It’s time to debunk some of the myths about Dermatillomania (skin picking disorder) and Trichotillomania (hair pulling disorder) as well as other forms of body focused repetitive behaviours.

Myth #1 – BFRB’s are just bad habits

It has become apparent in recent research that skin picking or hair pulling are actually a mental disorder that have genetic, anatomical, physiological and environmental causes.

Neuropsychiatry research has discovered that skin picking disorder (SPD) appears be related to anatomical changes in the brain. Structural and functional brain changes suggest a genetic link of the disorder. Although the results are preliminary, a study executed by the University of Chicago and University of Minnesota claims “the genes involved appear to affect the brain chemical (neurotransmitter) serotonin, which explains the obsessive-compulsive and anxiety-inducing nature of skin picking.”¹

Sufferers of dermatillomania describe it as soothing, satisfying and rewarding when dealing with difficult emotions. It’s a mindless craving to pick at their skin while dealing with life’s challenges. Unfortunately willpower alone isn’t enough to stop picking.

Myth #2 – Only women have it

Although the numbers show that more women seek treatment and help for skin picking (Dermatillomania, Excoriation disorder) or hair pulling (Trichotillomania) disorders, yet research suggests that just less than half of those suffering are male. The condition is underreported in men partly due to stigma or a lack of awareness. Men may be less likely to seek help or openly discuss their symptoms.

Men are less likely to recognise or be concerned about their behaviours. The triggers for skin picking in men can be similar to those in women, such as stress, anxiety, or a need for control. Men might also experience related issues like acne, ingrown hairs, or other skin conditions that exacerbate the urge to pick.

What we know is that women are more often concerned about their looks, thereby more likely to get a diagnosis and treatment. The psychological impact can be significant, leading to feelings of shame, embarrassment, and isolation. Men might struggle with societal expectations around masculinity, which can make it even harder to seek help or acknowledge the problem.

If you are a guy though, you certainly aren’t alone if you pick and pull, so the course can be a great place for you to start your journey to overcoming the behaviour.

Myth #3 – It’s temporary

Unfortunately skin-picking or hair pulling are chronic mental conditions which is persistent without intervention. Most of my clients have already suffered silently for years if not decades. They commonly believe that it is a bad habit and they should have the ability to just stop. Although the condition isn’t temporary, or curable. It can be managed with the right techniques. Early treatment and support are important for managing the condition effectively and improving quality of life.

Myth #4 – It’s self-harm

Is skin-picking a form of self-harm? No.

The key difference between skin picking or hair pulling vs. self-harm is repetition. Someone with excoriation disorder, for example, could absentmindedly pick their skin hundreds or thousands of times per day. Self-harm occurs much less often, and there is always a conscious awareness of the action.

The level of pain is another contrasting point separating skin-picking disorder from self-harm. In self-injury, the behaviour is performed to create a feeling of pain, but in excoriation, pain is not a motivating factor.

Lastly there are also differences in treatment of body-focused-repetitive behaviours vs. self-harm. A therapeutic style like habit reversal training (HRT) or cognitive behavioural therapy (CBT) could be ideal for BFRB treatments. Self-injury treatment tends to focus on the underlying problem contributing to self-harm. Medications may be an important aspect of self-harm treatment to target the source of the symptoms.

Myth #5 – There is no treatment

Ok, there is no magic pill that make it simply go away, but there are proven effective treatment methods that helps to control the urges and even experience remission — meaning, they no longer feel the urge to pick their skin/pull their hair or can avoid doing it for long periods. There is a risk for relapse, but with the right techniques even slips become manageable.

Unfortunately, some studies suggest that fewer than 20% of people with skin picking or hair pulling disorder end up seeking treatment because they are embarrassed about it. Some think it’s just a bad habit. Recovery is not a matter of willpower or just stopping. After suffering for 30 years I have done extensive research and developed this online course to make treatment affordable and accessible from wherever you are located, and on your own time.

References

Blum, Austin; Chamberlain, Samuel; Harries, Michael; Odlaug, Brian; Redden, Sarah; Grant, Jon. “Neuroanatomical correlates of impulsive […]n-picking) disorder.” Journal of Neuropsychiatry and Clinical Neuroscience, Summer 2018. Accessed May 31, 2024.

Digital, A. (2022, May 26). Excoriation vs. Self-Harm. The Recovery Village Drug and Alcohol Rehab. https://www.therecoveryvillage.com/mental-health/excoriation/excoriation-vs-self-harm/ Accessed Aug 21, 2024