Most of us find it hard to resist scratching a bite, picking a scab or squeezing a spot, but if you can't stop fiddling with your skin, it might be a mental health issue. — dpa
When pimples and blackheads sprout during puberty, it’s hard to keep your fingers away from them.
And many adults scratch scabbed-over wounds until they bleed again or mosquito bites until they weep.
But even without such tempting “targets”, some people can’t resist the frequent urge to pick at, dig at, scratch, squeeze or rub their skin – sometimes with sharp items – in which case, they are probably suffering from skin-picking disorder.
Also known as excoriation disorder or dermatillomania, this condition is more common in women than men, says Dr Steffen Gass, head of psychosomatic dermatology at the Professional Association of German Dermatologists (BVDD).
The constant picking isn’t without visible consequences.
“It leaves scars, of course,” Dr Gass says.
“And if the person’s hands aren’t completely clean, it can also lead to serious infections because germs are pressed in[to the skin].”
Facial scars the ones that stand out the most, causing emotional distress.
So the person scratches and squeezes them all the more to improve them – a vicious cycle and not merely a dermatological problem.
“Often, it’s essentially a sign of a mental health condition,” says Dr Gass.
The condition is diverse and of varied intensity.
Anxiety or severe depression may be behind it, but it can also represent tension “that the person effectively works off on their skin, and ultimately eases with a painful event”.
The areas of the body affected are those easily accessible to the hands, notes Dr Gass, namely, the face, as well as forearms and lower legs.
Many skin pickers who see a dermatologist say nothing about any psychological problems they have.
“They show their skin,” he says. ”And then it’s up to the doctor to recognise that they don’t have an evolved dermatosis” – don’t have a skin disease, that is, but something they caused themselves.
Doctors should act sensitively, take skin pickers seriously and build a relationship of trust, he emphasises.
For acute inflammation, they can prescribe medications and ointments.
More importantly, they need to determine the cause of the behaviour, recognising the connection between skin picking and psychological stress.
As an alternative to picking their skin when under stress, skin pickers can try autogenic training.
Or they can relieve stress by keeping their fingers busy with something else, for example, Baoding balls or a stress ball.
Explaining to them that continuing to pick their skin will only worsen its condition and lead to scarring won’t stop them from doing it.
“They know that already,” Dr Gass says. “You don’t have to tell them – they can see it themselves.”
The seriousness of the disorder shouldn’t be underestimated.
“For people not affected by it, the phenomenon seems at first glance to be mere ly unpleasant.
"But it can have drastic effects for some sufferers,” remarks psychologist Martin Grunwald, founder of the Haptic Research Laboratory at the University of Leipzig in Germany.
Grunwald is planning a joint study with Helios Park Hospital in Leipzig to find out why some people experience even minimal changes on their face so intensely, and why people react so differently to a pimple: Some tell themselves it’ll go away by itself and they needn’t bother with it, while others think it disfigures them and might go away faster if they squeeze it a little and apply ointment.
And then there are those who are convinced they’ve got a massive protuberance on their face that must be removed at all costs.
These people go into a state of panic.
”The signals that enter the brain are more or less the same for everyone, but what the brain makes of them is key,” says Grunwald.
In his view, skin picking disorder could be a form of body dysmorphic disorder (BDD).
“That means we’re dealing here with a perceptual-psychological problem – the person’s perception of their own body is distorted,” he says.
He conjectures that the reason skin pickers can’t simply leave their skin alone are misperceptions produced by their brain.
His advice is to take the first signs of the disorder seriously.
If you notice that you pick at or squeeze your skin in situations of acute stress, you should first try relaxation techniques.
And if the behaviour is frequent and you can’t stop, you should see a psychotherapist familiar with skin picking disorder. – By Katja Sponholz/dpa
