Treatment for Skin Picking Disorder (Excoriation Disorder / Dermatillomania)
Skin Picking Disorder (aka Excoriation Disorder or Dermatillomania) is characterized by the repetitive picking of one’s own skin. People suffering from skin picking may 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.
Diagnosis of Skin Picking Disorder
While we all may pick our skin from time to time, excoriation disorder is different. With dermatillomania, an individual can spend several hours a day picking. The picking may cause psychological distress, and affect a sufferer’s ability to manage their life effectively. Below are several behaviors that may be signs of excoriation disorder:
- The person picks their skin repeatedly and often.
- The picking occurs frequently enough to cause damage to the skin.
- The person has tried to stop picking, but with limited long-term success.
- Picking causes the individual significant distress and may interfere with work, socializing, or other aspects of daily life.
- The picking is not caused by another psychological problem, nor as an effect of substance use or a medical condition like scabies.
- The person is not suffering from another mental or psychotic disorder. For example, the individual does not repeatedly attempt to improve or perfect a perceived defect or flaw in their appearance, which may instead be a sign of Body Dysmorphic Disorder (BDD).
Skin picking can occur on any part of the body or on multiple places concurrently. The picking is often focused on areas with different appearances, such as pimples, scabs, cuticles, calluses, or previously picked areas. People may use their fingers or fingernails to pick, or use tools like tweezers or pins. The individual may also compulsively rub, bite, squeeze, or lance their skin. The most commonly picked places include: face, back, neck, chest, scalp, ears, cuticles, arms, hands, and legs.
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 begins around adolescence, it can occur at any age. People who suffer from skin picking are often found to suffer from trichotillomania (hair-pulling), depression, and obsessive-compulsive disorder concurrently.
If left untreated, skin picking disorder can continue for years and cause compounding emotional, physical, and social problems. The picking may fuel depression in addition to physical pain following an episode of picking. Severe excoriation can lead to disfigurement, repeated infections, or—in the most extreme cases—require surgery.
There is empirical evidence supporting Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) as effective treatments for skin picking disorder. Research also suggests that SSRIs (Selective Serotonin Reuptake Inhibitors) may help.
Consult an expert
Contact Harold Kirby at 610-517-3127 to schedule a consultation or appointment to discuss treatment for skin picking. Harold provides telehealth treatment for clients in Philadelphia and the surrounding areas of Pennsylvania and New Jersey (Main Line, Montgomery County, Camden, Cherry Hill), as well as in the South Carolina Lowcountry (Hilton Head, Bluffton, Beaufort, Colleston County, Dorchester County, Berkeley County, Charleston).
Additional, there are a variety of online resource for those suffering from excoriation disorder: