Many people bite their nails or occasionally find themselves chewing on a hangnail, but if you find yourself compulsively biting and eating the skin on your hands and fingers, you may have dermatophagia.
Dermatophagia is what’s known as a body-focused repetitive behavior (BFRB). It goes beyond just nail biting or occasionally chewing on a finger. It’s not a habit or a tic, but rather a disorder. People with this condition gnaw at and eat their skin, leaving it bloody, damaged, and, in some cases, infected. The compulsion most frequently affects the hands, such as the cuticles and fingers. However, it may also occur on other parts of the body, too.
Other BFRBs include:
- trichotillomania (hair-pulling disorder)
- excoriation (skin-picking disorder)
- onychophagia (nail-biting disorder)
- chronic tongue chewing
- trichophagia (hair eating)
- chronic lip biting
Keep reading to find out what you need to know about dermatophagia, what causes it, and how to treat it.
Signs of dermatophagia
You may have dermatophagia if you:
- frequently and repeatedly gnaw on and eat your skin, usually on your hands
- have red, raw skin in the affected area
- bleed in the affected area
- have skin damage, such as scarring, calluses, or discoloration
- are significantly distressed by the behavior or it interferes with your daily life
Risk factors and related conditions
- age (symptoms of BFRBs usually begin around puberty)
- stress levels
Dermatophagia isn’t typically the cause of serious medical complications, but in some cases, it can significantly affect your physical and mental health.
Some complications may include:
The most significant physical complication of dermatophagia is infection. When skin is left raw and open from biting, bacteria can enter the body through the wound. You should cover any sores or wounds to decrease the chances of infection. Signs of a skin infection may include:
- heat or swelling around affected area
- a wound that discharges pus
- pain or tenderness
- fever or chills
In some cases, dermatophagia can cause people to become embarrassed about their behavior and withdraw for social interactions. This can lead to shame, low self-esteem, and depression.
If you suspect dermatophagia, talk to a mental health professional. They will ask you questions about your symptoms, general mood, and medical history.
Dermatophagia and other similar BFRBs aren’t included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Instead, they fall under “other specified obsessive compulsive and related disorders.”
To be classified as a BFRB, the behavior must cause significant self-distress or damage, and affect your ability to function on a daily basis. It’s estimated that about 3 percent of the population has a BFRB, though many cases go undiagnosed.
The severity can vary greatly. BFRBs aren’t considered a form of self-mutilation, such as cutting. People with BFRBs are typically engaging in the behavior to relieve stress or get pleasure from the act rather than to intentionally harm themselves. While BFRBs may result in bodily harm, it’s unintentional.
If you see any signs of infection due to skin biting, you should seek medical attention as well.
When the behavior feels out of your control, there are several treatment methods available.
Cognitive behavioral therapy (CBT) may be effective in the treatment of BFRBs such as dermatophagia. This type of therapy focuses on thoughts and behaviors, and works toward adjusting behavioral responses to those thoughts.
Habit reversal training (HRT) may also be used. HRT involves awareness training, competing response training, and social support.
There are no medications specifically approved for the treatment of BFRBs, but some medications may help reduce symptoms and treat problems that often accompany them, such as anxiety and depression. Some medications your doctor may recommend include selective serotonin reuptake inhibitors (SSRIs) and clomipramine (Anafranil). Examples of SSRIs include:
There are a wide range of holistic treatments and lifestyle changes that may help reduce the symptoms of dermatophagia, including:
- stress reduction activities such as exercise, breathing exercises, and other healthy lifestyle choices
- replacement behaviors, such as chewing gum instead of biting skin
To treat skin damaged by dermatophagia, you should keep the area clean and covered with bandages until it heals. In some cases, antibiotics may be necessary to treat or prevent infection in the affected areas.
If you suspect dermatophagia, talk to a mental health provider as soon as possible. The earlier you treat the problem, the sooner you can find the most effective strategies to help you manage the behavior.