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Dermatillomania, also known as excoriation disorder or skin-picking disorder, is a condition that involves recurrent and compulsive picking at one's skin, leading to tissue damage. This is a type of body-focused repetitive behavior or BFRB disorder that often stems from a variety of interconnected factors.

Psychological triggers

Underlying psychological factors play a significant role in dermatillomania. Stress, anxiety, anger, and boredom often act as catalysts, compelling individuals to seek relief through repetitive skin picking. Emotional distress, including feelings of frustration or even boredom, may trigger this compulsive behavior.

In a study from 2017, researchers found that dermatillomania was linked to other BFRB disorders such as trichotillomania or hair-pulling disorder. 

Neurobiological influences

Research suggests that neurobiological factors contribute to dermatillomania. Dysfunction in the brain's reward system, particularly involving neurotransmitters like dopamine and serotonin, might influence the urge to pick at the skin. These imbalances may intensify the rewarding sensation or relief experienced during and after the act, reinforcing the behavior.

Environmental factors

Environmental factors can also contribute to the development of dermatillomania. Childhood experiences, such as trauma or neglect, could predispose individuals to engage in compulsive skin-picking as a coping mechanism. Additionally, societal pressures, perfectionism, or body image concerns might exacerbate the urge to pick at perceived imperfections on the skin.

Dermatillomania shares a notable association with BDD or body dysmorphic disorder, both revolving around an intense preoccupation with perceived flaws. While dermatillomania focuses on compulsive skin-picking as a response to these perceived imperfections, BDD encompasses a broader concern with one's appearance, often fixating on specific body parts.

The overlap between the two conditions lies in the obsessive scrutiny of perceived flaws, leading to distress and impairment in daily functioning. Individuals with either condition may engage in repetitive behaviors to alleviate their distress, whether through excessive grooming or persistent skin picking, driven by an unrelenting desire to rectify perceived imperfections.