From the Research
N-acetylcysteine (NAC) for dermatillomania is typically prescribed at doses ranging from 1,200 to 3,000 mg per day, divided into 2-3 doses, with a common starting regimen of 600 mg twice daily, as supported by the most recent study 1. The treatment of dermatillomania, also known as skin picking disorder, requires a comprehensive approach that includes pharmacological and non-pharmacological interventions.
- NAC is a glutamate modulator that has shown promise in reducing compulsive behaviors associated with dermatillomania.
- The dosage of NAC can be gradually increased to 1,200 mg twice daily if needed and tolerated, with treatment duration of at least 8-12 weeks recommended to evaluate effectiveness.
- NAC should be taken with food to minimize gastrointestinal side effects such as nausea or stomach discomfort, and patients should consult with a healthcare provider before starting treatment, especially if taking other medications, as NAC may interact with certain drugs including some antibiotics and nitroglycerin, as noted in 2 and 1.
- Common side effects of NAC include gastrointestinal discomfort, headache, and occasionally a rotten-egg smell.
- While the evidence for NAC in treating dermatillomania is promising, larger studies with longer durations are needed to fully establish its efficacy, as highlighted in 2.
- Other pharmacological interventions, including selective serotonin reuptake inhibitors (SSRIs), may also be considered in cases with significant comorbidities or previous behavioral/NAC treatment failure, as suggested in 3 and 4.
- Non-pharmacological treatments, such as cognitive behavioral therapy, habit reversal exercises, and support groups, have also proven to be helpful and are well tolerated amongst patients suffering from dermatillomania, as noted in 5.