Materiały źródłowe

• #1 Dermatillomania (Skin Picking): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/22706-dermatillomania-skin-picking

  Dermatillomania is a mental health condition where a person compulsively picks or scratches their skin, causing injuries or scarring. […] There aren’t any confirmed causes of dermatillomania, but experts suspect a few different factors might play a role, including genetics, changes in brain structure, and stress, anxiety or other conditions. […] People with dermatillomania are much more likely to have at least one first-degree family member who also has this condition. […] People with dermatillomania are more likely to have some key differences in the structure of brain areas that control how they learn and form habits. […] Dermatillomania might be a coping mechanism for other issues or mental health conditions.

• #2 Prevalence of and Risk Factors for Skin Picking Disorder Symptoms Among Adults in an Arab Middle Eastern Population: A Cross-Sectional Study

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9725924/

  Skin Picking Disorder (SPD) is a skin-related disease, also recognized as psychogenic excoriation, dermatillomania, or excoriation disorder. SPD is defined as a habitual picking of skin, which in turn harms skin tissue. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has formally classified SPD as a category of obsessive-compulsive (OCD) related disorder. SPD has been of particular interest to researchers because of the recent attention this disorder has received as well as its relatively high prevalence, morbidity, and comorbidity. Studies in community samples indicate that skin picking is common and often occurs in conjunction with other psychiatric disorders. Initially, its occurrence is focused and conscious, which after a certain time, becomes automatic and unconscious. This progression is similar to the features of grooming disorder and trichotillomania. In addition, SPD should be approached as a heterogenous spectrum in terms of presentation. Skin picking is usually triggered by stress, boredom, anxiety, or physical sensations (unevenness of the skin). Difficulties with emotional regulation and reactivity have also been shown to escalate picking behavior to control anxiety, depression, and other disturbing emotions.

• #3 Dermatillomania: A Case Report and Literature Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7910222/

  Skin picking disorder, also termed dermatillomania is a condition that leads to repetitive picking of their skin ending up in skin and soft tissue damage. […] It is classified in Diagnostic and Statistical Manual of Mental Disorder Fifth edition under the „obsessive compulsive and related disorders” section. […] Often associated with other psychiatric conditions like autism, alcohol abuse, obsessive compulsive, body dysmorphic, mood, anxiety and borderline personality disorders, it is a disorder that is quite often underreported. […] Several psychiatric co-morbidities have been found to be associated with skin picking leading to self-injury such as obsessive compulsive disorder (OCD), alcohol abuse or dependence, body dysmorphic disorder, mood disorder, anxiety disorder, borderline personality disorder and obsessive compulsive personality disorder.

• #4 Skin Picking | Excoriation | BFRB

  https://www.bfrb.org/skin-picking

  Occasional picking at cuticles, acne, scabs, calluses, or other skin irregularities is a very common human behavior; however, research indicates that approximately 2%-5% of the population picks their skin to the extent that it causes noticeable tissue damage and marked distress or impairment in daily functioning. […] The DSM-5 diagnostic criteria include: Recurrent skin picking that results in skin lesions, repeated attempts to stop the behavior, the symptoms cause clinically significant distress or impairment, the symptoms are not caused by a substance or medical, or dermatological condition, the symptoms are not better explained by another psychiatric disorder. […] Skin picking disorder is currently classified as Obsessive-Compulsive and Related Disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

• #5 Excoriation Disorder (skin picking disorder) | OCD-UK

  https://www.ocduk.org/related-disorders/skin-picking/

  Skin Picking Disorder is frequently linked to Obsessive-Compulsive Disorder, partly because of the compulsive similarities between the two which may be why Excoriation Disorder, to give it is formal name, is actually listed as a sub-category in both the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM) clinical classification manuals under the main heading of Obsessive Compulsive and Related Disorders. […] It is thought that those with excoriation disorder and skin picking problems often also have OCD, and for some this may be the case. […] Whereas OCD is considered an anxiety disorder, arguably skin picking is more of an impulse control disorder. So whilst there are some compulsive and ritualistic similarities between the two there are also important differences. Primarily, OCD is driven by unwanted intrusive thoughts (the obsessions), for example fears of bad things happening where the compulsions are carried out in an attempt to prevent bad things happening. Whereas skin picking is characterised primarily by body-focused repetitive behaviour (skin picking) to reduce tension/stress, rather than being initiated by an unwanted intrusive thought.

