Is it necessary to fight dermatillomania?

Many guys and girls are used to squeezing out pimples on their faces. They consider this a normal action, although it is one of the signs of a mental disorder. Dermatillomania, which few people know how to get rid of, is an obsessive desire to harm oneself.

The person constantly tries to comb or scratch the skin. Conduct disorder is also reflected in the desire to pull out hair or bite nails. To do this, use various tools: tweezers, nail scissors. For some, teeth or long nails are enough to cause damage. These are signs of dermatillomania.

Dermatillomania. From over-caring to scars

Dermatillomania. About 5% of people suffer from it to one degree or another / Isabel Seliger Dermatillomania is about control...

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Dermatillomania is about control. More precisely, the fear of losing him.

It's about anxiety. More precisely, about constant mobilization, as if you are about to take a leap to defend yourself, but instead you attack yourself.

Each time it is an obsessive-compulsive chain: a restless thought - an anxious expectation - fear - a habitual ritual. Manipulations lead to the desired relaxation, but not for long: anxiety subsides only for a while, and the feeling of guilt and shame for one’s own “weakness” and temporary weakening of control overwhelms one’s head. And every time everything is new.

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Reasons for appearance

Crusts on the head of an adult may appear due to allergic reactions. They may be provided by low-quality or simply unsuitable hair and scalp care products. In particular, crusts on the scalp in adults may occur after using:

• shampoo;
• gel or hairspray;
• Hair Dye.

The scalp can also be damaged due to:

• poor quality nutrition;
• stress;
• taking medications;
• weakened immunity;
• fungus;
• diseases of the hormonal system, which lead to increased production of sebum and accelerated regeneration of external cells.

Sometimes several causes act simultaneously, which complicates the treatment process.

It is worth noting that autumn and winter are the times when crusts appear in adults. The reasons for this pattern are weather conditions. When it’s cold, a person’s immunity decreases, various diseases begin to appear, the level of stress increases, and fungi, which, by the way, are on the scalp of absolutely all people, can become active.

What is dermatillomania?

Dermatillomania is an auto-aggressive (self-directed) reaction that manifests itself in the form of uncontrolled effects on the skin. Scratching wounds, squeezing out inflammations, combing uneven skin, picking off sores and hangnails, eating flayed parts of the skin (dermatophagy), biting the lips and cheeks from the inside - all these are manifestations of dermatillomania.

Sometimes people cause damage to their skin with their nails; in special cases, additional tools are used: tweezers, needles, tweezers.

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Symptoms

The urge to damage the skin on all possible affected areas occurs spontaneously, regardless of place and time. The result is dermatillomania. Unconsciously, a person begins to pick off an annoying pimple on his face or simply scratch his head before an important event. There is a systematic repetition of combing after various stressful situations:

• misunderstanding of others;
• physical activity;
• moral shock.

Each time you get a feeling of relief, the addiction intensifies and becomes a habit. At the moment the nails damage the skin, the patient receives a short-term feeling of relief or partial satisfaction. Sometimes patients feel euphoria, which reinforces the psychological habit of picking the skin with their fingers.

Read also: Are your nails brittle? What are the causes of the problem?

Dermatillomania manifests itself in the form of scratching the skin in exposed areas such as the hands and face, or under the hair on the skin. Scars spread throughout the body over time, and people suffer due to the inability to stop compulsive skin picking. Sometimes those suffering from this disease can begin to squeeze out even living moles.

Constant mechanical irritation of the skin sometimes leads to infections and dehydration of the skin. As a result, a person not only spoils his appearance, but also provokes the entry of bacteria into the body.

In addition to skin picking, dermatillomania is also characterized by repetitive compulsive behavior. This is manifested in the habits of picking the skin on the fingers, biting nails, biting the lips and the inside of the cheek, the desire to pick at incompletely healed wounds and tearing out body hair.

Hair pulling is classified as a separate subtype - trichotillomania.

Symptoms of trichotillomania include an irresistible desire to rip out hair, aware of the harm being caused. Eyebrows, eyelashes, hair on the arms and head suffer. A girl's desire to become beautiful ends with tufts of hair being torn out. Even bleeding and scars do not stop patients.

It is worth noting that dermatillomania and its varieties usually affect women and girls aged 15 to 45 years.

Among men, this behavior disorder is practically not registered.

How does a person with dermatillomania feel?

“My main victims are my fingers. Over the past ten years, I don't remember a single day when my skin around my nails was completely intact. I peel off the skin unconsciously. I usually don't even notice it until someone tells me to stop, and then I feel really embarrassed."

