- Compulsive Skin Picking – What Is Dermatillomania?
- Symptoms of Dermatillomania
- Effects of Skin Picking Disorder
- Treatment Options
- Dermatillomania: Symptoms, Causes, Treatments
- Dermatillomania Symptoms and Causes
- Dermatillomania Treatment
- What is Excoriation (Skin Picking) Disorder?
- Signs & Symptoms
- Impact & Effects
- Keep Reading
- Dermatillomania – Dermatillomania Treatment Options
- Symptoms and Causes of Dermatillomania
- Medications and Treatment Options
- How Do You Find the Best Treatment Center?
- Excoriation (Skin Picking) Disorder: What Is It?
- How Pathologic Skin Picking Is Related to OCD
- Skin picking (excoriation disorder): Causes and treatment
- Autism spectrum disorder
Compulsive Skin Picking – What Is Dermatillomania?
Dermatillomania, also known as skin picking disorder (SPD), is a serious problem in which an individual picks at their skin to the extent that it causes wounds. Many people don’t have an awareness of this condition but 2% to 3% of the population actually struggles with it. If you struggle with compulsive skin picking, you aren’t alone.
SPD is considered to be an impulse control disorder that is related to obsessive-compulsive disorder.
Occasionally, individuals will also display characteristics of other disorders such as substance abuse, borderline personality disorder or body dysmorphic disorder.
Dermatillomania is most common among teenagers and young adults. Females are more ly to struggle with it than men and may need to seek treatment for OCD
Symptoms of Dermatillomania
Individuals who suffer from dermatillomania may exhibit symptoms :
- Skin picking
- Compulsively rubbing skin
- Skin scratching
- Repetitive touching
- Digging into skin
- Squeezing skin repetitively
Skin picking is often accompanied by intense emotions and can be done with the fingers or by use of other tools, tweezers. Most sufferers of SPD focus on a primary area of their body, with the face being the most common.
Effects of Skin Picking Disorder
The skin can become discolored and scarred, with occasional severe episodes of major tissue damage. In rare cases, skin grafting can be required. Infection can also become a problem.
Individuals who suffer from this behavioral issue can experience feelings of guilt and helplessness, along with shame and embarrassment.
These feelings come as a result of the physical effects of the disorder and can be cyclical, driving the individual to pick more.
Although some believe that dermatillomania is the result of another disorder, recent studies and changes in the field of psychology suggest otherwise. A separate category for this area of disorders has been added to the DSM-5. In order to receive a diagnosis in this category, the person must:
- Experience some of the symptoms listed above
- Be under clinical distress or impairment
- Have symptoms that are not caused by a medical, substance or dermatological condition
- Have symptoms that cannot be explained by another psychiatric disorder
In order for an accurate diagnosis to be made, help from a medical professional should be sought.
Evidence shows that treatment is most effective when both pharmacological therapy and behavioral therapy are used in conjunction with one another.
Medications that inhibit specific serotonin neurotransmitters are found to help reduce compulsive behaviors and obsessive thoughts.
Cognitive-behavioral therapy is administered to help the individual understand their behavior patterns and thoughts so they can begin a healthy, guided direction down the path of healing.
At Promises Behavioral Health, we offer a variety of treatment options. These may include:
Learn more about compulsive skin picking and treatment options by calling 844.875.5609 today.
Dermatillomania: Symptoms, Causes, Treatments
Dermatillomania, also known as compulsive skin picking (CSP), is a mental illness wherein sufferers feel very strong urges to pick at their skin to the point of damaging it.
Some experts call it excoriation disorder or neurotic skin picking.
Regardless of what your mental health professional or family doctor calls it, it's a real disorder and people suffering from it usually can't stop on their own.
Dermatillomania Symptoms and Causes
To recognize dermatillomania, you need to understand what the signs and symptoms look . Some telltale symptoms of dermatillomania include:
- Compulsive and frequent picking at the skin to the point of causing tissue damage
- The picking and tissue damage results in significant distress for the individual engaging in skin picking behavior
- The skin picking causes the person considerable issues at work, school, in his or her social life, or other regular activities
It's also not uncommon for people with dermatillomania to have comorbid (simultaneously occurring) mental disorders, such as depression, anxiety, or obsessive-compulsive disorder.