• #6 Prevalence of and Risk Factors for Skin Picking Disorder Symptoms Among Adults in an Arab Middle Eastern Population: A Cross-Sectional Study

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9725924/

  Skin Picking Disorder (SPD) is a skin-related disease, also recognized as psychogenic excoriation, dermatillomania, or excoriation disorder. SPD is defined as a habitual picking of skin, which in turn harms skin tissue. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has formally classified SPD as a category of obsessive-compulsive (OCD) related disorder. SPD has been of particular interest to researchers because of the recent attention this disorder has received as well as its relatively high prevalence, morbidity, and comorbidity. Studies in community samples indicate that skin picking is common and often occurs in conjunction with other psychiatric disorders. Initially, its occurrence is focused and conscious, which after a certain time, becomes automatic and unconscious. This progression is similar to the features of grooming disorder and trichotillomania. In addition, SPD should be approached as a heterogenous spectrum in terms of presentation. Skin picking is usually triggered by stress, boredom, anxiety, or physical sensations (unevenness of the skin). Difficulties with emotional regulation and reactivity have also been shown to escalate picking behavior to control anxiety, depression, and other disturbing emotions.

• #7 Compulsive skin picking causes and how to stop

  https://www.treatmyocd.com/blog/compulsive-skin-picking

  Compulsive skin picking isn’t just a bad habit; it can be part of a cycle that temporarily eases distress but ultimately leads to more frustration and skin damage. […] Skin picking disorder, also known as excoriation disorder or dermatillomania, is a mental health condition characterized by compulsive picking, squeezing, or scratching areas of your skin, such as scabs or pimples. […] Skin picking disorder is a body-focused repetitive behavior (BFRB), which are a group of disorders that involve self-grooming to the point of causing significant damage. […] You might engage in BFRBs like compulsive skin picking for various reasons. Some people might pick their skin in response to anxiety or stress, while others may pick to fill a void. […] Compulsive skin picking can be an effect of an obsession with your appearance, as you might pick at perceived flaws in your skin.

• #8 Skin Picking | Excoriation | BFRB

  https://www.bfrb.org/skin-picking

  Occasional picking at cuticles, acne, scabs, calluses, or other skin irregularities is a very common human behavior; however, research indicates that approximately 2%-5% of the population picks their skin to the extent that it causes noticeable tissue damage and marked distress or impairment in daily functioning. […] The DSM-5 diagnostic criteria include: Recurrent skin picking that results in skin lesions, repeated attempts to stop the behavior, the symptoms cause clinically significant distress or impairment, the symptoms are not caused by a substance or medical, or dermatological condition, the symptoms are not better explained by another psychiatric disorder. […] Skin picking disorder is currently classified as Obsessive-Compulsive and Related Disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

• #9 Excoriation (skin-picking) disorder: a systematic review of treatment | NDT

  https://www.dovepress.com/excoriation-skin-picking-disorder-a-systematic-review-of-treatment-opt-peer-reviewed-fulltext-article-NDT

  Excoriation (skin-picking) disorder (ED), also known as dermatillomania, psychogenic excoriation, or neurotic excoriation, is characterized by recurrent picking of skin, leading to skin lesions and significant distress or functional impairment. […] Dermatological conditions such as acne or eczema often trigger the onset of ED. Skin-picking triggers can be multiple, and may vary across individuals, but include emotions such as stress, anger, and anxiety, sedentary activities such as watching television and reading, and boredom and feeling tired. […] The severity of skin-picking ranges from mild to severe; in subclinical cases, intervention may not be needed, whereas when diagnostic criteria for ED are met, treatment is indicated. […] It has been suggested that less than a fifth of patients seek treatment for their skin-picking.

• #10 Dermatillomania | Types, symptoms, diagnosis, treatment & effects

  https://cpdonline.co.uk/knowledge-base/mental-health/dermatillomania/

  According to Psychology Today, around 1.4% of the population are affected by dermatillomania. Of these, 75% are female. This chronic condition is also known as skin picking disorder or excoriation disorder. It falls under the BFRB (body-focused repetitive behaviours) category of disorders, which is also classified under Obsessive-Compulsive and Related Disorders in the DSM-5. […] The exact causes of dermatillomania are not understood but it is believed that a complex interplay of biological, psychological and environmental factors is at play. […] There is some research that suggests a potential genetic component to dermatillomania as it does tend to run in families. Additionally, abnormalities in the brains reward system and neurotransmitter imbalances, especially those involving serotonin, may also play a role in the development of the disorder.

