Understanding Skin Picking Disorder (Excoriation Disorder)

A Comprehensive Guide for Patients and Their Families

Psychiatry

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Last updated: Mar 24, 2025

What is Skin Picking Disorder?

Skin picking disorder, also known as excoriation disorder or dermatillomania, is a mental health condition characterized by recurrent picking at one's own skin, leading to tissue damage and significant distress.

Key Characteristics

  • Repetitive behavior: Frequent picking, scratching, or touching of skin
  • Physical damage: Visible wounds, scars, and infections
  • Emotional impact: Significant distress and impairment in daily functioning
  • Time consumption: Often spending hours per day picking

Common Triggers

  • Stress or anxiety
  • Boredom
  • Skin irregularities (real or perceived)
  • Specific textures or sensations
  • Strong urges or compulsions

Health Risks

Physical Complications

  • Infections
  • Scarring
  • Tissue damage
  • Possible disfigurement

Psychological Impact

  • Social anxiety
  • Depression
  • Low self-esteem
  • Relationship difficulties

Treatment Options

Behavioral Therapies

  1. Cognitive Behavioral Therapy (CBT)
  2. Habit Reversal Training
  3. Acceptance and Commitment Therapy

Medical Interventions

  • Selective Serotonin Reuptake Inhibitors (SSRIs)
  • N-acetylcysteine
  • Topical antibiotics when needed

Self-Help Strategies

  • Keep hands busy with fidget toys
  • Maintain good skin care routine
  • Identify and manage triggers
  • Use protective barriers (gloves, bandages)
  • Practice stress management techniques

When to Seek Help

Consult a healthcare provider if:

  • Picking causes significant distress
  • Wounds become infected
  • Daily activities are impaired
  • Self-help strategies aren't effective

Support Resources

  • Mental health professionals
  • Support groups
  • Online communities
  • Educational materials

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