Additionally, people with dermatillomania symptoms don't necessarily have to suffer from an underlying skin problem (i.e. acne, bug bites, scrapes, rash) to feel the urge to pick. People suffering from this condition will often pick and tear at the skin and actually create sores on the body part of the body they are focusing on, or even all over their bodies.
Researchers don't have enough information to come up with a clear set of causes for dermatillomania, but they theorize a number of factors could contribute to its development in susceptible people:
- Genetics – people who have a parent or sibling with excoriation disorder or other related disorders are more ly to develop the condition
- Stress – current research suggests another cause of dermatillomania may be life stressors that result in anxiety that the person copes with by skin picking
- Trauma – sometimes a single, very traumatic event can trigger the onset of this condition
Much more research is needed on dermatillomania treatment, but some studies suggest that cognitive behavioral therapy (CBT) may provide some relief to those suffering from it.
Other mental health professionals use acceptance and commitment therapy (ACT), a type of mindfulness-based CBT, wherein the person simply accepts the stresses and anxieties that trigger the behavior and then commits to refraining from the picking behavior.
Research also indicates that selective serotonin reuptake inhibitor (SSRI) medications may prove helpful in dermatillomania treatment. Some common SSRIs include:
Since each individual reacts differently to medication, more research is needed to determine which, if any, works best in the treatment of dermatillomania.
Many people suffering from the shame and embarrassment of this disorder do not know that help exists, so they continue to hide their condition and suffer from it in silence.
Gluck, S. (2013, May 6). Dermatillomania: Symptoms, Causes, Treatments, HealthyPlace. Retrieved on 2020, May 17 from https://www.healthyplace.com/ocd-related-disorders/excoriation-skin-picking-disorder/dermatillomania-symptoms-causes-treatments
What is Excoriation (Skin Picking) Disorder?
For an in-depth overview of treatment guidelines and considerations for skin picking disorder, download our free booklet, Experts Consensus Treatment Guidelines.
Excoriation Disorder, also known as skin picking disorder or dermatillomania, is characterized by the repetitive picking of one’s own skin. Individuals who struggle with this disorder touch, rub, scratch, pick at, or dig into their skin in an attempt to improve perceived imperfections, often resulting in tissue damage, discoloration, or scarring.
Skin picking disorder is one of a group of behaviors known as body-focused repetitive behaviors (BFRBs), self-grooming behaviors in which individuals pull, pick, scrape, or bite their own hair, skin, or nails, resulting in damage to the body.
Occasional picking at cuticles, acne, scabs, calluses or other skin irregularities is a very common human behavior; however, research indicates that 2% – 5% of the population picks their skin to the extent that it causes noticeable tissue damage and marked distress or impairment in daily functioning. 75% of people affected are female.
The behavior typically begins in early adolescence, although skin picking disorder can begin at any age. Without treatment, skin picking disorder tends to be a chronic condition that may wax and wane over time.
Signs & Symptoms
Excoriation (skin picking) disorder is currently classified as an “obsessive-compulsive and related disorder” in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
The DSM-5 diagnostic criteria include:
- Recurrent skin picking that results in skin lesions
- Repeated attempts to stop the behavior
- The symptoms cause clinically significant distress or impairment
- The symptoms are not caused by a substance or medical, or dermatological condition
- The symptoms are not better explained by another psychiatric disorder
Those who engage in skin picking tend to pick from multiple body sites, for extended periods of time, targeting both healthy and previously damaged skin. Targeted areas of the body may change over time.
Commonly reported experiences that lead to picking include: an urge or physical tension prior to picking, unpleasant emotions, cognitions (permission-giving thoughts, beliefs about how the skin should look or feel), sensations (a bump, sore spot), and/or a displeasing aspect of one’s own appearance (visible blemish). Commonly reported experiences following picking behavior include: urge reduction, sense of relief or pleasure, psychosocial difficulties or embarrassment, avoidance, reduced productivity, emotional sequelae such as anxiety or depression, skin infections, scars, lesions, and/or disfigurement.
Although the severity of excoriation disorder varies greatly, many people who struggle with skin picking exhibit noticeable skin damage, which they attempt to camouflage with makeup, clothing, or other means of concealing affected areas.
