Some people find in impossible to stop picking at their skin, even after they have caused obvious damage. Is this evidence of a mental health disorder, or is it a sign that someone is trying to intentionally harm themself? In other words, is skin picking self-harming?
What Is Skin Picking?
Before we answer the question, “Is skin picking self-harming?” we should take a moment to discuss what this behavior entails.
Skin picking typically involves the face, arms, and hands. People who engage in this behavior may use their fingernails or various implements (such as tweezers or pins) to pick at both healthy skin and perceived flaws (such as pimples, scabs, and lesions). They may also squeeze, lance, or even bite at the areas they have become fixated on.
The clinical terms for compulsive skin picking are dermatillomania and excoriation disorder. As established in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a person must meet the following criteria in order to be diagnosed with this condition:
- Recurrent skin picking to the point that it causes lesions or other damage
- Repeated failed attempts to either end this behavior or significantly reduce how frequently they engage in skin picking
- Experiencing considerable distress and/or impaired functioning as a result of this behavior
People who have this disorder may regularly spend considerable amounts of time picking at their skin. Without appropriate intervention, they may continue to do so for several months or even years.
Is Skin Picking Self-Harming?
Since the DSM-5 defines excoriating disorder as a distinct mental health condition, does this mean that the answer to the question, “Is skin picking self-harming?” is no? Not quite.
Excoriating disorder isn’t the only reason why someone may feel the compulsion to continually pick at their skin. Other possible causes of this behavior are:
- The person is reacting to hallucinations or delusions (for example, they may believe that bugs are crawling over or under their skin)
- The individual suffers from body dysmorphic disorder, and believes their actions will improve their appearance.
- They have been abusing certain drugs, such as cocaine or methamphetamine
- This behavior is a symptom of obsessive-compulsive disorder (OCD)
- They are intentionally trying to harm or inflict pain on themselves
The final item in the list above confirms that skin-picking can be a form of self-harm. The other entries in the list suggest that there are a variety of other reasons why someone might engage in this behavior.
So, is skin picking self-harming? It can be, depending on the motivation of the person who is doing it.
What Are Other Types of Self-Harm?
Skin picking for the purposes of self-injury is just one of many forms of self-harm. Other types of self-harming techniques that people use include:
- Cutting or burning their skin
- Inserting needles or other sharp objects underneath their skin
- Pulling out their hair
- Punching themselves
- Hitting their head or other body parts against hard objects
- Drinking caustic, corrosive, or otherwise toxic liquids
- Attempting to starve themselves
- Exercising excessively
Why Do People Self-Harm?
Self-harm isn’t rare. Studies indicate that as many as 17% of adolescents, 15% of college students, and 5% of adults intentionally harm or injure themselves. But it remains widely misunderstood, in part because of the pervasive shame and stigma that continue to be associated with this behavior.
People who intentionally injure themselves may do so for myriad reasons, including (but by no means limited to) the following:
- They are trying to punish themselves for a perceived flaw, failure, or shortcoming.
- They feel that their life has spiraled out of control, and self-harm is a means of regaining some sense of control over their body.
- They are living with untreated trauma, and their self-harming actions are attempts to give a physical form to their emotional pain.
- The self-harm is symptomatic of a mental health disorder.
It is important to understand that self-harm is not a suicidal behavior. To reinforce this, one of the clinical terms for self-harm is nonsuicidal self-injury, or NSSI.
Of course, some people who intentionally harm themselves may later attempt to end their lives, and some self-harming behaviors can result in accidental death, but by definition self-harm is distinct from suicide.
How Is Self-Harm Treated?
There are a range of treatment options for people who have been intentionally injuring themselves. Determining the right type and level of care can be influenced by several personal factors, such as the patient’s age and treatment history, how long they have been self-harming and if the behavior is related to a mental health concern.
Once a person has completed a thorough assessment, their treatment team may recommend services such as the following:
- Cognitive behavioral therapy (CBT)
- Dialectical behavior therapy (DBT)
- Transcranial magnetic stimulation (TMS) therapy
- Ketamine therapy
- Genetic testing
Find Treatment for Self-Harm in Atlanta
If you have been intentionally harming yourself, or someone in your family has been engaging in this dangerous behavior, please know that help is available.
Atlanta Integrative Psychiatry offers a dynamic array of innovative and effective services to help people regain control of their thoughts and behaviors so that they can live much healthier lives. Throughout your time with us, you can expect to receive evidence-based services from a team of experienced professionals. You can also expect to be treated with dignity, compassion, and respect.
When you’re ready to find your path toward a more hopeful future, the Atlanta Integrative Psychiatry Team is here for you. To learn more or to schedule a free assessment, please visit our Appointments page or call our center today.