What is Fictitious Dermatitis?

Fictitious dermatitis is a condition in which a person deliberately creates or worsens skin injuries, often without being fully aware of the emotional reasons behind the behavior. These injuries are not accidental and usually involve more intentional actions than simple scratching or picking. In clinical practice, Psychiatrist Dr. Sarthak Dave says that in such conditions the skin does not merely reflect disease, but becomes a language through which unspoken psychological distress expresses itself, turning inner pain into visible wounds.

This condition is uncommon, seen in a small percentage of dermatology patients, and affects women far more often than men. It can occur at any age but is most commonly noticed during adolescence and young adulthood, a time when emotional conflicts and inner struggles are more pronounced.

The skin findings are often unusual. Patients may present with blisters, ulcers, redness, swelling, bruising, or sinus-like wounds. These lesions tend to have sharp borders, straight lines, or geometric patterns that do not resemble naturally occurring skin diseases. A notable feature is that severe-looking lesions may exist right next to completely normal, healthy skin.

When asked about the development of these lesions, patients often provide vague or unclear explanations. This lack of detail is not intentional deception but reflects psychological distress that the individual may not fully understand or be able to express in words.

Fictitious dermatitis is not simply a dermatological problem. It is a manifestation of emotional suffering through the body. Treating the skin alone is rarely enough; understanding and addressing the psychological distress beneath is essential for long-term healing.