Due to shame and embarrassment, individuals may also engage in avoidance behaviors, including the avoidance of certain situations that may lead them to feel vulnerable to being “discovered” (e.g.
, wearing shorts, being seen by others without makeup, or intimacy).
Due to the nature of skin picking, it is important to consider whether the behavior is characteristic of excoriation disorder, or, whether it is better accounted for by another psychiatric disorder which warrants treatment.
For example, skin picking may be a symptom of a dermatological disorder, an autoimmune disorder, body dysmorphic disorder, obsessive-compulsive disorder, substance abuse disorder (e.g., opiate withdrawal), developmental disorder (e.g., autism spectrum disorder), or psychosis.
Comprehensive evaluation and accurate diagnosis is important in determining an appropriate treatment plan.
Impact & Effects
The impact of skin picking disorder on one's life may be significant. Individuals may experience shame and embarrassment, and as a result, may avoid certain social situations or activities (e.g., pools, gyms, beaches), and medical care.
These emotional sequelae can lead to painful isolation and result in a great deal of emotional distress, placing them at risk for a co-occurring psychiatric disorder, such as a mood or anxiety disorder.
Furthermore, these individuals often go to great lengths to cover, hide, or camouflage damaged skin and may have difficulty with time management due to the significant time involved in engaging in the behavior as well as efforts to conceal it.
Medical complications as a result of excoriation disorder are not uncommon.
Infection, which may require medical treatment, scabbing, open wounds, discoloration, scarring, or disfigurement are possible consequences of chronic skin picking behavior.
Skin picking can also lead to strained relationships with family members and friends. Family members may need professional help in coping with this problem.
What causes BFRBs?
How are body-focused repetitive behaviors treated?
Read our Experts Consensus Treatment Guidelines
How can I find a therapist?
Search treatment provider referrals
More articles & videos
Read skin picking / dermatillomania stories on The Mighty
Dermatillomania – Dermatillomania Treatment Options
It’s a condition that few people want to claim; picking one’s skin seems something you should easily be able to control. Unfortunately, for millions of Americans, it’s not a controllable habit, and it’s one that brings a great deal of embarrassment.
The inability to stop picking doesn’t mean that you’re crazy, nor does it necessarily mean that you have an obsessive-compulsive disorder (OCD). It does, however, mean that you will benefit from treatment in a facility that addresses the behavior.
Skin picking, or dermatillomania, is also known as excoriation disorder. It’s a psychological condition that manifests as repetitive, compulsive skin picking. In the DSM-5, it’s classified as an impulse control disorder, one of several body-focused repetitive behaviors.
Dermatillomania affects 1.4% of the population, and almost 80% of those affected are female.1
The biggest difference between dermatillomania and regular skin picking is that the behavior is chronic and results in severe tissue damage. Often people who suffer from dermatillomania will have extensive scarring.
Generally, people with this condition target their face, along with hands, fingers, arms, and legs.
Sometimes, they use their fingers or an instrument that allows them to pull, squeeze, scrape, or lance both healthy and damaged skin.
This picking behavior can last for months or even years. Because this is a chronic condition, symptoms rise and then disappear during the course of a person’s life.
Symptoms and Causes of Dermatillomania
In order to be diagnosed with dermatillomania, these three criteria have to be met:2
- Recurrent skin picking that results in lesions on the skin.
- Repeated attempts to stop or decrease the frequency of skin picking.
- Picking causes feelings of embarrassment, shame, or loss of self-control.
The cause of dermatillomania is still unclear, though some research suggests it might have a genetic component. There might also be a correlation between higher than average anxiety disorders and those who suffer from dermatillomania.3
The emergence of this condition often coincides with puberty, leading some researchers to suggest there’s a connection between perfectionism and the condition.4
Medications and Treatment Options
Not everyone who seeks treatment for dermatillomania will be prescribed medication, but in many cases it can be helpful when combined with therapy sessions. Not every medication will work for each person since the condition is widely varied. Some of the more promising mediations include antidepressants, anti-anxiety medication, and OCD medication.
Trauma and depression can be an underlying cause of dermatillomania, and medications that treat the disorder can, in turn, help stop the urge to pick.
For some, skin picking can be a nervous tick that they do when they are fearful, stressed, or worried. Anti-anxiety medications might be useful in these situations.
