Excoriation Disorder


Everyone picks their skin from time to time. Whether it is a blemish, a hangnail, a scab, or a patch of dry skin, we all pick at ourselves either absentmindedly or intentionally. You may be doing it right now as you read these words.

However, for some people, the urge to pick is overwhelming and destructive. They pick until they cause open sores and scars, and in extreme cases may require surgery to treat their injuries. Even though they are embarrassed or ashamed by their appearance and behavior, they can not stop.

They suffer from Excoriation Disorder — also known as dermatillomania or skin-picking disorder.

Excoriation disorder is a mental illness related to obsessive compulsive disorder (OCD). An individual may be diagnosed with the disorder if all the following are present:

  • they pick their skin obsessively - sometimes for hours - and are unable to stop
  • they pick themselves so much they cause tissue damage
  • the picking causes distress, and affects everyday life including work, school, daily activities, and forming relationships

The picking must not be caused by other issues such as skin conditions, drug withdrawal, or developmental disorders.

People with Excoriation Disorder may pick at different parts of their bodies, in different ways. They may pick at their lips, faces, heads, cuticles, back, arms or legs. They may pick and pull with their fingers and fingernails, or use their teeth, tweezers, scissors, clippers or needles to remove skin.

Picking may be brought on by mounting feelings of tension or stress, accompanied by feelings of relief when picking, followed by shame or guilt afterwards. It can cause a vicious cycle of self-harm, whereby feelings of shame from picking are alleviated by more picking. Many people who have the disorder also suffer with depression and anxiety.

Fortunately, Excoriation Disorder responds to therapy. Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) have both been found helpful in treating the disorder. If you pick yourself compulsively, contact the BFDC. We can help.