• #11 Dermatillomania | Types, symptoms, diagnosis, treatment & effects

  https://cpdonline.co.uk/knowledge-base/mental-health/dermatillomania/

  According to Psychology Today, around 1.4% of the population are affected by dermatillomania. Of these, 75% are female. This chronic condition is also known as skin picking disorder or excoriation disorder. It falls under the BFRB (body-focused repetitive behaviours) category of disorders, which is also classified under Obsessive-Compulsive and Related Disorders in the DSM-5. […] The exact causes of dermatillomania are not understood but it is believed that a complex interplay of biological, psychological and environmental factors is at play. […] There is some research that suggests a potential genetic component to dermatillomania as it does tend to run in families. Additionally, abnormalities in the brains reward system and neurotransmitter imbalances, especially those involving serotonin, may also play a role in the development of the disorder.

• #12 Skin-Picking Disorder (Excoriation): Symptoms, Causes, and Treatment

  https://www.therecoveryvillage.com/mental-health/excoriation/

  Currently, the exact causes of skin picking disorder are unknown. Like most mental health conditions, this disorder likely develops due to a combination of environmental and biological factors. […] Without clear causes of excoriation, people look to study factors that can increase an individuals risk of having excoriation. Some of the most common risk factors associated with excoriation include: […] Research suggests that this condition occurs more often in women than in men. […] For some, skin picking becomes a way to relieve stress and tension from outside influences. In these cases, picking tends to increase when a person is stressed. […] Another risk factor for excoriation is an intense focus on the part of the body. The person may begin picking to modify to distract from their physical form.

• #13 Dermatillomania (Skin Picking) | Psychology Today

  https://www.psychologytoday.com/us/conditions/dermatillomania-skin-picking

  Dermatillomania, also known as excoriation disorder (per the DSM-5) or skin-picking disorder, is a psychological condition that manifests as repetitive, compulsive skin picking. […] There may be a genetic component to excoriation disorder, since some people appear to have an inherited tendency to BFRBs such as skin picking and hair pulling, as well as higher-than-average rates of mood and anxiety disorders in first-degree relatives. Other factors that may play a role in the development of this condition include individual temperament, stress, and age. […] Chronic skin picking behavior often coincides with the onset of puberty, as well as a dermatological problem, such as acne. Dermatillomania can be associated with perfectionism, which leads to over-grooming; it can also be used as a means of avoiding stressful events or releasing tension that builds up as a result of negative emotions such as impatience, frustration, dissatisfaction, and even boredom.

• #14 Dermatillomania: Symptoms, Causes, and Treatment | Psych Central

  https://psychcentral.com/ocd/dermatillomania

  Triggers vary among individuals, but may include: stress, anxiety, anger, boredom, tiredness, engaging in sedentary activities like TV watching or reading, skin conditions, such as acne or eczema. […] Research from 2021 suggests that the age of onset may be during childhood, adolescence, or adulthood. However, skin picking tends to begin between 13 and 15 years old. There’s also a higher prevalence of dermatillomania among college students (3.8%).

• #15 Skin Picking Disorder (Excoriation): Causes, Symptoms, Treatment & Prevention Tips

  https://www.olivaclinic.com/blog/stop-excoriated-skin-picking-dermatillomania/

  Skin picking disorder is a psychological condition that prompts a repetitive urge to pick, scratch, dig or touch ones own skin. Individuals may pick or scratch healthy skin, lesions, scabs or minor skin irregularities (pimples, calluses, dry skin etc.), often to an extent where severe damage and bleeding is caused. This obsessive compulsive disorder is often chronic that can last for weeks, months and years if left untreated. Some periods of this disease can intensify and reduce depending on the mental condition of the individual. […] Compulsive skin picking or excoriation is a body focused repetitive behavior (BFRB) that usually starts during adolescence either during or after the onset of puberty. But it can also occur amongst younger children (under 10 years of age) or adults (between 35 and 45). More women are found to be affected by this disorder.

• #16

  https://link.springer.com/article/10.1007/s12144-023-05377-4

  The prevalence of the disorder ranges from 1.5 to 5.4%, but several authors argue that it is underestimated because some patients do not recognize the pathological nature of their picking behavior. […] Comorbidities with SPD include obsessive-compulsive disorder, alcohol abuse/dependence, body dysmorphic disorder, mood disorder, anxiety disorder, borderline personality disorder, and obsessive-compulsive personality disorder. […] Studies show a significant impact of the disorder at an individual and interpersonal level. SPD has a negative influence on quality of life and is associated with psychological distress, particularly anxiety, stress, tension, depression, and problematic management of emotions, which can be elicited or diminished by picking behavior, thus acting as positive/negative reinforcement.