Because many who pick their skin are diagnosed with OCD, medications SSRIs that are often prescribed to treat OCD symptoms can work for dermatillomania as well.
No matter which type of medication—if any—is included in your treatment program, therapy is a necessary addition. Learning how to cope with stress and recognize the feelings that precipitate the behavior as well as learning how to replace skin picking with more positive behaviors is the focus of therapeutic treatment.
It’s not always easy to get a diagnosis and treatment recommendation for dermatillomania. Often, a general physician will refer to a dermatologist rather than a mental health specialist. If you are concerned you might have this condition, advocate for your own mental health. Request a referral to a mental health physician so you can begin to receive the treatment you need.
How Do You Find the Best Treatment Center?
Fortunately, there are several behavior health treatment centers located around the country that work with compulsive disorders dermatillomania. If you’re considering treatment, make sure to inquire about the experience the facility has with treating this condition.
When you’re ready to find relief, call us. Our dedicated team of compassionate representatives is here to help you find your road to recovery.
- Lochner, C., Roos, A., Stein, D.J. (2017). Excoriation (Skin-Picking) Disorder: A Systematic Review of Treatment Options. Neuropsychiatr Dis Treat.
- Arnold, L.M., McElroy, S.L., Mutasim, D.F., Dwight, M.M., Lamerson, C.L., Morris, E.M. (1998). Characteristics of 34 Adults with Psychogenic Excoriation. J Clin Psychiatry, 59(10), 509-514.
- Spiegel, D.R., Finklea, L. (2009). The Recognition and Treatment of Pathological Skin Picking: A Potential Neurobiological Underpinning of the Efficacy of Pharmacotherapy in Impulse Control Disorders. Psychiatry (Edgmont, 6(2):38–42.
- Odlaug, B.L., Hampshire, A., Chamberlain, S.R., Grant, J.E. (2016). Abnormal Brain Activation in Excoriation (Skin-Picking) Disorder: Evidence from an Executive Planning fMRI Study. Br J Psychiatry, 208(2), 168–174.
Excoriation (Skin Picking) Disorder: What Is It?
Picking at scabs or bumps from time to time isn’t uncommon. But for some people, picking can become chronic. Frequent picking can irritate existing sores and even cause new ones to form. This can cause additional scabbing and lead to scarring.
This continued picking can develop into a condition called skin-picking disorder, or excoriation. People with this disorder pick at their skin habit or impulse. They often describe this impulse to pick as something they struggle to control.
Some people may spend a few minutes several times a day picking. Others may pick continuously for several hours each day.
Skin-picking disorder isn’t common, but it’s well documented. It’s considered a mental health condition related to obsessive compulsive disorder (OCD). Not everyone with OCD will develop skin-picking disorder, but many people who have this disorder often experience OCD, too.
Keep reading to learn more about excoriation, including why it may develop and how it can be managed.
Understanding the signs and symptoms of skin-picking disorder can help you recognize whether certain behaviors are the result of “normal” picking, or if they may signify something more serious.
For example, occasional picking is rarely problematic. Scabs often itch while the skin heals, leading many people to scratch at their skin. And despite advice to the contrary, many people pick at pimples and blackheads, too.
People with skin-picking disorder, however, may pick at scabs, bumps, pimples, or other skin lesions until they bleed again or become inflamed. They may also pick at the skin around their fingernails and toenails.
Sometimes, people with the disorder let the picked areas heal only to pick them again. It’s a cycle of habit and impulse that can be challenging to overcome.
Other signs and symptoms of skin-picking disorder include:
- Trying to remove “imperfections”: Some people repeatedly scratch skin or try to rub out “imperfections” they think they see in their skin. This, too, can cause additional lesions, cuts, and sores.
- Spending large amounts of time picking: Some people with this condition will pick at their skin several times a day. Others may pick for several hours at a time. Either way, the behavior can be a significant disruption to their social and professional lives.
- Developing scars and infections from frequent picking: The disorder can lead to infections, lesions, and scars that last for long periods of time. Infections may require treatment with antibiotics.
- Avoiding public events because of their skin: Frequent picking can leave skin covered in lesions and scars. Some people with this condition may avoid the beach, gym, or venues that require less clothing because of their skin’s appearance.