— Alaura Filbin shares her problem in a blog dedicated to dermatillomania.

The disorder is highly stigmatized, and it is shame that causes a person to remain silent and not seek help. It is difficult to explain to others (and most importantly, to yourself) why it is so difficult to control the obsessive desire to harm yourself.

“Dermatillomania causes pain, embarrassment and shame. But at that moment, when I am focused on picking the skin, I have a strange feeling of calm, order, pleasure and relief,”

says another blogger Luna Bloom.

During times of anxiety, a person with dermatillomania feels that the hands themselves are drawn to the place that he or she usually injures. Sometimes a relapse can occur even in a calm environment, when there is no hint of anxiety. In this case, the person, as if in a trance, feels every millimeter of the body in search of some kind of defect, and its elimination brings long-awaited comfort.

A person promises himself that this was the last time, he is ashamed of his weakness, considers himself weak-willed and wounded. Pimple scars, unhealed ulcers and scratches as a result of dermatillomania only increase the feeling of guilt, causing a person to withdraw and experience difficulties in his personal life, work and friendships.

Keeping the problem quiet creates the perception that the disorder is rare. According to research, about 5% of people suffer from bodily obsessions to one degree or another, and this is every twentieth.

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How to understand that it is dermatillomania?

The line between self-care and obsessiveness lies where the behavior begins to cause significant inconvenience and suffering, and interfere with daily life.

“I know that it is relatively “normal” to pick off pimples and sores, but it is absolutely not normal to rip off the skin under your nails so that it does not heal for 4 years. It's not normal to stand in front of a mirror for 10, 20, 30 minutes and pick at your skin. It's not normal if your cuticles are damaged because you're picking off every hangnail. It’s not normal if you start bleeding because you’ve torn off too deep a layer of skin.”

- says Alaura.

Dermatillomania always begins “innocently” and with minor injuries. Only when it becomes very difficult to stop and the body turns into a mess strewn with unhealing wounds, it can no longer be ignored.

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Why am I doing this?

Many people understand that by not allowing their wounds to heal, they are only aggravating the situation, but obsession takes over.

Often this behavior is dictated by the desire to make oneself better, to remove imperfections, as if to get rid of an annoying problem.

But systematically picking the skin gives only imaginary relaxation: in fact, a person is worried about another, “invisible to the eye” problem, but since it cannot be solved here and now, the person changes the focus of attention to what he (she) is able to eliminate. Namely, visual imperfections of the skin.

“I do this when I’m not paying attention, when I’m bored, when I’m anxious, when I’m just irritated by uneven skin. I realize that the latter is my fault. But everything else is unconscious impulses,”

- writes Alaura.

Sometimes the cause of dermatillomania can be a person’s personal characteristics: pathologically altered character traits that interfere with a peaceful life (perfectionism, suspiciousness), or disorders (hysterical, anxious, borderline). Dermatillomania as a symptom of neurosis can be expressed in the need to constantly use your hands, calm your nerves, and be distracted by such a ritual.

Although dermatillomania can be a cause and consequence of body dysmorphic disorder (when a person is overly concerned about a defect or feature of his body), this obsession cannot be called self-harm. Injuries are a result, not a goal.

A person suffering from dermatillomania does not want to harm themselves, and sometimes the damage is unconscious , such as when a person scratches their skin in their sleep. Self-harm is an attempt to consciously hurt yourself, to drown out mental pain with physical pain.

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How can I help myself?

Recognizing the disorder is the first thing a person with dermatillomania can do to help themselves. It can be difficult to notice destructive behavior and be critical of it, but recovery depends on awareness of the problem.

Understanding the senselessness and danger of dermatillomania, a person makes attempts to prevent skin damage: cutting his nails, putting on gloves, not turning on the light in the bathroom, or applying special ointments. This is an additional, but not primary way to cope with obsession - it seems that the disorder can be controlled, but this is only a temporary effect. Often the symptoms return, and sometimes dermatillomania develops into other addictions.

The next step after recognition and self-diagnosis is to seek help from specialists . This pathology is still poorly understood, so it is important to contact not only a dermatologist as a specialized skin specialist, but also involve psychotherapy.

Dermatillomania is an expression of internal problems, suppressed anxiety, aggression and a range of other emotions. It makes no sense to treat only visible manifestations (damage or scars) if the behavior remains unchanged and the person will resort to this method of response every time.