• #17 Excoriation (skin-picking) disorder: a systematic review of treatment | NDT

  https://www.dovepress.com/excoriation-skin-picking-disorder-a-systematic-review-of-treatment-opt-peer-reviewed-fulltext-article-NDT

  Excoriation (skin-picking) disorder (ED), also known as dermatillomania, psychogenic excoriation, or neurotic excoriation, is characterized by recurrent picking of skin, leading to skin lesions and significant distress or functional impairment. […] Dermatological conditions such as acne or eczema often trigger the onset of ED. Skin-picking triggers can be multiple, and may vary across individuals, but include emotions such as stress, anger, and anxiety, sedentary activities such as watching television and reading, and boredom and feeling tired. […] The severity of skin-picking ranges from mild to severe; in subclinical cases, intervention may not be needed, whereas when diagnostic criteria for ED are met, treatment is indicated. […] It has been suggested that less than a fifth of patients seek treatment for their skin-picking.

• #18 Dermatillomania (Skin Picking): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/22706-dermatillomania-skin-picking

  Dermatillomania is a mental health condition where a person compulsively picks or scratches their skin, causing injuries or scarring. […] There aren’t any confirmed causes of dermatillomania, but experts suspect a few different factors might play a role, including genetics, changes in brain structure, and stress, anxiety or other conditions. […] People with dermatillomania are much more likely to have at least one first-degree family member who also has this condition. […] People with dermatillomania are more likely to have some key differences in the structure of brain areas that control how they learn and form habits. […] Dermatillomania might be a coping mechanism for other issues or mental health conditions.

• #19 Excoriation Disorder (Skin Picking or Dermatillomania) | Mental Health America

  https://mhanational.org/conditions/excoriation-disorder-skin-picking-or-dermatillomania/

  Excoriation disorder (also referred to as chronic skin-picking or dermatillomania) is a mental illness related to obsessive-compulsive disorder. […] Currently, no specific cause has been identified for excoriation disorder. However, evidence suggests that there may be factors that influence development of this condition, including: Genetics: Individuals who experience dermatillomania are more likely to have at least one first-degree relative (parent or sibling) who also has this condition. […] Changes in brain structure: Individuals with excoriation disorder are more likely to have some key differences in the structure of brain areas that control how they learn and form habits. […] Stress, anxiety, or other conditions. Skin picking may be a way of coping with other mental health challenges. It may also be related to boredom or other factors.

• #20 Excoriation Disorder: Assessment, Diagnosis and Treatment – The Professional Counselor

  https://tpcjournal.nbcc.org/excoriation-disorder-assessment-diagnosis-and-treatment/

  Little is known about the etiology of excoriation disorder. Much of the current excoriation disorder research has been based on previous research conducted on trichotillomania. Excoriation disorder and trichotillomania are body-focused repetitive behaviors (BFRB) under the same DSM-5 classification, and the etiologies behind both disorders might be similar. Most theorists suggest that excoriation disorder is rooted in both biological and psychological factors. […] Biological factors related to excoriation disorder include genetic predispositions and neurological sensitivity to emotional stimuli, which result in emotional impulsivity and a need to self-soothe. In one study of 40 individuals who had excoriation disorder, 43% had a first-degree relative with the disorder. Specific genes (e.g., Hoxb8 and SAPAP3) have been identified as potential predictors of this disorder. In animal studies, mice with these genes engaged in excessive grooming to the point of skin lesions, behaviors similar to those of people who have excoriation disorder. Conversely, in another study, humans with the SAPAP3 gene only met criteria for excoriation disorder 20% of the time. It is important to note that genetics appear to play a role in the development of excoriation disorder, but other factors contribute to the disorder’s etiology and maintenance as well.

• #21 Dermatillomania: Symptoms, Causes, and Treatment | Psych Central

  https://psychcentral.com/ocd/dermatillomania

  Dermatillomania is characterized by repetitive skin picking that results in soft tissue damage. […] The exact cause of dermatillomania is unknown. […] The disorder may be linked to genetics, since it tends to run in families. A 2012 study found that of 60 people with skin picking disorder, 28.3% of their close family members also had the disorder. […] Research from 2017 suggests that dermatillomania has significant comorbidity with other BFRB disorders. The most common of these is trichotillomania (hair pulling disorder). […] Obsessive-compulsive disorder (OCD) and body dysmorphic disorder (BDD) are also more common in people with dermatillomania than in the general population. In fact, research suggests that 28% of those with BDD have dermatillomania. […] Overall, several mental health disorders and syndromes have been linked to skin picking: trichotillomania, OCD, obsessive-compulsive personality disorder, Tourette syndrome, BDD, anxiety disorder, alcohol dependence, mood disorder, borderline personality disorder, autism spectrum disorder, Prader-Willi syndrome, Lesch-Nyhan syndrome, Smith-Magenis syndrome.

