Also known as excoriation and trichotillomania respectively, these are impulse-control disorders in which a person has recurrent, irresistible urges to pick at their skin or pull out their body hair.
What are they?
The expressed aim of skin pickers or hair pullers is to achieve perfect hair or skin, but the reverse is the result. Both behaviors can cause physical damage. A person with trichotillomania
may pull hair from their scalp and/ or other parts of their body such as eyebrows, eyelashes, and legs (and sometimes also from pets), which can result in noticeable hair loss. They may also swallow the hair, which can cause vomiting, stomach pain, and bleeding that can lead to anemia. Skin picking can result in scabs, abrasions, and lesions that may become infected. Both of these conditions can also be associated with OCD . Skin picking and hair pulling
often begin as a reaction to an immediate stress or may be a response to a traumatic experience or abuse. The behavior can be learned from other members of the family with similar habits or develop by chance and become associated with stress relief, which is a powerful behavioral reinforcement. Females are more likely to be affected, and symptoms often start in girls aged 11–13 years. Hair pulling or skin picking can
cause significant impairment or disruption in daily life for affected individuals. They may avoid routine activities or work, have difficulty concentrating, become socially isolated, and suffer financial strain.
Repetitive behavior
Habits associated with these disorders
often begin as a response to stress or anxiety but become addictive—the more that a person pulls or picks, the greater their urge to do it, in spite of the various negative consequences.
TREATMENT
❯ Behavioral therapies to promote healthy stress management. Habit reversal training, combining awareness with alternative behavior, and stimulus control using a different activity while an urge dissipates.
❯ Antidepressants prescribed along with therapy.
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