Self-inflicted lesions in dermatology: The scars of self-harm
Background: Nonsuicidal self-injury behaviors (NSSIBs) are common within the general population, and dermatologists may be the first physicians a patient would see for this condition. There is a scarcity of dermatologic literature that discusses the recognition and management of self-mutilation and suicidal self-injuries from a dermatologic perspective. Purpose: This review discusses the drivers, presentations, and therapies available for NSSIB. Methods: We conducted a review of the risk factors, skin-finding characteristics, approach to patient assessment, and treatment and management strategies for NSSIB. Results: Coexisting medical conditions and mental health disorders increase the risk of NSSIB. Patients with NSSIB may present with a spectrum of dermatologic findings, which provide valuable insight and clues into the underlying mechanism of injury. Common treatment strategies include psychotherapy, lifestyle modification, support groups, medication use, and, in severe cases, inpatient care. Patients may benefit from botulinum toxin and hyaluronic acid treatments, dermabrasion and microneedling, laser therapy, surgical revision, and camouflage techniques. Conclusion: Unraveling the complex layers comprising NSSIB provides an understanding of the intricate motives behind self-mutilation, allowing dermatologists to comprehend the deeper psychological dimensions of their patients’ distress and tailor interventions that address the visible skin manifestations and the underlying mental health complexities.
