How to Stop Being Your Own Snack: Tips for Surviving Dermatophagia and Excoriation?

[bipolarsunshine99]

Any person who has been diagnosed with excoriation disorder or dermatophagia, do you have any tips to manage it better? How do you identify the triggers and, most importantly, how do you stop it? Is it possible to cure it?

[deValentin]

Body-focused repetitive behaviors (BFRBs) like skin excoriation are classified in the obsessive-compulsive and related disorders section of the DSM-5 because there are similarities and differences between them and OCD.

I don’t presently have an excoriation disorder, but when I was younger, I couldn’t leave a skin scab alone. I had to pick at it. It provided me with some kind of nervous tension release I guess, and when I started it, I had to complete it until I got a “just right” feeling. I wouldn’t rest until my mind was somewhat appeased, no matter the long-term consequences. So, I can relate to some extent.

How to control it? Have you heard of “intransitive choices”? Intransitive choices are when between 5 min. doing something and 5 min. not doing it you prefer the first option. However, when the choice is between a significant time doing something and a significant time not doing it, you prefer the second option.

Let’s say after a stressful day at work, you feel the need, when relaxing on your couch, to pick your skin. You may feel the same need when you look in the mirror and see a blemish on your face. Few seconds of skin picking won’t cause much damage and it provides you with some emotional relief. All your other worries go in the background while you’re at it. However, doing it for a long period of time has negative serious consequences. I guess it’s why you wrote that message. When you look at the big picture, you don’t like what you’re doing to your skin.

Why not establish some rules like, I won’t do anything that unnecessarily damage my body; when triggered, I’ll calm down and find better ways to relieve my discomfort. You need to establish rules beforehand because, when you’re triggered, you can’t rely on your feelings to decide. The mood of the moment doesn’t see the big picture. It’s like with drinking. If you don’t decide beforehand to limit your drinking to one glass of wine or have a designated driver, when you go out for instance, consequences down the road could be disastrous. When you’re in a conducive mood and atmosphere, one glass leads easily to another one, and, without preset rules, there will be “no red lights or alarm bells” to alert you to the dangers that await you.

It's in some regards the same with skin picking. When you start, it becomes difficult to stop. "I've got so far, I may as well continue" type of reasoning. It's why it's better to set some boundaries to begin with, in my opinion.

[Natureloverpeace]

I think it’s HRT (Habit Reversal Training) and ComB (Comprehensive Model for the Behavioral Treatment of BFRBs) that are used to treat this. Charlie Mansueto, Ph.D., OCD and Related Disorders Specialist has published on this. You may want to look up what he has to say on this topic.