• #22 Excoriation Disorder: Assessment, Diagnosis and Treatment – The Professional Counselor

  https://tpcjournal.nbcc.org/excoriation-disorder-assessment-diagnosis-and-treatment/

  Little is known about the etiology of excoriation disorder. Much of the current excoriation disorder research has been based on previous research conducted on trichotillomania. Excoriation disorder and trichotillomania are body-focused repetitive behaviors (BFRB) under the same DSM-5 classification, and the etiologies behind both disorders might be similar. Most theorists suggest that excoriation disorder is rooted in both biological and psychological factors. […] Biological factors related to excoriation disorder include genetic predispositions and neurological sensitivity to emotional stimuli, which result in emotional impulsivity and a need to self-soothe. In one study of 40 individuals who had excoriation disorder, 43% had a first-degree relative with the disorder. Specific genes (e.g., Hoxb8 and SAPAP3) have been identified as potential predictors of this disorder. In animal studies, mice with these genes engaged in excessive grooming to the point of skin lesions, behaviors similar to those of people who have excoriation disorder. Conversely, in another study, humans with the SAPAP3 gene only met criteria for excoriation disorder 20% of the time. It is important to note that genetics appear to play a role in the development of excoriation disorder, but other factors contribute to the disorder’s etiology and maintenance as well.

• #23 Dermatillomania (Skin Picking) | Psychology Today

  https://www.psychologytoday.com/us/conditions/dermatillomania-skin-picking

  Most experts believe that BFRBs are to some extent genetic; the disorders tend to run in families, and twin studies have suggested an inherited component. However, genes are likely only one potential cause of BFRBs, including excoriation disorder/dermatillomania. Other factors such as stress levels, family environment, and temperament are thought to play a role as well. […] Anxiety disorders often co-occur with dermatillomania, and episodes of anxiety whether they constitute a diagnosable disorder or not are a common trigger of skin-picking episodes.

• #24 Excoriation disorder – Wikipedia

  https://en.wikipedia.org/wiki/Excoriation_disorder

  Excoriation disorder, more commonly known as dermatillomania, is a mental disorder on the obsessive-compulsive spectrum that is characterized by the repeated urge or impulse to pick at one’s own skin, to the extent that either psychological or physical damage is caused. The exact causes of this disorder are unclear but are believed to involve a combination of genetic, psychological, and environmental factors, including stress and underlying mental health conditions such as anxiety or obsessive-compulsive disorder (OCD). […] A common hypothesis is that excoriation disorder is often a coping mechanism to deal with elevated levels of turmoil, boredom, anxiety, or stress within the individual, and that the individual has an impaired stress response. […] There is limited knowledge regarding the neurobiology that drives excoriation disorder, and there have been few neuroimaging studies of those with excoriation disorder. […] Studies have shown a linkage between dopamine and the urge to pick. […] There is significant evidence to suggest that skin picking disorders are due to inherited traits or genes.

• #25 Skin-Picking Disorder: Triggers and Treatments

  https://www.asteroidhealth.com/blog/skin-picking-disorder-triggers-and-treatments

  Skin-picking disorder, also known as dermatillomania or excoriation disorder, is a complex mental health condition characterized by compulsive skin picking that often results in tissue damage, scars, and social or emotional impairment. […] Skin-picking disorder, also known as excoriation or dermatillomania, is often driven by a variety of triggers that can be emotional, physical, or environmental. Common psychological triggers include stress, anxiety, boredom, fatigue, and feelings of anger or frustration. […] Research suggests that genetics and brain structure differences contribute to the development of skin-picking disorder. A family history of obsessive-compulsive disorder (OCD) or related body-focused repetitive behaviors can increase susceptibility. […] Neurobiological studies reveal abnormalities in brain regions responsible for affect regulation, impulse control, and habit formation. Key areas involved include the nucleus accumbens and anterior cingulate cortex.

