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More than 900,000 people in France crush their skin for hours, creating significant and sometimes irreversible skin lesions. They suffer from dermatillomania. Focus on this disorder, its causes and its treatment.*

Dermatillomania has been recognized as a trouble in its own right in the fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) in 2013 as Excoriation (Skin Picking) Disorder. This term was translated into French in 2015 by dermatillomania or pathological crushing of the skin. ” Dermatillomania is a body-focused repetitive behavior (CRCC) and classified as Obsessive-Compulsive Disorder (OCD). informs Alexandra Lecart, clinical psychologist who practices as a liberal in Paris in the Center for Integrative Therapies and New Technologies (CTINT) and is the author of the first French-language book on dermatillomania.*

A common disorder that is still too little known

This disorder affects 1.4 to 1.5% of the population, like anorexia nervosa, i.e. 930,000 people in France, yet it is still unknown. Three quarters of people with dermatillomania are women and this disorder begins in adolescence. Affected people check the status of their skin looking at and touching each other and have an irrepressible urge to remove all imperfection seen or felt. “As is the case in the bulimia, the person is in a state of semi-consciousness. This hypnotic state makes her go from one imperfection to another and does not realize the time spent to triturate her skin “explains the specialist on this disorder which he compares to an addiction:”As a person addicted to games or alcohol will think one more game, one more drink, one who suffers from dermatillomania will think another imperfection and I stop“.

As attacks can last for hours, this disorder has aesthetic and medical consequences. ” The pores of the skin are open, the skin is red, blistered and may bleed. Since the lesions are self-perpetuating, this can lead to dermatological complications and leave scars. ” teaches Alexandra Lecart who specifies that these self-perpetuating lesions can pass for acne on the face.

Dermatillomania: what causes and treatment?

This pathology usually grows on land anxious (stressed people, performance anxiety, perfectionist profiles…). ” We also find in the causes issues of sexual assault (incest, rape, etc.) or issues of unspoken family issues (taboos, secrets, etc.). The person often had a childhood where physical contact and hugs were rares” informs Alexandra Lecart. The psychologist explains:he person is angry with a parent or abuser. This repressed anger is expressed with an unconscious self-aggression of the skin. “.

After one crisisthe person feels shame of having done these injuries to herself. This psychological disorder is treated with a therapy, including cognitive behavioral therapy (CBT) as well as ACT therapy which is part of the third wave of CBT. Mindfulness mediation and hypnosis can complement this. ” EMDR has proven significant results in the treatment of trauma adds Alexandra Lecart. Follow-up with a psychiatrist is essential in case of depression associated which is often the case. It is recommended to consult a dermatologist in order to manage possible infections of the skin and scars.

*Stop scratching! Understanding dermatillomania to better treat it Editions Enrick B May 2023

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