their picking. Those with both OCD and dermatillomania report that they will pick their skin due to a perceived contamination of the skin, while those with both body dysmorphic disorder (BDD) and dermatillomania reportedly pick to fix perceived imperfections in the skin.[2]

Studies have shown the following rates of psychiatric conditions found in patients with dermatillomania: trichotillomania (38.3%), substance abuse (38%), major depressive disorder (approximately 31.7% to 58.1%), anxiety disorders (approximately 23% to 56%), obsessive-compulsive disorder (approximately 16.7% to 68%), and body dysmorphic disorder (approximately 26.8% to 44.9%).[2] There are also higher rates of dermatillomania in patients in psychiatric facilities; a study of adolescent psychiatric inpatients found that dermatillomania was present in 11.8% of patients.[2] It is also present at high rates with some other conditions: 44.9% of patients with body dysmorphic disorder also have dermatillomania; 8.9% of patients with OCD have dermatillomania; and 8.3% of patients with trichotillomania have dermatillomania
I also forgot to mention I do this with my scars/scabs as well. Rarely do any of my scars heal properly because of this. :/

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