• #26 Dermatillomania (Skin Picking): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/22706-dermatillomania-skin-picking

  Dermatillomania is a mental health condition where a person compulsively picks or scratches their skin, causing injuries or scarring. […] There aren’t any confirmed causes of dermatillomania, but experts suspect a few different factors might play a role, including genetics, changes in brain structure, and stress, anxiety or other conditions. […] People with dermatillomania are much more likely to have at least one first-degree family member who also has this condition. […] People with dermatillomania are more likely to have some key differences in the structure of brain areas that control how they learn and form habits. […] Dermatillomania might be a coping mechanism for other issues or mental health conditions.

• #27 Excoriation Disorder (Skin Picking or Dermatillomania) | Mental Health America

  https://mhanational.org/conditions/excoriation-disorder-skin-picking-or-dermatillomania/

  Excoriation disorder (also referred to as chronic skin-picking or dermatillomania) is a mental illness related to obsessive-compulsive disorder. […] Currently, no specific cause has been identified for excoriation disorder. However, evidence suggests that there may be factors that influence development of this condition, including: Genetics: Individuals who experience dermatillomania are more likely to have at least one first-degree relative (parent or sibling) who also has this condition. […] Changes in brain structure: Individuals with excoriation disorder are more likely to have some key differences in the structure of brain areas that control how they learn and form habits. […] Stress, anxiety, or other conditions. Skin picking may be a way of coping with other mental health challenges. It may also be related to boredom or other factors.

• #28 White Matter Abnormalities in Skin Picking Disorder: A Diffusion Tensor Imaging Study | Neuropsychopharmacology

  https://www.nature.com/articles/npp2012241

  Skin picking disorder (SPD) is characterized by the repetitive and compulsive picking of skin, resulting in tissue damage. […] Neurocognitive findings in SPD implicate difficulty with response inhibition (suppression of pre-potent motor responses). […] It was hypothesized that SPD would be associated with reduced fractional anisotropy in regions implicated in top-down response suppression, particularly white-matter tracts in proximity of the bilateral anterior cingulate and right frontal (especially orbitofrontal and inferior frontal) cortices. […] These findings implicate disorganization of white-matter tracts involved in motor generation and suppression in the pathophysiology of SPD, findings remarkably similar to those previously reported in trichotillomania. […] Given this overlapping familiality between SPD and trichotillomania, and that these conditions are associated with pathological habits that are difficult to suppress, it has been suggested that SPD can be viewed as a pathological grooming disorder alongside trichotillomania.

• #29 Skin-Picking Disorder: Triggers and Treatments

  https://www.asteroidhealth.com/blog/skin-picking-disorder-triggers-and-treatments

  Understanding these underlying factors helps in developing comprehensive treatment approaches that address both biological and psychological components of the disorder. […] Evidence points to a combination of genetic predispositions, neurobiological differences, and psychological influences such as stress, anxiety, and emotional regulation issues. […] Neuroimaging studies have indicated abnormalities in brain regions responsible for impulse control and affect regulation, including the anterior cingulate cortex and white matter tracts. This supports the idea that nervous system dysfunction contributes.

• #30 White Matter Abnormalities in Skin Picking Disorder: A Diffusion Tensor Imaging Study | Neuropsychopharmacology

  https://www.nature.com/articles/npp2012241

  The current data implicate disconnectivity in white-matter tracts connecting neural regions involved in motor generation and suppression. […] These findings add considerable support to the notion that in addition to the phenomenological and comorbid overlap between SPD and trichotillomania, these disorders likely share overlapping neurobiology. […] The aim of this study was to assess the integrity of white-matter tracts in subjects with SPD compared with healthy control subjects. […] It was hypothesized that SPD would be associated with reduced fractional anisotropy (FA), thought to be characteristic of disorganized and/or damaged white-matter tracts, in regions implicated in top-down response suppression and in trichotillomania. […] The key finding was that SPD was associated with reduced integrity of distributed white-matter tracts connecting the anterior cingulate cortices to other neural nodes bilaterally. […] Future work should use diffusion tensor imaging in conjunction with functional imaging to explore the relationship between white-matter tract disorganization and dysfunction of particular nodes within the networks responsible for habit suppression.