In the treatment of dermatillomania, cognitive behavioral psychotherapy has shown good results, during which the patient learns to react to life situations in a new way (solve problems constructively, and not destructively, causing harm to oneself). It is important to determine the exact cause of the disorder and learn to track triggers.

Together with psychotherapy, yoga and meditation, relaxation techniques, sports and active pastime, hobbies that bring pleasure and positive emotions bring good results in the treatment of dermatillomania. Drug treatment is prescribed as a last resort, when dermatillomania has developed against the background of other serious mental illnesses (depression, post-traumatic stress disorder and others).

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Treatment options

Dermatillomania must be treated comprehensively. It is very difficult to get rid of a disease that is constantly progressing on your own.

Among the main methods of treatment are the following:

• use of dermatological agents to relieve symptoms of itching;
• seeking help from a dermatologist, cosmetologist, trichologist;
• undergoing a course of treatment with a psychologist.

The main emphasis in the fight against this disorder is on the psycho-emotional side.

The most popular methods of struggle are psychotherapy and hypnosis.

Medicinal sedatives are prescribed only when prolonged depression is the underlying cause. In other cases there is no need to use them.

Cognitive behavioral psychotherapy

For people with dermatillomania, treatment is carried out using various methods of cognitive behavioral psychotherapy. Several techniques are used for treatment, the main one being habit retraining training.

Read also: CRACKS IN THE FINGERS NEAR THE NAILS: CAUSES, TREATMENT - City portal Kstovo Info

According to him, skin damage is a conditioned reaction to certain events in the lives of people suffering from dermatillomania. The sick person may be unaware of the triggers that are ingrained in their mind.

Habit retraining training works in the following areas:

• training in awareness in situations that precede manifestations of mania;
• searching for a replacement behavior when a stressful situation occurs;
• training in self-soothing techniques.

The second method is trigger control. Stimulus regulation involves the use of special “habit blockades”. These are peculiar restrictions on the possibility of injuring the skin.

Cognitive restructuring is a technique that helps a person with dermatillomania learn to think correctly when faced with obsessive desires to damage the skin. Helps develop positive thinking and quickly eliminate negative thoughts.

The main goal of cognitive behavioral psychotherapy is to teach a person to adequately perceive psychological situations that cause him discomfort. This type of treatment helps develop the ability to become aware of the problems contained in thoughts and sensations without scratching the wounds.

A course of treatment based on cognitive behavioral therapy should consist of a minimum of 3 sessions. The average duration of treatment is 2-3 months.

Hypnosis

One of the effective methods for getting rid of dermatillomania is called hypnosuggestive psychotherapy. This type of treatment involves putting a person into a trance state where attention and concentration are muted.

A patient under hypnosis is taught certain reactions to situations and events, called triggers. New thoughts and behavior patterns take root in the subconscious, which allows for a long-term improvement in the health of a person with dermatillomania.

With the help of various techniques of suggestion (three “yes”, chattering, psychoanalytic, body-oriented, etc.), a complete restructuring of the reaction to stimuli occurs. After 5-6 sessions of hypnosis, the main symptoms of the disease will cease to appear. And if hypnosuggestive psychotherapy is carried out in combination with NLP (neurolinguistic programming), the effect will last 3-5 years.

Individual and group therapy

If the case is not started, they resort to individual or group techniques. The first involves one-on-one conversations with a psychologist. During the conversations, the reasons for the development of the disease are clarified, which will allow the doctor to draw up a treatment plan. The patient is asked to think about the following problems:

• how often does he scratch his head?
• what provoked such actions;
• what he feels while scratching his skin;
• does pulling out hair bring him joy?
• does he feel better after this?
• is his disorder noticeable to others, etc.

Read also: Black spot on the big toe nail: causes of appearance, methods of eliminating the problem

This allows the patient to independently assess the situation and conduct self-analysis. During the sessions, a psychologist will help him reconfigure and get rid of the obsessive desire to scratch his skin until it bleeds.

In parallel with individual classes, group classes are conducted. First, all patients get to know each other, share their problems and tell how they tried to cope with them. The main feature of group therapy is a variety of role-playing games that allow you to master new behavior patterns. Patients also spend time together in an interesting and active way. This could be joint yoga, meditation or some kind of sport. It happens that a group of patients attends cultural events or during a session discusses a book they have read, etc.

Psychologists explain that an interesting hobby will help you take your mind off obsessions and lift your spirits. Patients who were depressed and did not communicate with anyone have a chance to become socially active again.

The optimal number of individual therapy sessions is 10, group therapy is 5-7. The duration depends on the initial condition of the patient, the success of his treatment and the work of the psychologist. On average, treatment takes from 1 to 6 months.

