10 Minutes

Edited & clinically reviewed by THE BALANCE Team
Fact checked

Picking your skin on a regular basis can be an indication of stress-related problems. It’s a benign habit for the great majority of people. However, the behavior can sometimes spiral out of control, resulting in bleeding, scars, or other damage to the skin. It’s called dermatillomania or excoriation disorder when it reaches that point.

This practice usually begins with the goal of fixing a skin issue, such as a pimple, a lump, an irregular cuticle, or something that “just doesn’t feel right.” When picking results in bleeding and scabs, the scabs might become targets for more picking. This process has the potential to become a recurrent cycle.

Dermatillomania is a type of BFRB (body-focused repetitive behavior). Cheek biting, trichotillomania (hair-pulling), and nail-biting are examples of BFRBs. Remember that each of these actions is widespread; they are only disorders if they cause the person significant distress. If, for instance, cheek biting causes recurrent bleeding or hair plucking causes obvious bald patches, the behavior is causing serious problems.

The specific etiology of skin picking disorder has yet to be discovered. However, it is possible that it develops in conjunction with other medical or mental health disorders like attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), or autism. Skin picking is thought to affect 1.4 percent of the population in the US or about 5 million people in the US alone. Adolescence or early adulthood are the most usual times for the problem to appear; childhood occurrences are less common.

When picking skin is more serious, the repeated damage to the skin results in “excoriated acne,” or skin abnormalities. These anomalies are frequently the object of more skin plucking, establishing a difficult-to-break cycle. Skin damage or bleeding can sometimes become severe, resulting in a so-called “excoriation wound.” Excoriated skin might take a long time to heal. The scars that are left behind might sometimes be lifelong. Skin that has been excoriated is skin that has been injured by dermatillomania.

The precise cause of skin picking condition is unknown, but a variety of factors, including genetic, environmental, and biological effects, are likely to have a role.

Abnormal skin picking affects approximately 2 percent to 4 percent of the population.

Skin picking can begin at any age, but it is most common during adolescence when skin disorders like eczema, acne, or psoriasis appear. According to one study, developmental difficulties, emotional control issues, and early trauma and abuse may all play a role in the development of skin picking disorder.

The following are some issues that could be misinterpreted for skin picking disorder:

  • Scabies is a type of skin illness. Scabies is highly itchy, but it is frequently overlooked when it affects well-dressed middle-class people. The scratching that nearly always comes with an itch might make it difficult to diagnose.
  • Eczema is an example of an itchy skin disorder.
  • Disorders that affect the entire body are known as systemic diseases. Itching can be exacerbated by elevated bilirubin levels caused by liver illness. Itching can also be a symptom of a variety of different medical disorders.
  • Drug usage or withdrawal can lead to chemical dependency.
  • Skin plucking can sometimes be a sign of a more serious ailment. Furthermore, skin picking could be an indication of body dysmorphic disorder, which is characterized by an obsession with imagined bodily flaws.

You must have symptoms that revolve around recurrent skin picking to be labeled with excoriation disorder. Apart from symptoms, specific dermatillomania tests are done by qualified medical and mental health professionals to label someone with dermatillomania. The manifestations must also cause significant suffering or impairment and be induced by something other than a substance, a medical ailment, or a psychiatric issue.

  • Picking at the skin on a regular basis, resulting in skin lesions
  • Efforts to stop the habit have been made several times.
  • Attempts to reduce or halt skin picking on a regular basis

Skin picking can also be caused by the use of certain drugs, like methamphetamine or cocaine. Skin picking can be caused by medical illnesses like scabies and mental health disorders such as body dysmorphic disorder or psychotic disorder. Because these disorders are unrelated to skin picking disorder, a doctor will rule them out as possible reasons before diagnosing a patient.

Skin picking is diagnosed when a person has tried unsuccessfully to reduce or even eliminate picking, which causes extreme anguish and anxiety and interferes with everyday functioning.

A person must display skin picking that results in lesions in order to be diagnosed with skin picking disorder. Other psychological or physiological conditions cannot be the source of such symptoms.

Link to OCD

OCD and skin picking appear to have a strong association, which is unsurprising. Skin plucking is far more common in those with OCD than in the general population, according to a study. Despite the fact that both illnesses can co-occur, they are very distinct. Skin picking symptoms can be analogous to those of OCD.

Many people express a compulsion-like tendency to pick at skin flaws prior to picking, as well as a relief from anxiety once the imperfection is eradicated. Nevertheless, later on, the individual may feel guilt or embarrassment over his choices, which can result in depression.

Skin picking compulsions are common among OCD sufferers, and these thoughts are often invasive and distressing. Skin picking disorder patients, on the other hand, like the practice of picking their skin. While kids may enjoy the act, they are nevertheless at risk of developing skin infections, scars, social isolation, and anxiety as a result of it.

You are not the only one you have this condition, but if you have a skin picking disorder, you will probably spend more time alone. If you are like many others who suffer from skin picking, you may have noticeable sores and even scarring as a result of your habit.

The majority of people with this disorder don’t talk about it, and they seldom seek medical assistance because healthcare experts and loved ones typically encourage them to just stop. Due to embarrassment and shame, they are quite proficient at concealing their problem. What matters most is that you recognize that you can change your habit with time and effort.

