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Animal study hints at potential treatment for skin-picking disorder

A condition known as skin-picking disorder may sound obscure but it’s one of the more common mental health disorders and can have devastating effects on its sufferers. An estimated 4 percent of the population – or roughly 1 in 25 people – suffer from the condition, in which they repeatedly pick or scratch the skin, sometimes leading to scarring or disfigurement.

People suffer in complete silence. They think they are the only one who has it, despite the fact that it’s very common, and it kills people.

“Skin-picking disorder is a surprisingly common condition, yet many patients avoid seeking help because of the shame and embarrassment,” says Joseph Garner, PhD, associate professor of comparative medicine at Stanford. “People suffer in complete silence. They think they are the only one who has it, despite the fact that it’s very common, and it kills people.”

The condition may lead to serious infection, requiring oral or intravenous treatment with antibiotics, he says. Patients may benefit from cognitive behavioral therapy, but there are precious few practitioners in the United States who are equipped to do this form of therapy, he says.

In a new study, Garner and his colleagues tested two antioxidants in mice with a form of skin-picking and found both compounds to be effective in treating the condition. Laboratory mice commonly suffer from ulcerative dermatitis, in which they excessively groom themselves, often leading to serious infection. These mice serve as a good model for the disease in humans.

In the study, mice who were fed the antioxidant N-acetylcysteine (NAC) all showed some improvement,   and some 40 percent were cured, though the results took up to eight weeks. Another group of mice given glutathione, the body’s naturally occurring antioxidant, got better much faster; about half who got this treatment were fully cured, the researchers found.

NAC has been used in humans in a number of experimental settings, and some case reports suggest it could be useful in people with skin-picking disorder. However, it can be hard to tolerate, as it causes gastrointestinal side-effects, Garner says. Intranasal glutathione, on the other hand, bypasses the gut and liver and goes directly to the brain. In doing so, it may avoid these potential side-effects.

“It’s clearly working differently, or at least more directly,” Garner says. “This different response profile gives us some hope that there may be some non-responders, or people who can’t tolerate NAC, who may be helped by glutathione.”

He says it represents the first potential new treatment for the condition in years. He now hopes to test intranasal glutathione in a clinical trial among human patients with skin-picking disorder.

The latest study appears online in the journal PLOS ONE. The experiments were conducted by researchers at the University of North Carolina at Chapel Hill.

More on skin picking and related disorders can be found at www.trich.org.

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