Inositol for Dermatillomania

Inositol has been named as one of the potentially effective pharmacological treatments for body-focussed repetitive behaviors (bfrbs) such as trichotillomania and dermatillomania. To date there is only one published uncontrolled study by Dr. Seedat in 2001 in which 3 women with compulsive skin picking were treated with inositol, and were seen to improve even up to 16 weeks post follow-up. Dr. Fred Penzel, a member of the Scientific Advisory Board for the Trichotillomania Learning Centre (TLC), also highly recommends the use of inositol based on his observations of the positive effects in his work with trichotillomania patients at the clinic where he practices and describes its use in detail in his book The Hair-Pulling Problem : A Complete Guide to Trichotillomania.

What is Inositol?

Inositol is a carbocyclic sugar, which can be found in cereals with high bran content, oranges and bananas, beans, brown rice and nuts. It is regarded as a member of the B-complex family of vitamins, however it is not officially recognised as a vitamin as it can be synthesized in the body from glucose, by intestinal bacteria. It functions in part as a signaling molecule in insulin regulation, nerve transmission, and calcium, serotonin and cholesterol regulation. It is considered a natural mood balancer, used to treat a wide range of diseases and disorders such as high cholesterol, cancer, depression, schizophrenia, autism, ADHD, psoriasis, diabetic nerve pain and most recently BFRBs like compulsive skin picking.

How does is work?

Although inositol is manufactured in the body and is present in all body tissues, long term use of antibiotics, as well as  regular consumption of more than 2 cups of coffee daily can destroy the resulting in a deficiency. In addition no serious side effects are known, even for therapeutic dosages over 10 times the normal dietary intake, except for diarrhea in some cases of very high doses. Aside from food, inositol can also be manufactured in a laboratory. It is available as a supplement in a white powdered form, which is soluble so it can be dissolved in juice or water to be injested. It is believed to have a calming effect as it is involved in the production and action of neurotransmitters (chemicals that transmit messages between nerve cells) like serotonin and acetylcholine.

According to the American Psychiatric Association (APA)

[inositol] is indicated as a viable treatment for obsessive compulsive disorder (OCD) and related disorders such as depression and anxiety

Inositol can also be used in conjunction with vitamin B12 and Omega 3 for better results. It is recommended start off with low dosage of 2grams twice a day and slowly build the dosage up to the required 18 grams per day. Whatever is not absorbed will be excreted. Inositol must be taken in large quantities to achieve successful results. It works by stabilising the mood and thus reduces stress and anxiety. This in turn eliminates the individual's urge to pick in a number of cases. In addition, inositol helps to maintain proper electrical energy and nutrient transfer across the cell membrane, thereby helping to establish healthy cell membranes that facilitate nerve impulses.

Can anyone take it?

Inositol is a non-prescription supplement and is therefore accessible to ever yone. However there are some special precautions to consider before taking it:

1. Inositol cannot be taken by patients who are using Lithium as it seems to block its action.

2. Gas, bloating and diarrhoea are the chief side effects.

3. Caffeine lowers the levels of Inositol in the body, therefore patients who choose to follow this form of treatment should cut down on their daily intake of caffeine or preferably eliminate it from their diets altogether.

4. Inositol should be purchased in powder form and dissolved in water or fruit juice for maximum absorption. It has a sweet, pleasant flavour which is easy to swallow.

5. Inositol should be taken consistently for at least 6 weeks to gauge if there is any improvement

6. increased improvement is seen if the individual changes their diet to a wheat-free, low sugar diet

Further more extensive research is called for in the effectiveness and longevity of effects of inositol use in the treatment of skin picking disorder. As with any pharmacological medication of supplementation, it is always advisable to seek advice from a health professional, and remember that it may not have the same desired results for everyone.