Excoriation Disorder: When Scratching Your Skin Becomes an Obsession

Daniela (whose name has been changed to protect her identity) began showing early behaviors of depressive disorder. excoriation when I was 8 . “Maybe there was something before, but I don’t remember,” he said. Today, Daniela is 40 years old. Explain why she has always been very allergic to different things and that, as a result, he lived with constant hives and breakouts on his skin. “At that time, there were no special hypoallergenic products like today for more sensitive skin. I think that’s part of the reason my allergies never completely went away,” he recalls. From these small lesions or pimples on the skin which generated an annoying sensation, Daniela started scratching them or trying to remove them with his fingernails, generating larger wounds that never fully healed because when I felt a scab forming on the wound I had to remove it again with my fingers.

Thus passed several years of comings and goings and challenges from her parents who urged her “not to scratch” because she was make wounds and leave marks on the skin . Daniela remembers that as a teenager, the injuries were concentrated on the head and scalp, because they were areas that allowed him to hide wounds and marks which was left behind by compulsive scratching. “For me it was something relaxing. I usually did it before bed or while watching TV. And if I felt pain, I would leave that area and look for another one because it was a sensation I liked,” he recalls.

Unlike other behaviors like self-harm, Excoriation disorder, also known as dermatillomania, is usually not related to feelings of anxiety, but rather relaxation. The psychologist from the Nuevo Norte Center (@nuevonortetricotilomania) Caterina Bruzzone explains that excoriation consists of scratching the skin until it generates skin lesions. “Usually they take care of their nails, although there are people who occupy objects such as clips or pins “, Explain. The specialist adds that squeezing the pimples as well as scratching crusts or skin irregularities , are also manifestations of excoriation disorder. “Many people like to squeeze pimples, pick skin off their fingers, or pick scabs. What makes it a disorder is that the person has made multiple attempts to stop their behavior, without positive results,” explains the psychologist.

Caterina also confirms that, unlike self-harm – which generally occurs in people who feel very distressed and find something in it that helps them free themselves from the anxiety of the moment – lDermatillomania is rather associated with a pleasant sensation. The specialist in the treatment of disorders such as excoriation and trichotillomania confirms that, as happens to Daniela, “in general, in excoriation people look for the moment to perform the behavior because it is pleasant, but it is not necessarily a behavior after a state of anxiety. »And this is one of the points that differentiates it from self-harming behaviors such as cutting or burning. “Sometimes it happens as a result of distress, but it is not a condition. Often, excoriation, like trichotillomania, occurs in states of leisure, about to sleep, or upon waking in the morning. specifies the specialist.

However, even if these are behaviors that generate a state of relaxation in the majority of patients, it is the compulsive component that makes them harmful , and in many cases this has a significant impact on the lives of those who suffer from it. “The most serious thing is that they generate very visible marks or scars, which generate shame and many questions people, like “what happened to your legs?” », explains Daniela. This means that she and other women who live with the marks of dermatillomania choose to wear long-sleeved t-shirts even in summer. They avoid dresses or shorts and even less dare to wear swimsuits that leave visible the wounds on their body resulting from the excoriation.

Daniela is one of those patients who still suffers today from marks on the legs when the heat arrives and prefers to wear clothes that cover his entire body to avoid questions. And the fact is that after adolescence, when his disorder was focused on injuries to the head and in inconspicuous places, it gradually disappeared. move to other areas of the skin such as the legs . “For me, the problem is mainly aesthetic because the injuries are small and superficial. But there are a lot of them,” he comments. When you feel that you have already scratched or painfully injured a part of your body, you let it heal but quickly. finds another one who allows him to continue with the constraint and get that feeling of relaxation and relief. “You constantly feel like people are looking at you or noticing the marks on your skin,” he explains.

In the case of Daniela, now a mother of 3 children, one of the main fears that haunts her on a daily basis is that one of the children begins to imitate compulsive behaviors what is also called skin picking in English. Fortunately for this family, the transmission of this compulsion to scratch the skin It did not affect the children . According to a study led by psychiatrist John Grant of the Department of Psychiatry and Behavioral Neurosciences at the University of Chicago, the prevalence of this disorder is higher in the female population. Additionally, research has shown that This is a problem that could affect between 2% and 3% of the population, making it a more common disorder than is usually believed. “It’s a lot more common than you think because people generally don’t talk about it,” says Daniela. And it is precisely for this reason that after a long pilgrimage from consultation to consultation and from time to time of total perplexity in the face of the problem she was suffering from, when she began her treatment almost 3 years ago with specialists in the field, she finally managed to understand that she was not the first, much less the only , woman with this disorder. “It gave me a lot of relief,” he explains. For years, Daniela sought help from different specialists who, without knowing much about this type of illness – classified as obsessive-compulsive disorder in the DSM V Manual of Psychiatric Illnesses – downplayed the problem or did not fully understand the depth of their problem. “ By far, what helped me the most in starting treatment with a specialist was understanding that it is indeed an illness and that there are ways to treat it,” comments- he.

And, as is the case with trichotillomania – the compulsion to pull out one’s hair – excoriation disorder It is often minimized or made invisible. . Caterina Bruzzone explains that, despite being classified as an OCD-related anxiety disorder, she opted for an approach that includes elements treatments to combat addictions. Which had good results in his patients. “If it is treated as an anxiety disorder, we fail in that approach because excoriation involves much more than anxiety. It’s not necessarily a feeling of anxiety that triggers the problem,” explains Caterina. The psychologist from Centro Nuevo Norte explains that, as in Daniela’s case, Allergies are an important factor in the development of the disease and there are also other sensory components that make people scratch or touch their skin more frequently and more intensely. “In general, the population at risk is made up of adolescent or pubescent women suffering from skin allergies,” specifies the psychologist.

Thus, according to the specialist, the approach to addiction is much more complete because it encompasses the experience of uncontrollable behavior protective measures, the importance of the family in the approach, in addition to the allergic and sensory components that are part of the problem . It is in this context, and by approaching the problem according to this broad approach, that Daniela managed to bring her excoriation disorder into a sort of “remission”. However, She herself explains that there is a permanent latency and it is a theme that accompanies him every day. But knowing that it is actually a mental health problem that It doesn’t just affect him. but to many other women who avoid talking openly about the subject for fear of judgment or comments like “but, stop scratching”, or that They attribute the problem to voluntary, non-compulsive behavior is that she finally managed to feel calmer and with better tools to deal with episodes of excoriation or scratching of the skin, which are increasingly rare.