Excoriation disorder

Skin Picking Disorder is an impulse control disorder and describes a disorder that is characterized by a repeated touching, squeezing and scratching of certain skin areas due to an irresistible urge. Editing the skin can lead to severe tissue damage. This results in shame and guilt and a growing social isolation.

In German it is called Dermatillomanie. This term comes from the Greek and is composed of Derma ( = skin), tillein ( = pick ) and Mania ( = enthusiasm, madness ). Similar meaning also the English Skin Picking and Neurotic excoriations or the French Acne excoriée. In the German self-help scene, the term skin picking is now most commonly used.

History and prevalence

Already in 1875, spoke for the first time, the English physician Sir Erasmus Wilson of " neurotic excoriation ". In France, it was observed also that especially young girls suffering from this disorder at puberty. Therefore, the term " acne excoriée des jeunes filles " (scratch - acne in young girls).

So far, skin picking is only very little explored. Statistics, empirical data and figures are still rare and understand the following information on the frequency as approximate estimates. Also, do not lie still no uniform criteria before to see exactly when someone is suffering from skin picking and when.

According to the current state of research outweigh among affected women. Depending on the study of the proportion of women between 60 to 90 %. However, it is not excluded that the proportion of men is underestimated, because men in general are less likely psychological help than women.

The disease can occur at any time, however, most frequently develops in late childhood or early adolescence, as several studies show. There is often at the beginning of a relationship with acne. In addition to since childhood and youth affected there is a second group who had need of treatment Skin Picking between 30 and 45 years occurs.

Symptoms

Persons affected by Skin Picking edit pimples, hairs, or scabs, but also healthy skin with fingers, tweezers, needles or other sharp objects that can cause sores and scars. This Affected follow an impulse, which they can hardly oppose resistance. This action leads to distress or impairment in everyday life. The reasons for this action are different. Both the trigger and the consequences may change in the course of the disease and different.

The time that is spent per day for editing the skin varies from person to person and also not the same every day. Information ranging from a few minutes up to several hours for a skin picking episode. Most patients report multiple episodes per day. This may be, in extreme cases up to 150 episodes a day.

Follow

Often the affected area can not heal, so it comes to inflammation, ever increasing injuries and eventually cause scarring. Dermatillomanie patients suffer because of the scars, sores or red spots often with great shame and guilt feelings and try to hide the affected area or they avoid contact with others. This can lead to social isolation and thus a significant loss of quality of life.

Classification

In Skin Picking is an impulse control disorder and not - as is often assumed - about an obsessive-compulsive disorder. This means that sufferers feel the editing of their skin as pleasant and relaxing. Meanwhile, they experience a trance-like state, are ignored in the cautionary thoughts and negative consequences. The plot is like a valve, through them stress, boredom or anger and grief to be drained. Only when this ecstatic spurt is over, they can take your hands off of her skin and feelings of regret and shame to take the place.

Skin picking is " associated with both the DSM ( Diagnostic and Statistical Manual of Mental Disorders ) as in the ICD ( International Classification of Mental Disorders ) of the category Abnormal habits and impulse control disorders ."

Diagnostic features of " impulse control disorders not elsewhere classified " according to DSM- IV

• Failure to resist an impulse, an impulse or temptation to perform an act that is harmful to the person himself or to others
• Soaring feeling of tension or arousal prior to the act
• Experience of pleasure, satisfaction or relaxation during the implementation
• After action remorse, self-reproach or guilt may or may not occur

Other disorders that are classified in this group are, for example, trichotillomania ( repetitive hair-pulling to such an extent that distress or impairment in everyday tasks and activities occur ) or kleptomania ( stealing items that are not needed ).

Treatment options

Even if the disease is so far little explored and also among professionals is poorly understood, a cognitive behavioral therapy is recommended, as the effectiveness of behavioral therapy methods in skin picking is scientifically proven.

In addition, the Habit reversal training has proven that can also be applied in self- directed by the person concerned. According to recent studies reported 50 % of the users of a clear decrease of skin picking.