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Skin Picking or Excoriation Disorder

A person may have 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, social or other important activities of living.
  5. The picking is not caused by another psychological problem or as a result of the effect of substance, or a medical condition like scabies.
  6. The person will not be suffering from another mental disorder including delusions, tactile hallucinations or a psychotic disorder. The individual repeatedly attempts to improve or perfect a perceived defect or flaw in their appearance like in body dysmorphic disorder.

The most commonly picked places include: Face, back, neck, chest, scalp, ears, cuticles, arms, hands and legs. It can, however, be done on any part of the body or multiple places concurrently. It often occurs in areas with skin differences like pimples, scabs, cuticles, calluses or previously picked areas.

People most often use their fingers or fingernails to pick but also use tools like tweezers, pins or other items. The individual can also compulsively rub, bite, squeeze or lance their skin.

An individual can spend a good deal of time picking up to several hours daily, in fact. The problem may have been present for months or years.


The truth is that we all pick our skin from time to time. Skin picking disorder is different and a problem primarily because of the significant preoccupation with picking and the distress both psychologically and to the person’s ability to manage their life effectively.

People who suffer with skin picking are often found to suffer with trichotillomania, (hair pulling) depression and obsessive compulsive disorder concurrently.

As many as 1 in 20 people may suffer skin picking disorder and it appears to effect women more frequently but effects men as well. The onset can occur in childhood and adulthood. We do not actually know what causes it at present.


There is evidence to support CBT cognitive behavioral therapy and ACT acceptance and commitment therapy may help with skin picking disorder. Research report that SSRI’s ( selective serotonin reuptake inhibitors) may also help.

People suffering skin picking disorder often do not know that treatment is available. Their problems continue for years causing emotional, physical and social problems. The picking may fuel depression, and 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.

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. Best to you. May you be well. Below are two websites for you to do more research if you like:




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You’re encouraged to get in touch directly with us to get yourself on the road to managing your issues.

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