• #31 Excoriation Disorder: Assessment, Diagnosis and Treatment – The Professional Counselor

  https://tpcjournal.nbcc.org/excoriation-disorder-assessment-diagnosis-and-treatment/

  In terms of psychological factors, skin picking behaviors help regulate uncomfortable emotions and can become a behaviorally-reinforced coping mechanism used to manage negative feelings. Some researchers suggest that excoriation disorder is rooted in higher levels of emotional impulsivity and that this characteristic supports and encourages the development of the disorder. Those with excoriation disorder experience obsessive thoughts about skin picking and engage in more impulsive, sensation-seeking behaviors (e.g., picking, rubbing) than those without the disorder. Those with excoriation disorder often have a greater difficulty with response inhibition and an increased difficulty suppressing an already initiated response as compared to control participants. For example, it might be more difficult for those with excoriation disorder to retract their hand if they already started reaching for an object to use to excoriate. This elevated level of impulsivity may be rooted in brain abnormalities; however, further research is necessary to clearly establish this connection.

• #32 Excoriation (Skin-Picking) Disorder | Abnormal Psychology

  https://courses.lumenlearning.com/wm-abnormalpsych/chapter/excoriation-skin-picking-disorder/

  Clinical studies have posited that there is a strong link between traumatic childhood events and excoriation disorder. […] Studies have shown a linkage between dopamine and the urge to pick. […] There may be another neurological explanation for excoriation disorder: individuals with the condition have less motor-inhibitory control, but show no sign of difference in cognitive flexibility, when compared to individuals without the condition. […] In some patients, excoriation disorder begins with the onset of acne in adolescence, but the compulsion continues even after the acne has gone away. Skin conditions such as keratosis pilaris, psoriasis, and eczema can also provoke the behavior. […] Certain stressful events including marital conflicts, deaths of friends or family, and unwanted pregnancies have been linked to the onset of the condition. […] Traumatic childhood events may initiate the behavior.

• #33 White Matter Abnormalities in Skin Picking Disorder: A Diffusion Tensor Imaging Study | Neuropsychopharmacology

  https://www.nature.com/articles/npp2012241

  Skin picking disorder (SPD) is characterized by the repetitive and compulsive picking of skin, resulting in tissue damage. […] Neurocognitive findings in SPD implicate difficulty with response inhibition (suppression of pre-potent motor responses). […] It was hypothesized that SPD would be associated with reduced fractional anisotropy in regions implicated in top-down response suppression, particularly white-matter tracts in proximity of the bilateral anterior cingulate and right frontal (especially orbitofrontal and inferior frontal) cortices. […] These findings implicate disorganization of white-matter tracts involved in motor generation and suppression in the pathophysiology of SPD, findings remarkably similar to those previously reported in trichotillomania. […] Given this overlapping familiality between SPD and trichotillomania, and that these conditions are associated with pathological habits that are difficult to suppress, it has been suggested that SPD can be viewed as a pathological grooming disorder alongside trichotillomania.

• #34 Excoriation disorder – Wikipedia

  https://en.wikipedia.org/wiki/Excoriation_disorder

  Excoriation disorder, more commonly known as dermatillomania, is a mental disorder on the obsessive-compulsive spectrum that is characterized by the repeated urge or impulse to pick at one’s own skin, to the extent that either psychological or physical damage is caused. The exact causes of this disorder are unclear but are believed to involve a combination of genetic, psychological, and environmental factors, including stress and underlying mental health conditions such as anxiety or obsessive-compulsive disorder (OCD). […] A common hypothesis is that excoriation disorder is often a coping mechanism to deal with elevated levels of turmoil, boredom, anxiety, or stress within the individual, and that the individual has an impaired stress response. […] There is limited knowledge regarding the neurobiology that drives excoriation disorder, and there have been few neuroimaging studies of those with excoriation disorder. […] Studies have shown a linkage between dopamine and the urge to pick. […] There is significant evidence to suggest that skin picking disorders are due to inherited traits or genes.

• #35 Excoriation (Skin-Picking) Disorder | Abnormal Psychology

  https://courses.lumenlearning.com/wm-abnormalpsych/chapter/excoriation-skin-picking-disorder/

  Clinical studies have posited that there is a strong link between traumatic childhood events and excoriation disorder. […] Studies have shown a linkage between dopamine and the urge to pick. […] There may be another neurological explanation for excoriation disorder: individuals with the condition have less motor-inhibitory control, but show no sign of difference in cognitive flexibility, when compared to individuals without the condition. […] In some patients, excoriation disorder begins with the onset of acne in adolescence, but the compulsion continues even after the acne has gone away. Skin conditions such as keratosis pilaris, psoriasis, and eczema can also provoke the behavior. […] Certain stressful events including marital conflicts, deaths of friends or family, and unwanted pregnancies have been linked to the onset of the condition. […] Traumatic childhood events may initiate the behavior.

