Excoriation Disorder

Treatment Methods for Skin Picking Disorder

There are several behaviors that may be signs of Skin Picking Disorder.

Skin Picking, Excoriation or Dermatillomania:

Is characterized by the repetitive picking of one’s own skin. People suffering with skin picking, scratch, rub, pick or dig into their skin in an attempt to correct or improve perceived imperfections often resulting in some form of damage to the skin.

Skin Picking Disorder: Diagnosis

Infrequent picking at one’s cuticles, scabs, calluses is not uncommon in human beings. Research, however, indicates that approximately 2-5% of the population pick their skin in such a fashion as to create noticeable damage and the picking causes significant distress that may interfere with daily functioning. Skin picking disorder tends to be chronic and can wax and wane over time. Roughly 3/4 of people effected are female. While skin picking generally starts in adolescents it can occur at any age.

A person may be diagnosed with skin picking disorder if:

  1. They pick their skin repeatedly and often.
  2. The frequent picking happens enough to cause damage to the skin.
  3. The person has tried to stop many times without long-term success.
  4. Picking causes the individual a lot of distress and can interfere with work, socializing, or other areas of life.
  5. The picking is not caused by another psychological problem or as a result of or the effect of substance use or a medical condition like scabies.
  6. The person is not suffering from another mental disorder, such as delusions, tactile hallucinations, or a psychotic disorder. For example, the individual does not repeatedly attempt to improve or perfect a perceived defect or flaw in their appearance. This may be a sign of Body Dysmorphic Disorder (BDD).

Areas Affected by Skin Picking

Picking can occur on any part of the body or on multiple places concurrently. It often occurs in areas with skin differences like pimples, scabs, cuticles, calluses, or previously picked areas. People usually use their fingers or fingernails to pick but they may also use tools like tweezers, pins, or other items. The individual can also compulsively rub, bite, squeeze, or lance their skin. The most commonly picked places include:

  • Face.
  • Back.
  • Neck.
  • Chest.
  • Scalp.
  • Ears.
  • Cuticles.
  • Arms.
  • Hands.
  • Legs.

Treatment Options

The truth is that we all pick our skin from time to time. Skin picking disorder is different, though. It is a problem primarily because of the preoccupation with picking. An individual can spend a significant amount of time picking, up to several hours each day. Furthermore, this behavior may be present for months or years.

It may also cause psychological distress and distress toward the person’s ability to manage their life effectively. As many as 1 in 20 people may suffer skin picking disorder and it appears to affect women more frequently, though it does affect men, too. The onset can occur in childhood or adulthood. However, we do not currently know what causes it. People who suffer from skin picking are often found to suffer from trichotillomania (hair-pulling), depression, and obsessive-compulsive disorder concurrently.

People suffering from skin picking disorder are commonly unaware of treatment options. Their problems continue for years and may cause emotional, physical, and social problems. The picking may fuel depression and can create mild to severe pain after an episode. When severe, it can lead to disfigurement, repeated infections, or, in the most extreme cases, require surgery.

There is evidence to support that Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) may help with skin picking disorder. Research also suggests that SSRIs (Selective Serotonin Reuptake Inhibitors) may also help.

Seek Help

If you or someone you know is suffering with skin picking problems near Philadelphia, Montgomery County or the Main Line, please contact me for an evaluation.

Several websites are available below for you to do more research if you like.