Opinion

Latimer: Skin picking a unique disorder

Do you often have an irresistible urge to pick at your skin?

If you’ve got a small bump or bit of dry skin, do you leave it alone or are you someone who just can’t help but obsessively pick at it?

If you can’t stop picking and it’s interfering with your life, you may have skin picking disorder.

Excessive skin picking has been discussed in medical literature for more than a century, but it is just now being given consideration as a psychiatric condition in discussions for the new diagnostic manual.

In the past it has often been thought of as a variant of obsessive-compulsive disorder, but now it seems it may be something quite separate.

Individuals with skin picking disorder—repeatedly pick at their skin until it bleeds; have likely attempted to reduce or stop picking more than once, and are distressed by the behaviour.

People with this condition often spend several hours every day picking at their skin.

Situations that trigger picking are different for every person but can include stress, anxiety, boredom, fatigue or anger.

Picking can also be triggered by the feel or look of the skin.

Often, the individual doesn’t notice picking at first, but becomes aware of it when the spot begins to bleed or when someone else notices the behaviour.

Although it can range in severity, the picking can cause social embarrassment and interruption to work and life obligations as well as tissue damage, scarring and sometimes serious infection.

They may not want to leave the house because of embarrassment about their appearance.

Skin picking disorder can begin at any time in life, but looks the same in all age groups and across cultures.

It affects between 1.4 and 5.4 per cent of people.

It is typically a chronic lifelong issue that may wax and wane in its severity, but generally changes little over time.

It is quite rare for individuals with skin picking issues to seek treatment.

It is estimated that less than 20 per cent of those with this condition seek help. Although it hasn’t been named as a specific disorder in the past, there are some viable treatment options that can be quite helpful for those struggling with the urge to pick.

As with many bad habits or even other more serious grooming disorders such as the hair pulling of trichotillomania, cognitive behaviour therapy can be helpful in decreasing skin picking.

Some medication studies have also been done to examine pharmacological help for those with skin picking issues.

Serotonin reuptake inhibitors have had mixed results to date.

The research data base for treatment of any type is quite slim.  Much more research is needed into the treatment of this disorder.

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