During individual therapy, you must not forget to constantly carry out facial care procedures. You should also visit a dermatologist or other doctor regularly.

A loved one of mine has dermatillomania. What should I do?

Dermatillomania is destructive impulses, cravings that are difficult to resist. It is important to understand this and not shame a person with dermatillomania for their habit. Shame accompanies your loved one throughout their life. Delicacy and good manners in this matter are the main thing that will help in communication.

“Just stop doing this,” “Pull yourself together,” “Stop being weak (weak)” are not phrases that will help your loved one heal. “To everyone who is telling me to stop, I want to respond: I know what you mean, but believe me, this problem will not go away if you just tell me to stop. I appreciate your intentions, but I feel like I failed again,” says Alaura. Instead, the girl asks for something to occupy her hands (if the desire to damage the skin cannot be controlled even in a public place).

“How can I help you?”, “Let’s think together why you want to harm yourself?”, “What can be done instead?” - these questions, spoken in a calm, friendly tone, will relieve tension and distract a person with dermatillomania.

It is important for people with dermatillomania to know the following:

1. it is surmountable;
2. Having a disorder is not a shame, but you need to seek help;
3. silence only stigmatizes the disorder;
4. you are not alone, there are many of us.

The disorder itself or its result (scars, poorly healing wounds, lesions on the skin) does not make you worse. You can help yourself if you ask for help. You can improve your life.

Dermatillomania – self-harming behavior

It may seem incredible, but the habit of squeezing pimples or chewing hangnails can turn into a tragedy - dermatillomania. Dermatillomania is a psychological behavioral disorder that is literally reflected and even imprinted on the skin, since its manifestations include constant compulsive scratching and scratching of the skin.

Dermatillomania - an obsessive condition 48712

Dermatillomania - behavior disorder

Dermatillomania is a psychological disorder, the course of which is very similar to neurotic excoriations, although its nature is very closely related to another disorder - dysmorphophobia. This is a fairly rare condition, so its definition and symptoms vary, although, however, experts believe that the incidence statistics of dermatillomania are much higher - such patients simply rarely seek help. Recently, dermatillomania has been included in the spectrum of symptoms of obsessive-compulsive disorder (OCD): in the latest fifth version of the DSM (Diagnostic and Statistical Manual of Mental Disorders), the “bible of psychiatrists” around the world, this disease is classified as a variant of OCD. However, dermatillomania and obsessive-compulsive disorder have perhaps only one thing in common - obsessive repetitive behavior. Opponents of this classification believe that dermatillomania is still more like an addiction than an obsessive condition.

This disease hides deep psychological reasons that in some unknown way force a person to scratch his skin again and again. Many psychological causes of dermatillomania lie in suppressed feelings - anger, disappointment. However, most often the disease is provoked by such common “complexes” as self-abasement, guilt or shame. Often, dermatillomania is a consequence of an anxiety disorder or clinical depression. Sometimes dermatillomania is triggered by significant acute or prolonged chronic stress.

Typically, dermatillomania does not develop simply because of internal “negativity” - it is often preceded or facilitated by skin diseases or simply cosmetic problems, especially those that appear on open areas of the body. The risk of developing this disorder is high in people suffering from itchy rashes: they are more likely to form an “itchy” stereotype.

This disorder, which is a consequence of negative feelings, can itself also lead to troubles in daily and social life, although some people suffering from dermatillomania manage to successfully hide its symptoms and traces for a long time.

How does dermatillomania develop?

This pathology is purely a behavioral disorder, although, as with body dysmorphic disorder, it all starts with the mirror. At first, as a rule, noticing the first minor manifestations on the skin, say, acne, a person begins to suspect that he is suffering from something more serious (although in fact this is not the case). This unnerves him, constantly irritates him, he fixates on an imaginary illness, cannot distract himself from the pimple - and as a result, he scratches his skin repeatedly and uncontrollably. The circumstances surrounding the development of dermatillomania may vary from person to person: some may become enraged by acne, while others will get carried away with scratching a small injury on the scalp, believing that the damage will not be noticeable to strangers.

Scratching and accompanying scars can spread to one or more areas of the body: the face, scalp, neck and décolleté. Scratching appears somewhat less frequently on more covered parts of the body, such as shoulders, armpits, back, arms and legs.

