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      Cocaine and Stimulant Induced Skin Picking

      Why you must consider quitting

      For quite sometimes now we have been addressing the issues surrounding substance abuse. We have dealt with various effects of drugs and so far we are not seeing anything good about drugs. And what is worrying is that even though this piece of information is now consumable by many people, drug related conditions are still on the rise. One of the most disturbing conditions is the way cocaine is rearranging peoples’ faces and transforming their lives negatively. Even though this is very evident and the victims themselves can see for themselves the damage caused by cocaine addiction on the mirror, they are still very much hooked into their addiction. This is what we have been addressing and for the purpose of this article, we are going to focus on beauty and how cocaine and stimulant induced skin picking. Before we settle into the discussion, I want to share with you an experience one of the patients went through and this is also a representation of what many addicts are also going through.

      For the purposes of confidentiality I will refer to the patient as GK. After abusing cocaine for some time, one day he stood before his mirror and he dint like what he saw. What was before him was an increasingly common and distressing indicator of excessive cocaine and stimulant use. Skin picking was the problem. He spent several hours before the mirror squeezing and tweezing as the smallest of spots becomes a painful wound. Hair pulled out, bugs under the skin, insects or mites in his clothes and house. We are going to rely on GK experience to shed some light on this extremely upsetting, hidden behavior, examining the chemistry behind it, why it happens and the role cocaine and other stimulants have to play. This is a discussion you don’t want to miss but in the meantime you can schedule for an appointment with doctor Dalal Akoury the MD and founder of AWAREmed Health and Wellness Resource Center. She will be of greater help to you in all matters relating to addiction and beauty. And now back to the discussion of Cocaine and stimulant induced skin picking…

      Skin Picking

      Skin picking due to excessive crack cocaine use has become more common as more people use crack disorderly and because of this there is sudden increase in negative health issues linked to this habit. Professionally in the medical understanding skin picking is seen as a compulsive foraging response (CICF – ‘cocaine induced compulsive foraging’) but the compulsion to skin pick has also been called psychogenic excoriation, delusional parasitosis, self-inflicted dermatoses, dermatillomania, formication, or hypoesthesia; which is quite surprising considering that there has been so little research on the subject.

      The features of skin picking may include excessive scratching, picking, gouging, lancing, digging and squeezing of normal or slightly marred skin. Even though the whole body can be involved, commonly the most picked areas include; fingernails, face, lips, scalp, arms and legs. This is made possible because drugs like cocaine, methylephenidate, phenelzine amphetamine and anticholinergic drugs often produce increased nerve activity tactile sensations like burning, tingling and crawling (worms under the skin) that can lead to skin picking. So while it is clearly a chemical reaction to the drugs you’re taking, it can be closely linked with psychological issues such as extreme anxietyor childhood trauma. So why do some people skin pick excessively, where others don’t?
      Studies suggest that it’s a coping mechanism for dealing with emotional pain. Physical pain distracts the individual and can help to alleviate feelings of guilt through self-punishment. Many S-P’s (skin pickers) report increased levels of tension prior to skin picking and a sense of relief or satisfaction following the picking. Some experience an altered state of consciousness whilst picking resembling a dissocialized state. However, lack of pain during picking episodes may also be related to opioid dysregulation. We can see elevated levels of B-endorphin in S-Ps, because pain, in this case through self-injurious behavior, leads to the release of B-endorphins, which in turn leads to the release of tension.

      Victims of childhood abuse often have elevated levels of B-endorphins too, in their CSF (cerebrospinal fluid) in the brain, because of repeated exposure to pain, or from being prohibited to reacting to the infliction of pain. Women with a history of childhood abuse also exhibit increased pituitary adrenaline and automatic heart rate responses to stress. So in many cases, skin picking is a chemical reaction that has been built up from past trauma, where a person’s elevated b-endorphins or ACTH response is reacting with the drug they’re taking: crack cocaine.

      Cocaine increases the activity of dopamine, a neurotransmitter in the automatic nervous system associated with pleasure which is important for reinforcement of behaviour.However, for reasons we don’t have the space to go into, too much use of cocaine can lead to a lack of dopamine in your system, which in turn leads to mood and anxiety disorders.

      S-Ps often suffers from one or more of the following conditions:

      • Major depression
      • Bipolar disorder (manic depression)
      • Dysthymia (depression tendencies)
      • Panic attacks
      • Agoraphobia
      • Post-traumatic stress
      • Obsessive compulsive disorder
      • Eating disorders
      • Trichotillomania (hair /eyelash/body hair pulling)
      • Kleptomania (compulsive stealing of objects) and
      • Body dysmorphic disorder (hated self-image).

      Beside the mention conditions, some studies have also established that more than half of the individuals with serious skin picking conditions also reported a history of body rocking, thumb sucking, knuckle cracking, cheek chewing and head banging. Along-side with all these, skin picking also causes a lot of anguish. Like for instance, the victim can feel embarrassed and this may lead to shame and even impaired social functioning and in some cases people withdraw altogether from social activities and confine themselves to their home. Some people also experience medical complications as a result of skin picking, like ulcers, infections, permanent discoloration and scarring. Remember that too much scratching leads to open wounds and sores and when this is combined with injecting, infection can travel from the skin to the blood, causing serious illnesses such as septicemia or endocarditis.

      Cocaine Induced Psychosis & ‘Foraging’

      Chronic cocaine or crack use can result in cocaine induced paranoia (CIP) and coke-induced compulsive foraging (CICF) type behaviors. ‘Compulsive foraging’ covers a cluster of cocaine induced behaviors of which skin picking is just one. Another ‘foraging disorder’ is when coke users hunt for hours for specs of cocaine around a place where it was once used (also called ‘surfing’). Food deprivation or hunger increases the probability of foraging responses and because it’s an appetite suppressant, coke can make users vulnerable to malnutrition thus continuing foraging behavior. Skin picking is a foraging response.

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