Recognize your personal triggers

Picking can be triggered by a multitude of factors, including itch, boredom, or negative emotions, as well as defects or merely looking at or touching your skin. It’s possible that you’ll enjoy the process of picking. Understanding your triggers might help you decide which therapy to try first. If you’re selecting because of a skin condition like acne or itch, for instance, you might want to contact a dermatologist first. If your picking is caused by anxiety, depression, or a strong desire, you should seek help from a mental health practitioner who specializes in skin picking.

Make it more difficult to pick at your skin

Modifying your environment to make it very difficult to pick is one basic method for reducing picking, known as stimuli control. Keeping your fingernails short, wearing rubber gloves when you’re most prone to pick, and keeping the skin harder to reach by wearing tight-fitting garments or long-sleeve shirts are all various elements of this strategy. You can also use a variety of objects to divert your hands, such as stress balls, silly putty, tangle toys, and fidgets. Once you’ve discovered something that works for you, make sure you have one with you at all times, including at work, at home, and in your purse.

Forget about your guilt

The first step is to admit that there is a problem with skin picking and to quit hiding it. You must let go of the shame connected with chronic picking in order to heal. This is only possible once the behavior has been exposed.

It’s possible that your conduct began innocently enough – perhaps you had a skin irritation or a sore that you picked at without thinking. Perhaps you were concerned about loose skin surrounding your nails or a hangnail because you were agitated. The picking, on the other hand, made things worse, and the cycle began.

Think about going to therapy

The majority of people will not benefit from antidepressants or drugs for obsessive-compulsive disorder. Instead, seeing a therapist is suggested and the need of finding the perfect match for both the patient and the therapist is emphasized.

The therapist should preferably be familiar with body-focused repetitive behaviors, such as skin picking. A hypnotherapist can be beneficial since this approach is a powerful tool to transform ingrained habits and behaviors and thought patterns.

Skin-picking support groups and therapists among the many local and online options are accessible.

Maintain a stress-free environment by practicing mindfulness

Stress reduction is an important part of the healing process. It is recommended that you practice stress management practices on a daily basis, such as:

  • Meditation.
  • Visualization
  • Guided imagery
  • Deep breathing
  • Yoga

These relaxing techniques, in combination with a good diet, exercising regularly and having enough sleep, form an integrated approach to treating skin-picking conditions.

When people with skin picking conditions start picking, they usually slip into a trance or ‘zone out.’ It’s critical to understand how to stay grounded in the current moment in order to stop the behavior.

Skin-picking desires can be recognized when you gain awareness through a consistent mindfulness-based meditation practice. Rather, you can choose something different, like go out for a stroll, in those moments.

Talk therapy is currently regarded to be a good way to help people stop picking at their skin. If you are given this option, it will almost always be through community-based mental health services.

Cognitive-behavioral therapy is the most popular type of talking therapy for skin picking disorder, and it may incorporate a method called habit reversal training.

CBT for Skin Picking

Luckily, BFRBs like dermatillomania is thought to be fairly curable. Behavior therapy is the most common treatment for dermatillomania. Even though some types of CBT include efforts to influence your thinking, dermatillomania behavior therapy usually does not. Knowing about the condition and how to handle it is the first stage in OCD skin-picking treatment with cognitive-behavioral therapy. 

The next step is sometimes referred to as “behavioral monitoring.” You may be requested to keep note of your skin-picking activity throughout this stage. The next phase will be for you to make visible bodily changes that will lead to less skin plucking.

CBT for dermatillomania typically involves weekly meetings with your therapist. Much of the time is spent evaluating what succeeded and what didn’t in the previous session. New approaches are also discussed, which are likely to reduce your skin picking even more.

Habit reversal training is a technique for changing one’s habits. The therapist will assist you in identifying the conditions, pressures, and other causes that cause you to pick at your skin. Your therapist will then assist you in finding alternative activities to skin plucking, like squeezing a rubber ball. This will help you relax and keep your hands occupied.

Controlling the stimuli is another form of therapy. This involves making modifications to your environment to assist you to stop picking at your skin. Wearing gloves or Band-Aids, for instance, can assist you to avoid touching the skin and avoiding the need to pick. If seeing face imperfections or pimples causes you to pick, you could conceal mirrors.

A high-end luxury inpatient treatment facility is more than a peaceful retreat; it is a healing atmosphere in which you can work to conquer your skin-picking disorder or dermatillomania.

Managing your dermatillomania in an upscale dermatillomania treatment program involves more than just medical care. When the environment is pleasing to the eye, rehabilitation may be a more enjoyable experience. Unwanted irritants or diversions can be prevented in a superior rehab center’s peaceful environment. You are more likely to relax and devote yourself to the rehabilitation process if you feel at peace. Because you are accustomed to a better quality of life, a luxury treatment center provides the proper tranquil setting for your recuperation.

A luxury residential treatment center is more than just a beautiful building. It has a positive reputation due to its effectiveness. Only highly qualified dermatillomania therapy experts will be on duty. There will be a large number of professionals on hand to ensure that you get the finest care possible.

While luxury residential therapy offers a wide range of specialized services, it also has more tangible and evident benefits. 5-star resort-style hotels are typically found in scenic or peaceful settings. There are deluxe mattresses, more personal space, and gourmet meals on the menu. On-site workers will be available 24 hours a day, seven days a week. Treatment can resemble a vacation or a visit to a posh spa. This isn’t to argue that the rehabilitation procedure isn’t difficult and lengthy. It does, however, indicate that you will be able to do so in comfort.

FAQs