Scratching Beneath the Surface: Understanding the Psychosocial Dynamics of Self-Injurious Skin Picking

Abstract

INTRODUCTION: Acne vulgaris, a common skin disorder caused by clogged hair follicles and sebaceous glands, affects up to 85% of people aged 12 to 25 and can persist into adulthood. It's more prevalent in women and varies in severity across ethnicities, influenced by lifestyle and environmental factors. Acne is classified by lesion types, from mild comedones to severe nodular forms. It significantly impacts psychological wellbeing, leading to low self-esteem, anxiety, and social withdrawal. Additionally, acne is linked with Self-Injurious Skin Picking (SISP), a related psychiatric condition treated with medication and therapy. OBJETIVE: To analyze and describe the main aspects of psychosocial dynamics of self-injurious skin picking in the last years. METHODS: This is a narrative review, which included studies in the MEDLINE -PubMed (National Library of Medicine, National Institutes of Health), COCHRANE, EMBASE and Google Scholar databases, using as descriptors: "psychosocial" AND "self-injurious skin picking" AND "dermatology" AND "psiquiatry" AND "anxiet" in the last 10 years. RESULTS AND DISCUSSION: Cultural norms and media portrayals that equate blemish-free skin with beauty significantly impact individual self-perception and societal standards, leading to psychological distress for those with visible skin conditions like acne. The widespread use of digital image-editing tools further perpetuates unrealistic beauty ideals, contributing to increased body dissatisfaction and demand for cosmetic products aimed at achieving these ideals. This situation is exacerbated by bullying and discrimination against those with imperfections, often leading to severe psychological impacts such as depression and anxiety. Additionally, the behavior known as SISP, recognized in the DSM-5 as an obsessive-compulsive disorder, illustrates the severe psychological and physical consequences of societal pressures related to appearance. SISP predominantly affects females, beginning typically in adolescence, and is influenced by factors such as stress, anxiety, and societal pressures, further emphasizing the profound effect of cultural beauty standards on mental health and social interactions. CONCLUSION: Acne vulgaris, a common skin disorder caused by clogged hair follicles and sebaceous glands, affects up to 85% of people aged 12 to 25 and can persist into adulthood. It's more prevalent in women and varies in severity across ethnicities, influenced by lifestyle and environmental factors. Acne is classified by lesion types, from mild comedones to severe nodular forms. It significantly impacts psychological wellbeing, leading to low self-esteem, anxiety, and social withdrawal. Additionally, acne is linked with SISP, a related psychiatric condition treated with medication and therapy.