Dermatillomania: what it is, causes, symptoms and treatment

Human beings carry out behaviors of which, at times, we are not aware. Automatic behaviors are carried out without a mental effort that makes us realize the task we are carrying out, such as constantly touching our hair. However, there are times when this type of behavior can cause us harm and / or discomfort and we try to abandon them without much success.

Even being aware of them, sometimes we cannot stop carrying out this type of behavior. An example appears in people who suffer from dermatillomania, a disorder in which patients carry out behaviors that cause damage to their skin. We expand the information on this behavior in the following Psychology-Online article on dermatilomania: what it is, causes, symptoms and treatment.

Index

1. What is dermatilomania
2. Types of dermatilomania
3. Causes of dermatillomania
4. Symptoms of dermatillomania
5. Treatment of dermatillomania

Dermatillomania consists of

Repetitive behavior can be carried out for a long time (even hours) and causes skin lesions, lesions that the person may try to hide.

Dermatilomania, also called psychogenic excoriation or excoriation disorder, appears in the DSM-5 (American Psychiatric Association) and ICD-11 (World Health Organization) diagnostic classifications:

• Within the DSM-5 it constitutes a diagnostic category in itself and is included within the group “Obsessive Compulsive Disorder and Related Disorders ”.
• Regarding the ICD-11 classification, it is included in the category “Repetitive Behavior Disorder Body-Centered ”within the group“ Obsessive-Compulsive Disorders and Other Disorders Related ”.

Is dermatilomania a type of obsessive-compulsive disorder? Although in both classifications it is grouped together with obsessive-compulsive disorders, the main The difference with these is that an obsession does not necessarily have to exist, although a behavior does appear compulsive.

However, similar to obsessive compulsive disorder, the person finds their repetitive behaviors annoying and tries to get rid of them or at least reduce them.

Following Arnold, L.M., Auchenbach, M.B. and McElroy, S.L. (2001, seen in Fernández Rodríguez, M., García Miranda, I. And Villaverde González, A., 2020)^[2] Before its inclusion in the diagnostic classifications, a classification within excoriation disorder had been proposed that included three subtypes:

• Impulsive subtype: in which the patient shows little resistance to the performance of the behavior and scratching has more to do with arousal, pleasure or reduction of tension.
• Compulsive subtype: the patient does show resistance to the performance of the behavior and scratches to prevent a situation that he fears or to avoid increased anxiety.
• Mixed subtype: in this subtype there are characteristics of the previous two.

Let's see what are the causes of dermatillomania. The origin of dermatilomanic problems can be found in the response that the patient gives to certain itching and / or skin sensations from which impulsive-compulsive behaviors appear (Torales, J., 2020)^[3].

Torales Benítez, J., Rodríguez Masi, M. and Riego Meyer, V. (2014)^[4] propose as the most common triggers for scratching looking and feeling the skin, boredom, tiredness or stress. Unpleasant emotions like sadness or anger, experimentation of anxiety or other situations such as being in bed, talking on the phone, or watching television could also trigger the problem behavior.

Finally, at the biological level, another possible cause of dermatillomania has been suggested: a serotonergic deficit it is related to repetitive behaviors on the one hand; on the other hand, it has also been proposed that neurotic excoriation may represent a hygienic behavior that has survived throughout evolution.

The symptoms of dermatillomania are:

• The person is scratches, pinches, punctures, bites, scratches, or peels the skin of the body or scalp repeatedly.
• You feel scratching as irrational behavior and it causes you discomfort.
• As a consequence of the previous point, he tries to reduce or eliminate the behavior.
• The person may try to hide injuries caused by repeated scratching.

It is important to carry out a treatment for dermatillomania since it is a disorder that tends to become chronic if it is not intervened on it. How to cure dermatillomania? How to get rid of head scratching mania? Let's see how dermatilomania is overcome.

The cognitive behavioral therapy it would be the treatment of choice for dermatillomania. Following Torales Benítez, J. and Arce Ramírez, A. (2014)^[5] The most appropriate techniques are cited, taking into account that the patient's level of consciousness about his repetitive acts must be considered for the choice of one or the other:

• Stimulus control.
• Habit reversal training.
• Psychoeducation.
• Relaxation techniques, you can start practicing relaxation with a guided audio like the one at the end of the article.
• Cognitive restructuring.
• Contingency control techniques.

Therapy acceptance and commitment it is also recommended in cases of excoriation disorder.

The drug therapy it can also help in those cases in which the patient does not respond to psychotherapy.

Finally note that the yoga, aerobic exercise, acupuncture, or biofeedback techniques can add benefits to the therapy of dermatillomania (Torrales, J. et al, 2020)^[3].

This article is merely informative, in Psychology-Online we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.

If you want to read more articles similar to Dermatillomania: what it is, causes, symptoms and treatment, we recommend that you enter our category of Clinical psychology.

1. Cruzado Rodríguez, J.A. (2014) Obsessive Compulsive Disorder and Related Disorders. In Caballo, V.E., Salazar, I.C. And Carrobles, J.A. (2014) Manual of Psychopathology and Psychological Disorders. Madrid. Pyramid.
2. Fernández Rodríguez, M., García Miranda, I. And Villaverde González, A. (2020). Psychogenic excoriation: an obsessive-compulsive spectrum disorder. North of Mental Health, 16 (62) 77-83.
3. Torales, J., Ruiz Díaz, N., Barrios, I., Navarro, R., García, O., O'Higgins, M., Castaldelli-Maia, J.M., Ventriglio, A. and Jafferany, M. (2020) Psychodermatology of skin picking (excoriation disorder): A comprehensive review. Dermatologic Therapy, 33 (4) doi: 10.1111 / dth.13661.
4. Torales Benítez, J., Rodríguez Masi, M. and Riego Meyer, V. (2014) Clinic of excoriation disorder. In Torales, J. (2014) Excoriation Disorder: from emotion to injury. Asunción: EFACIM.
5. Torales Benítez, J. and Arce Ramírez, A. (2014) Cognitive-behavioral therapy in excoriation disorder. In Torales, J. (2014) Excoriation Disorder: from emotion to injury. Asunción: EFACIM.

• World Health Organization (WHO) (2018) International Classification of Diseases, 11th revision. Recovered from https://icd.who.int/es