Table of ContentsView AllTable of ContentsSymptomsDiagnosisLink to OCDCausesTreatmentsCoping

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Table of Contents

Symptoms

Diagnosis

Link to OCD

Causes

Treatments

Coping

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Skin-picking disorder is a mental health condition in which people compulsively pick their skin to remove small irregularities, such as moles or freckles. This behavior can lead to injuries, skin lesions, infections, and scarring. The condition can also create considerable distress and disruptions in a person’s life.

Also known asexcoriation disorderor dermatillomania, this disorder is classified as an “obsessive-compulsive and related disorder" in thefifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

At a GlanceRepetitive skin picking is a serious and disruptive problem that causes skin damage, infection, and permanent scarring. This condition appears to be strongly linked to obsessive-compulsive disorder, although there are important differences between the conditions. Treatment for skin picking disorder typically involves psychotherapy, although medications may also sometimes be prescribed. Keep reading to learn more about the symptoms of skin picking disorder and how you can cope if you have this condition.

At a Glance

Repetitive skin picking is a serious and disruptive problem that causes skin damage, infection, and permanent scarring. This condition appears to be strongly linked to obsessive-compulsive disorder, although there are important differences between the conditions. Treatment for skin picking disorder typically involves psychotherapy, although medications may also sometimes be prescribed. Keep reading to learn more about the symptoms of skin picking disorder and how you can cope if you have this condition.

Symptoms of Skin Picking Disorder

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.

This behavior may include:

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 orinterpersonal relationships.

Types of Skin Picking

Picking behaviors are often described as either automatic or focused.

When to See a Doctor

Diagnosis of Skin Picking Disorder

To be diagnosed with excoriation disorder, you must exhibit symptoms that focus on recurrent skin picking. These symptoms include:

The use of some substances, such as cocaine or methamphetamine, can also cause skin picking behavior. Medical conditions such as scabies and mental disorders such as psychotic disorder or body dysmorphic disorder can also cause skin picking.

Skin picking disorder is not related to these conditions, so a doctor will rule out those as potential causes before making a diagnosis.

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.

Recap

Not surprisingly, there appears to be a strong link between skin picking andOCD.In fact, research shows that skin picking occurs in people with OCD at a much higher rate than in the general population.However, though both disorders can co-occur, they are quite different.

Similarities

Symptoms of skin picking can be similar to those of OCD.Prior to picking, many people describe acompulsion-like urgeto pick at imperfections in the skin and a relief ofanxietywhen the imperfection is removed. Later, however, the person may feel shame or be embarrassed about his picking, which can often lead todepression.

Differences

People with OCD who experience skin picking compulsions typically find these thoughts intrusive and distressing. Those with skin picking disorder, on the other hand, find the act of picking their skin enjoyable. While they may find pleasure in the act, they are still vulnerable to consequences of the behavior, including skin infections, scarring, anxiety, and social isolation.

Some problems which could be mistaken for skin picking disorder include:

Skin picking may also present as a symptom of another condition. In addition, skin picking may be a symptom ofbody dysmorphic disorder, a condition that involves a preoccupation with imagined bodily defects.

Commonly Co-Occurring ConditionsSkin picking disorder may also be more likely to co-occur with other mental health conditions. Some that commonly co-occur with this disorder include:OCDDepressionBipolar disorderAnxiety disordersOnychophagia (nail-biting)Trichotillomania(hair-pulling)

Commonly Co-Occurring Conditions

Skin picking disorder may also be more likely to co-occur with other mental health conditions. Some that commonly co-occur with this disorder include:OCDDepressionBipolar disorderAnxiety disordersOnychophagia (nail-biting)Trichotillomania(hair-pulling)

Skin picking disorder may also be more likely to co-occur with other mental health conditions. Some that commonly co-occur with this disorder include:

Causes of Skin Picking Disorder

The exact causes of skin picking disorder are not entirely understood, but a number of different factors likely play a role including genetic, biological, and environmental influences.

Skin picking can start at any age but usually begins in adolescence with the onset of skin conditions such as acne, eczema, or psoriasis. Some research suggests that developmental disabilities, problems withemotional regulation, and childhood trauma and abuse may also play a part in the onset of skin picking disorder.

Treatment for Skin Picking Disorder

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.

Treatments for skin picking disorder may include the use of psychotherapy, medications, or a combination of the two.

Psychotherapy

Talk therapy may be helpful for relieving symptoms of this condition.

Medication

Medications, oftenselective serotonin reuptake inhibitors(SSRIs) may be needed.These medications may also be helpful for relieving co-occurring symptoms of anxiety or depression.