Skin-picking disorder is a repetitive “self-grooming” behavior. It’s also called a body-focused repetitive behavior (BFRB). Other BFRBs include pulling hair or picking nails.
Skin-picking disorder is classified as a type of OCD. The compulsive urge to pick is often too powerful for many people to stop on their own. The more a person picks at their skin, the less control they have over the behavior.
It’s unclear what causes a person to develop this disorder.
The disorder often begins after one of two events or stimuli:
- An infection, injury, or wound starts healing and creates a scab. The itching causes the person to scratch and pick. The new wound or lesion starts to heal and creates another scab. That begins the cycle of picking.
- The behavior is a stress relief habit during a time of stress. The repetitive action and control that skin picking gives may provide relief from other events that can’t be controlled.
Skin-picking disorder occurs in both children and adults. It can begin at almost any age, but it typically appears first in adolescence or at the onset of puberty. Women are more ly to develop it than men.
Several conditions commonly occur alongside skin-picking disorder. These illnesses or disorders may be symptoms of a condition, or they may share many common underlying risk factors.
These co-occurring illnesses include:
- Obsessive-compulsive disorder (OCD): This mental health disorder often causes repetitive behaviors that greatly interfere with a person’s quality of life.
- Body dysmorphic disorder: People with this body-image disorder experience obsessive negative thoughts about how their body looks. This can lead to skin picking to remove “imperfections.”
- Major depressive disorder: Depression can lead to a host of behaviors, including skin picking.
- Trichotillomania (hair-pulling): Approximately 38 percent of people with skin-picking disorder also experience this condition.
- Other BFRBs: Although hair-pulling is the most common co-occurring BFRB, others are possible. This includes nail biting, biting the lips until they bleed, and chewing on the inside of your cheeks.
Skin-picking disorder can’t be self-diagnosed. Although you may suspect your symptoms are caused by skin-picking disorder, your doctor will want to rule out any other underlying conditions before making a diagnosis.
After performing a physical exam, your doctor will ask you about your behaviors and the feelings you have while performing the habit. They’ll also determine whether the lesions or scabs you’re picking are the result of a skin disorder or condition eczema or psoriasis.
If your doctor suspects skin-picking disorder, they may refer you to a mental health professional. Family medicine doctors or internists may make this referral if they think the skin picking is the result of stress, anxiety, or OCD.
The treatment options available for skin-picking disorder fall into two main categories: medication and therapy.
A mental health professional or counselor can help you identify the triggers that lead to skin picking. Then, together, you can develop ways to stop the behavior when you feel these triggers.
This may include learning to use healthier behaviors when you want to pick your skin. For example, squeezing a stress ball, playing with a Rubik’s cube, painting, or other behaviors that occupy your hands are sometimes used to stop picking.
A mental health expert may also help you learn to resist things in your environment or on your body that make you more ly to pick. Wearing gloves or adhesive bandages to cover scabs or cuts may also help you avoid picking.
Antidepressants may help ease self-picking behaviors. Selective serotonin reuptake inhibitors (SSRIs) are most commonly prescribed for this condition.
Other medications, including psychiatric and anticonvulsant drugs, may be prescribed for “off-label” use. This means that although the medication is primarily used to treat a different condition, it may also be used to treat skin-picking disorder.
Once a diagnosis has been made, your doctor will work with you to develop a treatment plan. Finding a treatment plan that works for you may take a process of trial and error.
Although treatment can help you manage the symptoms and quash the behaviors, you may experience periods when you pick again. This can happen even after long periods of stopping the behavior.
That doesn’t mean you can’t “overcome” the disorder. It just means that you and your doctor may need to revisit your treatment plan and update it to suit your needs.
As you take steps toward management, there are a few things you can do to help steer your treatment plan:
Find a support group in your community. This group of people will understand your experience and can support you as you try to find a treatment plan that works for you. They can also help you understand the course of the disorder and what you might expect in the future.
Ask a mental health expert or therapist for some guidance. Your hospital’s education outreach office may have a list of experts and groups for you to contact.
Above all else, be supportive of yourself. Set goals for yourself, and celebrate when you reach them. However, remember that, in the beginning, success may be slow-going. Boost yourself for every small accomplishment, and show yourself some grace if you don’t meet a certain goal.