Symptoms of dermatillomania

A characteristic symptom: people with dermatillomania experience a short-term feeling of relief and even pleasure when scraping or scratching. Soon the stress peak comes again, which again gives way to a feeling of relief or pleasure when you manage to successfully pick off a crust on the skin or squeeze out a pimple... The cycle is repeated countless times, so it is not surprising that the skin becomes covered with scars and scars.

The urge to scratch - a kind of self-injurious impulses - can happen at any time of the day and in any place (even in a public and very crowded place), since they are not controllable. Of course, most often they happen in front of a mirror, but it is not uncommon for such a need to occur while walking, traveling on public transport, at work, while watching TV, reading... Usually attacks last for several minutes and are repeated several times a day. However, in severe cases, attacks of scratching can last up to an hour or more, repeating day after day.

The leading symptom of dermatillomania is compulsive scratching. 45341

The process of “cleansing” your skin is triggered by certain emotional states – most often anxiety, boredom, excitement or fear. The mechanics of the attack are similar to behavioral addiction. The trigger (triggering moment) can be not only the condition described above, but also one’s own appearance, especially if a person begins to look at his skin closely enough. Often people can hear an inner voice belonging to parents or peers that tells them something unpleasant about their skin condition. There is a narrowing of attention and a state of mild excitement. When the “violator” of skin smoothness is eliminated, pus or other contents are released from its cavity, the person experiences pleasure and relaxation. Then he moves away from the mirror and sees red or bleeding skin, or after some time he discovers that the infection has spread and he is overcome with a feeling of shame for his lack of ability to control himself. Thoughts appear that friends and relatives will again see traces of his weakness, will reproach him or simply “think badly of him.” Shame, as an intense negative experience, already prepares the ground for the next attack on oneself.

Dermatillomania may be accompanied by other symptoms also associated with obsessive repetitive behavior: the habit of biting nails, tearing or biting hangnails and cuticles, the habit of biting lips or the skin inside the cheek, pulling out hair (it is classified as a separate disorder - trichotillomania). One way or another, a person is irresistibly drawn to pick a scab, despite the fact that he knows that this can cause harm, and his action may be followed by bleeding or a scar will remain - but he still continues his manipulations. These impulses cannot be controlled because they are irrational, so it is almost impossible to get rid of dermatillomania after another attack without special treatment: few people manage to avoid frequent repetition of scratching “rituals” using willpower alone.

Treatment of dermatillomania

This disease often requires the intervention of not only a psychotherapist, but also a professional dermatologist. It is very important to correctly establish the diagnosis, because this pathology is still poorly understood and requires serious support from a medical specialist (psychotherapist or psychiatrist; psychologists will not be able to help with such disorders). Treatment of dermatillomania is carried out using various techniques, so-called talking therapy. Cognitive behavioral psychotherapy brings good results.

Yoga, meditation, various relaxation techniques, sports, and in general any activity that brings positive emotions can also be of great help. Therefore, experts recommend that such people acquire a couple of hobbies. Medicines (mostly antidepressants) are prescribed if depression is diagnosed, and dermatillomania has developed precisely against its background. However, among other things, such drugs can still be useful in severe cases of this disorder (with prolonged attacks of scratching, their high frequency, etc.).

Intrusive skin trauma and hair pulling 45636

Since attacks of dermatillomania occur against the background of a narrowed consciousness and are poorly or almost not realized, for this reason it is recommended to avoid the main triggers, including:

• View of your own skin from a close distance: it is not recommended to come close to the mirror or even avoid contemplating your own reflection, reducing “communication” with this object to the very minimum.
• Often an attack can be triggered not only after looking at oneself, but also after feeling the skin. In such cases, it is recommended to stick a patch or pieces of tape on the fingertips - when the hand touches the face or other “problem” areas of the skin, the consciousness will register this fact.
• Stressful situations: this rule is quite difficult to follow, since no one is immune from unpleasant surprises, but yoga and meditation really strengthen your nerves in the best sense of the word.

It is not necessary that the habit of scratching the skin and picking off scabs is associated with this disease: only a doctor can make a diagnosis. However, if you're worried that you won't be able to overcome this harmful pattern on your own, see a therapist and find out if you have dermatillomania or similar disorders that are closely related to obsessive-compulsive disorder and body dysmorphic disorder. Such problems are very difficult to solve on your own, so it is better not to hesitate to seek advice from a specialist. If you think that you probably have this particular disease, then you should immediately, urgently seek help: such a disorder does not go away on its own, it is associated with deeper psychological problems, for the solution of which you will need the help of a qualified psychotherapist. It is also recommended to consult a dermatologist to minimize the consequences of the disease - scars and cicatrices.