If you are experiencing symptoms that you think might be skin picking, be sure totalk to a therapistor doctor.

Coping of Skin Picking Disorder

Research suggests that skin picking disorder may be sensory processing conditions that affect how people perceive, process, and regulate sensory information.This can include being overly responsive to sensations such as skin picking.

Finding alternative ways toself-sootheand provide stimulation aside from picking at the skin may be helpful for managing the urge to pick. Squeezing a stress ball or using afidget spinner, for example, might provide some degree of distraction and relief.

Researchers have also suggested that alternative treatments such ashypnosis, acupuncture, exercise, and yoga may be helpful in the treatment of skin picking disorder.However, studies are needed to determine if these approaches might offer relief either on their own or when used in conjunction with psychotherapy and medication.

OCD Subtypes: Types of Obsessive-Compulsive Disorder

12 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.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/s11882-015-0532-2American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders.5th ed. American Psychiatric Association; 2013.Snorrason I, Lee HJ.Assessing excoriation (skin-picking) disorder: Clinical recommendations and preliminary examination of a comprehensive interview.Int J Environ Res Public Health. 2022;19(11):6717. doi:10.3390/ijerph19116717National Institute of Mental Health.Obsessive-compulsive disorder.Lochner C, Roos A, Stein DJ.Excoriation (skin-picking) disorder: a systematic review of treatment options.Neuropsychiatr Dis Treat. 2017;13:1867-1872. doi:10.2147/NDT.S121138Odlaug BL, Grant JE.Pathologic skin picking.Am J Drug Alcohol Abuse.2010;36(5):296-303. doi:10.3109/00952991003747543Hayes 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):314-319. doi:10.1016/j.janxdis.2009.01.008Lang R, Didden R, Machalicek W, et al.Behavioral treatment of chronic skin-picking in individuals with developmental disabilities: A systematic review.Res Dev Disabil.2010;31(2):304-15. doi:10.1016/j.ridd.2009.10.017Odlaug BL, Hampshire A, Chamberlain SR, Grant JE.Abnormal brain activation in excoriation (skin-picking) disorder: evidence from an executive planning fMRI study.Br J Psychiatry. 2016;208(2):168–174. doi:10.1192/bjp.bp.114.155192Pile V, Lau JYF, Topor M, Hedderly T, Robinson S.Interoceptive accuracy in youth with tic disorders: Exploring links with premonitory urge, anxiety and quality of life.J Autism Dev Disord. 2018;48(10):3474-3482. doi:10.1007/s10803-018-3608-8Grant JE, Chamberlain SR.Trichotillomania and skin-picking disorder: An update.Focus (Am Psychiatr Publ). 2021;19(4):405-412. doi:10.1176/appi.focus.20210013Houghton DC, Alexander JR, Bauer CC, Woods DW.Abnormal perceptual sensitivity in body-focused repetitive behaviors.Compr Psychiatry. 2018;82:45-52. doi:10.1016/j.comppsych.2017.12.005

12 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.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/s11882-015-0532-2American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders.5th ed. American Psychiatric Association; 2013.Snorrason I, Lee HJ.Assessing excoriation (skin-picking) disorder: Clinical recommendations and preliminary examination of a comprehensive interview.Int J Environ Res Public Health. 2022;19(11):6717. doi:10.3390/ijerph19116717National Institute of Mental Health.Obsessive-compulsive disorder.Lochner C, Roos A, Stein DJ.Excoriation (skin-picking) disorder: a systematic review of treatment options.Neuropsychiatr Dis Treat. 2017;13:1867-1872. doi:10.2147/NDT.S121138Odlaug BL, Grant JE.Pathologic skin picking.Am J Drug Alcohol Abuse.2010;36(5):296-303. doi:10.3109/00952991003747543Hayes 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):314-319. doi:10.1016/j.janxdis.2009.01.008Lang R, Didden R, Machalicek W, et al.Behavioral treatment of chronic skin-picking in individuals with developmental disabilities: A systematic review.Res Dev Disabil.2010;31(2):304-15. doi:10.1016/j.ridd.2009.10.017Odlaug BL, Hampshire A, Chamberlain SR, Grant JE.Abnormal brain activation in excoriation (skin-picking) disorder: evidence from an executive planning fMRI study.Br J Psychiatry. 2016;208(2):168–174. doi:10.1192/bjp.bp.114.155192Pile V, Lau JYF, Topor M, Hedderly T, Robinson S.Interoceptive accuracy in youth with tic disorders: Exploring links with premonitory urge, anxiety and quality of life.J Autism Dev Disord. 2018;48(10):3474-3482. doi:10.1007/s10803-018-3608-8Grant JE, Chamberlain SR.Trichotillomania and skin-picking disorder: An update.Focus (Am Psychiatr Publ). 2021;19(4):405-412. doi:10.1176/appi.focus.20210013Houghton DC, Alexander JR, Bauer CC, Woods DW.Abnormal perceptual sensitivity in body-focused repetitive behaviors.Compr Psychiatry. 2018;82:45-52. doi:10.1016/j.comppsych.2017.12.005

