When learning about the existence of dermatillomania, many people begin to worry if they too have this disorder because they pick their skin. How do you know if you have a compulsion versus a strong desire to give into urges? At what point does picking at your skin become a disorder? Some questions to ask yourself include:
- Do you pick at your skin enough to cause you emotional distress?
- Does your skin picking prevent you from engaging in social activities?
- Do you feel that you are being held back in life because of your skin picking?
- Do you keep your obsessive skin picking a secret for fear of judgment?
- Do you feel ashamed that you are unable to stop picking at your skin?
- Does this make you feel alone?
Released in May of 2013, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) officially lists dermatillomania as excoriation disorder, under the Obsessive-Compulsive and Related Disorders category with the following criteria:
Recurrent skin picking that results in skin lesions
Repeated attempts to stop the behavior
The symptoms cause clinically significant distress or impairment
The symptoms are not caused by a medical or skin condition, or a substance
The symptoms are not better explained by another psychiatric disorder
The OCD Center of LA provides an online assessment to test if your skin picking is an issue to be worried about. They also have an article outlining the ABC’s of Dermatillomania by Karen Pickett, LMFT:
An “A” is something that almost “Anyone” would pick. This could be a piece of dry skin hanging off your arm, a pus-filled whitehead on your chin that pops at your mere touch, or a scab that’s barely hanging on which you easily detach.
A “B” is a “Bump”, pimple, scab, etc. that only a skin picker would pick. This is something that would either become an “A” over time or go away on its own if left alone. But, a skin picker will frequently start picking at it and make it significantly worse. It may then bleed, ooze, scab, and possibly become infected. This in turn will cause two additional problems – it will cause the picker significant distress, and it will give them something new to pick at later.
“C” stands for “Create“, meaning the individual with excoriation disorder is not picking at anything objectively “real”, but in the process of picking at her skin, she “creates” a scratch or scab. A “C” is something that only someone with dermatillomania would pick. There is often nothing apparent on the skin, but the picker starts picking or scratching, and in the process creates a wound.
As always, see a trained practitioner if you believe your skin picking is interfering with your day-to-day activities and causing you emotional distress. Additional testing may need to be done to determine if your skin picking is exacerbated by a skin disorder or psychological condition.