As a dermatologist with a keen interest in behavioral skin conditions, I often encounter patients who engage in the act of picking at their skin. This behavior is medically recognized as Excoriation Disorder, which is also referred to as skin picking disorder or dermatillomania. It's classified as a body-focused repetitive behavior (BFRB) and is included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) under the category of obsessive-compulsive and related disorders.

The disorder is characterized by the repetitive and compulsive picking at one's own skin, leading to noticeable skin lesions or injuries. Individuals with this condition often experience an urge to pick, followed by relief once the act is performed, which can then lead to a cycle of picking and healing that can be difficult to break.

### Prevalence and Demographics

While it is not as commonly discussed as other mental health disorders, excoriation disorder affects a significant number of people. Studies suggest that its prevalence ranges from 1.4% to 5.4% in the general population, with higher rates observed among those with other mental health conditions such as anxiety and depression.

### Causes

The exact cause of excoriation disorder is not fully understood, but it is believed to involve a combination of genetic, neurological, and environmental factors. Some researchers suggest that it may be linked to serotonin dysregulation in the brain, which is a neurotransmitter that affects mood and anxiety levels. Additionally, individuals with a family history of obsessive-compulsive disorder (OCD) or other BFRBs are at a higher risk of developing the disorder.

### Symptoms

The primary symptom of excoriation disorder is the compulsive picking of the skin, which can result in various physical manifestations such as:

- Open sores or ulcers
- Scarring from repeated picking
- Infections due to broken skin
- Irritation and inflammation

Beyond the physical symptoms, individuals with the disorder may also experience significant emotional distress, including feelings of guilt, shame, or anxiety related to their skin picking behavior.

### Treatment

Treatment for excoriation disorder typically involves a multidisciplinary approach that may include:


1. Psychotherapy: Cognitive-behavioral therapy (CBT) is often the first line of treatment. It helps individuals identify triggers for their picking behavior and develop healthier coping mechanisms.


2. Medication: Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed to help regulate serotonin levels in the brain, which can reduce the compulsion to pick.


3. Habit reversal training: This involves learning to recognize the urge to pick and then substituting that behavior with a less harmful habit.


4. Support groups: Sharing experiences with others who have the same condition can provide emotional support and practical advice.


5. Self-care: Good skin care practices, stress management, and maintaining a healthy lifestyle can also play a role in managing the disorder.

### Conclusion

Excoriation disorder is a serious and complex condition that requires understanding, empathy, and appropriate treatment. It's important for individuals who engage in skin picking to seek professional help to manage their symptoms and improve their quality of life.

read more >>

Excoriation Disorder, also known as skin picking disorder or dermatillomania, is characterized by the repetitive picking of one's own skin.read more >>