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

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/s11882-015-0532-2American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders.5th ed. American Psychiatric Association; 2013.Snorrason I, Lee HJ.Assessing excoriation (skin-picking) disorder: Clinical recommendations and preliminary examination of a comprehensive interview.Int J Environ Res Public Health. 2022;19(11):6717. doi:10.3390/ijerph19116717National Institute of Mental Health.Obsessive-compulsive disorder.Lochner C, Roos A, Stein DJ.Excoriation (skin-picking) disorder: a systematic review of treatment options.Neuropsychiatr Dis Treat. 2017;13:1867-1872. doi:10.2147/NDT.S121138Odlaug BL, Grant JE.Pathologic skin picking.Am J Drug Alcohol Abuse.2010;36(5):296-303. doi:10.3109/00952991003747543Hayes 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):314-319. doi:10.1016/j.janxdis.2009.01.008Lang R, Didden R, Machalicek W, et al.Behavioral treatment of chronic skin-picking in individuals with developmental disabilities: A systematic review.Res Dev Disabil.2010;31(2):304-15. doi:10.1016/j.ridd.2009.10.017Odlaug BL, Hampshire A, Chamberlain SR, Grant JE.Abnormal brain activation in excoriation (skin-picking) disorder: evidence from an executive planning fMRI study.Br J Psychiatry. 2016;208(2):168–174. doi:10.1192/bjp.bp.114.155192Pile V, Lau JYF, Topor M, Hedderly T, Robinson S.Interoceptive accuracy in youth with tic disorders: Exploring links with premonitory urge, anxiety and quality of life.J Autism Dev Disord. 2018;48(10):3474-3482. doi:10.1007/s10803-018-3608-8Grant JE, Chamberlain SR.Trichotillomania and skin-picking disorder: An update.Focus (Am Psychiatr Publ). 2021;19(4):405-412. doi:10.1176/appi.focus.20210013Houghton DC, Alexander JR, Bauer CC, Woods DW.Abnormal perceptual sensitivity in body-focused repetitive behaviors.Compr Psychiatry. 2018;82:45-52. doi:10.1016/j.comppsych.2017.12.005

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

American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders.5th ed. American Psychiatric Association; 2013.

Snorrason I, Lee HJ.Assessing excoriation (skin-picking) disorder: Clinical recommendations and preliminary examination of a comprehensive interview.Int J Environ Res Public Health. 2022;19(11):6717. doi:10.3390/ijerph19116717

National Institute of Mental Health.Obsessive-compulsive disorder.

Lochner C, Roos A, Stein DJ.Excoriation (skin-picking) disorder: a systematic review of treatment options.Neuropsychiatr Dis Treat. 2017;13:1867-1872. doi:10.2147/NDT.S121138

Odlaug BL, Grant JE.Pathologic skin picking.Am J Drug Alcohol Abuse.2010;36(5):296-303. doi:10.3109/00952991003747543

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):314-319. doi:10.1016/j.janxdis.2009.01.008

Lang R, Didden R, Machalicek W, et al.Behavioral treatment of chronic skin-picking in individuals with developmental disabilities: A systematic review.Res Dev Disabil.2010;31(2):304-15. doi:10.1016/j.ridd.2009.10.017

Odlaug BL, Hampshire A, Chamberlain SR, Grant JE.Abnormal brain activation in excoriation (skin-picking) disorder: evidence from an executive planning fMRI study.Br J Psychiatry. 2016;208(2):168–174. doi:10.1192/bjp.bp.114.155192

Pile V, Lau JYF, Topor M, Hedderly T, Robinson S.Interoceptive accuracy in youth with tic disorders: Exploring links with premonitory urge, anxiety and quality of life.J Autism Dev Disord. 2018;48(10):3474-3482. doi:10.1007/s10803-018-3608-8

Grant JE, Chamberlain SR.Trichotillomania and skin-picking disorder: An update.Focus (Am Psychiatr Publ). 2021;19(4):405-412. doi:10.1176/appi.focus.20210013

Houghton DC, Alexander JR, Bauer CC, Woods DW.Abnormal perceptual sensitivity in body-focused repetitive behaviors.Compr Psychiatry. 2018;82:45-52. doi:10.1016/j.comppsych.2017.12.005

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