Dermatophagia: what to do if you eat your own skin

It’s embarrassing to admit, but I pick and gnaw my hands. This habit dates back to childhood. I try various methods to defeat dermatophagia, but the effects are short-lived. Together with a psychiatrist, I will explain what it is, why it appears, and if it can be eliminated.

Understanding Dermatophagia: Causes and Symptoms

Dermatophagia involves the compulsive chewing and consumption of skin on the hands, lips, or inside of the cheeks, and is often associated with obsessive-compulsive disorder (OCD) or other mental health conditions.

Individuals with OCD are plagued by distressing, intrusive thoughts or images, such as the fear of contracting a serious illness from germs or experiencing harm in public spaces. These thoughts can trigger intense anxiety, prompting the individual to engage in specific actions or rituals to alleviate the discomfort. These actions are known as compulsions, and can include behaviors like washing hands repeatedly, arranging objects symmetrically, or checking that appliances are switched off. OCD sufferers develop their own unique compulsions as a means of achieving temporary relief from their symptoms.

The act of compulsively biting one’s skin is also classified as a compulsive behavior, and can be triggered by negative emotions such as anxiety or boredom.

These types of conditions are categorized as OCD-like disorders and are referred to as repetitive body-oriented behaviors according to both the American Manual of Mental Illness and the 11th Revision Updated International Classification of Diseases.

Other comparable actions include trichotillomania, which involves pulling out hair, as well as excoriation, which involves picking at the skin, small wounds, and acne.

Psychiatric Disorders Related to Dermatophagia

Dermatophagia is not always a symptom of obsessive-compulsive disorder; it is often associated with anxiety spectrum disorders. When evaluating dermatophagia, it is crucial to assess if the patient is experiencing other maladaptive symptoms such as tension, anxiety, or a sense of impending unpleasantness. Physiological symptoms associated with anxiety disorders, such as abdominal pain, chills, rapid heartbeat, tingling in the extremities, a feeling of suffocation, sweating, and fear of losing control, should also be taken into consideration. Although skin biting may be a symptom of more severe mental disorders, it is a rare occurrence.

In some instances, dermatophagia can result from purely physiological issues. For example, persistent cheek biting in a child could be a sign of an inflammatory condition in the affected area causing discomfort, resulting in chewing or picking at the painful areas. In such cases, the help of a dentist may be necessary instead of a psychologist or psychotherapist. An incorrect bite can also cause a person to bite their cheeks or lips.

What is the onset age of dermatophagia?

This obsessive condition usually occurs in children and teenagers and can be short-lived – repeating several times a day or a few times a week, and then disappearing. It can also last for several years and disappear in adulthood.

Dermatophagia often persists into adulthood, but a person only bites their skin in stressful situations.

For example, I developed dermatophagia at around 12-13 years old and it still periodically occurs – when I get anxious or nervous, I bite and chew the skin on my hands.

As a ten-year-old child, I used to gnaw my lips daily, sometimes until they bled. Even as a 22-year-old, I still found myself biting my lips and experiencing a strange sensation of relief. It’s not a pleasurable feeling, but it seems to bring me some sense of comfort. One day, my boyfriend told me that my lips looked unpleasant with the wounds and advised me not to apply lipstick on them. This comment made me feel like biting off my lips and chewing on the crusts again. However, I distracted myself by thinking about other things, like what to cook for dinner or what to do for the holidays. Over time, the habit gradually diminished, but it resurfaced whenever something unpleasant happened in my life. To control myself, I started applying lip gloss or using hygienic lipstick, and it worked. Now, I no longer gnaw my lips; I simply lick them.

Story from patient

Health Hazards Associated with Skin Biting

Typically, a person may unconsciously nibble on their skin and not tend to the resulting wounds. This can lead to the development of pus and inflammation in the affected area.

The Consequences of Skin Biting

Typically, individuals with dermatophagia repeatedly bite the same skin areas, leading to constant trauma, thinning of the skin, and diminished protective properties. This can increase the risk of inflammatory processes. For instance, if the skin around the nail bed is bitten, paronychia may develop, which is inflammation of the periungual tissues.
Moreover, a person with dermatophagia often keeps their hands in their mouth, and the hands may not always be clean. This can result in infectious diseases such as rotavirus and hepatitis A, as well as parasitic infections.

Comment from psychiatrist

Could Dermatophagia Be Managed Independently?

Symptoms of dermatophagia may sometimes resolve on their own, either by a person using their willpower to overcome the habit or simply losing interest in it. However, it can also worsen, particularly when triggered by stress.

For mild cases of dermatophagia, self-management is possible by identifying the situations and thoughts that trigger the behavior and paying attention to the accompanying emotions. For instance, if a person tends to bite their lips when feeling anxious or fearful, they could try redirecting their focus, practicing relaxation techniques or deep breathing.

However, in cases where dermatophagia is part of obsessive-compulsive disorder, substituting one ritual for another could have detrimental effects and exacerbate the behavior. In such cases, seeking professional help is necessary.

Which Doctor to Consult for Dermatophagia?

If dermatophagia is disrupting your daily life, seeking help from a psychologist, psychotherapist, or psychiatrist can be beneficial. However, the specialist will not focus solely on treating the dermatophagia, but rather its underlying cause, which is often related to internal anxiety.

Most cases of obsessive behaviors, including dermatophagia, can be effectively managed with psychotherapy, particularly cognitive-behavioral therapy. In some instances, medications may be prescribed, especially for severe cases or underlying mental health conditions. Cognitive-behavioral therapy aims to modify a person’s thinking patterns to alter their perception of events.

Treating Dermatophagia: What are the options?

If a person experiences severe symptoms of dermatophagia and also suffers from other conditions, such as trichotillomania, excoriation, sleep disturbances, and fatigue, it is advisable to seek help from a psychiatrist. The doctor will diagnose any underlying mental health conditions and may recommend medication and psychotherapy.

Cognitive-behavioral therapy has been proven effective for managing anxiety and obsessive-compulsive disorders, including dermatophagia. The therapy involves the patient recalling situations when they engage in skin biting, analyzing the accompanying emotions and physiological reactions such as abdominal pain, diarrhea, or palpitations. The goal is to identify the underlying thoughts that trigger the behavior.

It’s important to note that the psychotherapist will not focus on treating the symptom itself but rather address the root cause, which is the individual’s thoughts and emotions at the time of skin biting. The duration of treatment will vary depending on the severity of the disorder, with mild cases typically responding more quickly to therapy, while severe cases may require years of treatment.

Remember

1. Dermatophagia is the compulsive act of chewing on one’s skin as a symptom of a number of mental disorders.
2. Typically, the problem appears during childhood or adolescence and disappears during adulthood. However, some people may experience it for life.
3. You can cope with dermatophagia on your own if it isn’t that severe. To do so, you need to observe your thoughts and situations in which you begin to gnaw at the skin, and then switch your attention to something else.
4. Whenever someone cannot get rid of obsessive behaviors by themselves, he should consult a psychologist, psychotherapist, or psychiatrist. The doctor will not treat dermatophagia, but the underlying cause.
5. Treatments include cognitive-behavioral psychotherapy, which involves an active dialogue between the doctor and the patient, as a result of which a person changes their attitude and behavior.