How Pathologic Skin Picking Is Related to OCD
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Pathologic skin picking, or excoriation, is a mental illness in which you compulsively pick your skin to remove small irregularities such as moles or freckles, causing skin lesions. It's classified as a disorder that's related to obsessive-compulsive disorder (OCD) and its symptoms certainly share some similarities with those found in OCD.
The main characteristic of pathologic skin picking also referred to as excoriation or dermatillomania, is repetitive or compulsive picking, or even digging, in the skin to the point of causing skin damage, scarring and/or infection. It is not uncommon for people with skin picking to engage in picking for several hours per day. As a result, people with pathologic skin picking often have difficulty maintaining steady employment or interpersonal relationships.
When picking, people may use their fingers, tweezers, pins or other instruments to remove a perceived blemish. Common areas of focus include the face, back, neck, and scalp.
Although picking can involve normal skin, picking is most commonly triggered by small blemishes, imperfections, scabs, and insect bites. Symptoms of skin picking can be similar to those of OCD.
Prior to picking, many people describe a compulsion- urge to pick at imperfections in the skin and a relief of anxiety when the imperfection is removed.
Later, however, the person may feel shame or be embarrassed about his picking, which can often lead to depression.
Approximately 2 to 4 percent of the population is affected by pathological skin picking. Interestingly, most people seeking treatment are female.
Skin picking can start at any age but usually begins in adolescence with the onset of skin conditions such as acne, eczema, or psoriasis.
Skin picking, or excoriation, is diagnosed when the individual has tried unsuccessfully to lessen or even stop the picking, which causes excessive distress and anxiety and impairs daily functioning.
Not surprisingly, there appears to be a strong link between skin picking and OCD. Skin picking occurs in people with OCD at a much higher rate than the general population.
Also, skin picking is often tied to body dysmorphic disorder, which involves a preoccupation with imagined bodily defects.
So while it's not technically OCD, skin picking is classified by the Diagnostic and Statistical Manual-5 (DSM-5) as an obsessive-compulsive related disorder.
Before making a diagnosis of dermatillomania, in other words, skin picking as a mental health disorder related to OCD, it's important to rule out other possible causes of the picking. It's also important to note that all picking is pathological. Picking that is considered on the spectrum of OCD usually causes significant distress and impairment of ordinary activities.
Some problems which could be mistaken for picking include:
- Skin infections such as scabies. Scabies can be extremely itchy, but it often missed when it occurs in well-groomed middle-class people. The scratching which almost always accompanies the itch can obscure the diagnosis.
- Skin diseases such as eczema.
- Systemic (bodywide) diseases. Elevated bilirubin levels from liver disease can cause intense itching. Itching may also accompany many other medical conditions.
- Chemical dependency on drug use or withdrawal.
Skin picking often causes considerable embarrassment and distress as a result of the unsightly wounds caused by picking, as well as the lengths the affected person may have to go to conceal her picking, such as wearing long sleeves during warm summer months or covering her face with a scarf.
Unfortunately, many people do not seek treatment because of the embarrassment associated with skin picking. This can be dangerous or even life-threatening as people often require medical interventions for their skin wounds, which can easily become infected.
Skin picking appears to respond best to treatment with cognitive-behavior therapy (CBT). Medications, often selective serotonin reuptake inhibitors (SSRIs) may be needed. If you are experiencing symptoms that you think might be skin picking, be sure to talk to your doctor or mental health professional.
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Craig-müller SA, Reichenberg JS. The Other Itch That Rashes: a Clinical and Therapeutic Approach to Pruritus and Skin Picking Disorders. Curr Allergy Asthma Rep. 2015;15(6):31. doi:10.1007/s11882-015-0532-2
Obsessive-Compulsive Disorder. National Institute of Mental Health. Revised October 2019.
Hayes SL, Storch EA, Berlanga L. Skin picking behaviors: An examination of the prevalence and severity in a community sample. J Anxiety Disord. 2009;23(3):314-9. doi:10.1016/j.janxdis.2009.01.008
Bjornsson AS, Didie ER, Phillips KA. Body dysmorphic disorder. Dialogues Clin Neurosci. 2010;12(2):221–232.
Diagnostic and Statistical Manual of Mental Disorders(DSM–5). American Psychiatric Association. 2013.
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Skin picking (excoriation disorder): Causes and treatment
People may pick their skin occasionally. For example, they might itch a scab or pop a pimple. However, occasional skin picking can develop into a chronic behavior called skin picking disorder, or excoriation disorder.
The exact cause of skin picking disorder remains unknown. That said, it may develop alongside other health conditions, such as obsessive-compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), or autism.
Skin picking disorder can significantly impact a person’s quality of life and overall health.
In this article, we discuss the potential causes and common treatments of skin picking.
Share on PinterestPeople with skin picking disorder may repeatedly pick at pimples, blisters, or scabs.
Skin picking disorder is a body focused repetitive behavior (BFRB) that affects about 1.4% of adults in the United States.
People with skin picking disorder may repeatedly pick, pull, or tear at healthy skin, pimples, blisters, or scabs.
Skin picking disorder occurs more frequently in females than males. Symptoms most often develop during adolescence and adulthood.
Symptoms of skin picking disorder include:
- engaging in skin picking despite multiple attempts to address the behavior
- developing recurring skin lesions or open wounds due to picking
- experiencing significant psychological, physical, or social impairment as a result of skin picking
People may pick their skin for various reasons. Some may feel compelled to remove perceived imperfections, while others pick in response to stress, boredom, or habit.
In many ways, skin picking disorder is a repetitive or obsessive grooming behavior similar to other BFRBs, such as hair pulling and nail picking.
Skin picking behaviors can last anywhere from a few minutes to several hours or several months, with periods of remission in between.
If untreated, skin picking can lead to painful lesions, bleeding, scars, and significant psychological distress.
Share on PinterestSkin picking disorder may develop in response to stress or mental health conditions.
People can develop skin picking disorder in response to:
- An infection, rash, or injury that creates a scab: The scab may itch while it heals, which leads people to scratch or pick it until it bleeds and a new wound forms. They may then pick at the new scab. A picking cycle forms and the behavioral pattern becomes a habit.
- Stress or mental health conditions: During times of stress, people might pick or scratch their skin, pull their hair, or bite their nails to relieve it. Others might feel compelled to pick their skin as a form of self-grooming or in an attempt to remove real or imagined imperfections in the skin.
Although skin picking has no specific cause, it may result from biological and environmental factors.
Skin picking disorder can develop alongside OCD or another mental health condition. We discuss this in more detail below.
OCD is a mental health condition characterized by unwanted repetitive thoughts and behaviors. According to the National Alliance on Mental Illness, OCD affects more than 2% of the U.S. population.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists skin picking as a common compulsion that develops in people with OCD.
Trichotillomania is a compulsive condition related to OCD. It leads to habitual behaviors such as hair pulling, nail biting, and teeth grinding.
An estimated 38% of people who have skin picking disorder also have trichotillomania.
ADHD is a neurodevelopmental condition that interferes with a person’s ability to pay attention and control impulsive behaviors.
The Centers for Disease Control and Prevention (CDC) list ADHD as “one of the most common” neurodevelopmental conditions among children.
People with ADHD may develop skin picking disorder in response to their hyperactivity or low impulse control.
Autism spectrum disorder
Autism spectrum disorder (ASD) is a neurodevelopmental condition that affects behavior and communication.
Doctors consider autism a spectrum disorder because it can cause a vast range of symptoms that appear at different intensities.
Although autism symptoms can differ from person to person, common symptoms include:
- inconstant eye contact
- showing little or no enjoyment during activities or interactions involving other people
- showing more or less sensitivity to sensory information, such as noise, lights, or temperature
- repeating certain behaviors or phrases, which is known as echolalia
The behavioral symptoms of ASD can manifest as repetitive behavior, such as skin picking, that often includes self-injury.
Treatment options for skin picking disorder usually include medication and therapy. Treating any underlying condition can help alleviate the impulse to pick.
Skin picking disorder related to an underlying mental health or developmental condition might respond to medications such as:
- selective serotonin reuptake inhibitors (SSRIs) and other antidepressants
- anticonvulsants such as lamotrigine (Lamictal)
- antipsychotics such as risperidone (Risperdal)