• #36 Use of Topiramate in Skin-Picking Disorder: A Pilot Study

  https://www.psychiatrist.com/pcc/topiramate-in-skin-picking-disorder/

  Repetitive skin picking that culminates in skin lesions and excoriations has a fairly common prevalence and causes clinically significant distress. […] Due to similarities in symptoms and comorbidity, skin-picking disorder has been suggested to share etiology with a growing list of other neuropsychiatric disorders that make up the obsessive-compulsive spectrum including body dysmorphic disorder, Tourettes syndrome, and trichotillomania (compulsive hair pulling). […] Dysfunction in the dopamine reward pathway has also been speculated as a possible cause of skin picking since dopamine agonist drugs such as cocaine and methamphetamine have been associated with an uncontrollable urge to pick the skin among users. […] Topiramate modulation of -aminobutyric acid (GABA)-ergic neurotransmitters in addition to sodium and calcium channels has elicited interest that it might be a useful agent for treating skin-picking disorder. […] Our study suggests that topiramate ameliorates the symptoms observed in skin-picking disorder.

• #37 Dermatillomania | Types, symptoms, diagnosis, treatment & effects

  https://cpdonline.co.uk/knowledge-base/mental-health/dermatillomania/

  According to Psychology Today, around 1.4% of the population are affected by dermatillomania. Of these, 75% are female. This chronic condition is also known as skin picking disorder or excoriation disorder. It falls under the BFRB (body-focused repetitive behaviours) category of disorders, which is also classified under Obsessive-Compulsive and Related Disorders in the DSM-5. […] The exact causes of dermatillomania are not understood but it is believed that a complex interplay of biological, psychological and environmental factors is at play. […] There is some research that suggests a potential genetic component to dermatillomania as it does tend to run in families. Additionally, abnormalities in the brains reward system and neurotransmitter imbalances, especially those involving serotonin, may also play a role in the development of the disorder.

• #38 Skin Picking Disorder (Dermatillomania)

  https://www.mentalhealth.com/library/dermatillomania

  At this point, the cause of excoriation is unknown. It’s classified in the DSM-V with obsessive-compulsive disorders, so it could have a similar cause, such as a serotonin imbalance in the brain, which is thought to be a possible cause of OCD. […] Generally speaking, though, skin picking disorder is like any other human behavior and is likely the result of genetic factors, environmental factors, or a combination of the two. […] Having said that, some risk factors might lead to the development of dermatillomania. These include: Boredom – Some people with this disorder begin picking at their skin simply because they have nothing else to occupy their attention. […] Presence of anxiety or stress – Skin picking is used by some people to cope with stressful situations. […] Experiencing negative emotions – Emotions like shame and guilt are uncomfortable to deal with, so some people might cope with these emotions by picking at their skin.

• #39 Dermatillomania: A Case Report and Literature Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7910222/

  SSRIs have proved to be the most effective in treating the psychiatric component of dermatillomania and SSRIs have shown immense efficacy in patients suffering from OCD. […] Non-pharmacological treatments such as cognitive behavioral therapy, habit reversal therapy and support groups have also proved to be helpful and are well tolerated amongst patients suffering from dermatillomania.

• #40 Treatment and Healing for Skin Picking Disorder

  https://mavamedical.com/control-the-skin-picking-disorder/

  Some people choose to cope with dullness or relaxation by skin picking. Such self-mutilation becomes soothing, and soothing traces of self-harm through repetition are performed. […] Some individuals show greater sensitivity than normal. For example, feeling an overwhelming urge to pick at bumps, scabs, or other imperfections may demonstrate a sensitivity to the skin’s surface. […] Some compulsive behaviors, such as skin picking, tend to occur in conjunction with some degree of neurotransmitter imbalance in one’s brain, such as a deficit of serotonin. […] Minor irritants or stress factors may trigger an episode of skin picking, but like most tendencies, it can be a habit over time.

• #41 Skin Picking Disorder (Excoriation): Symptoms, Treatment, and Causes

  https://www.webmd.com/mental-health/skin-picking-disorder

  Skin picking disorder is when you repeatedly and uncontrollably pick at your skin, sometimes resulting in injury and scarring. […] There’s probably no one cause for dermatillomania. Experts think several factors play a role, including: […] Differences in brain structure. People with dermatillomania may have differences in the area of their brain that controls how they learn habits. […] Stress, anxiety, or other conditions. Some people with stress, anxiety, or depression may soothe themselves by picking at their skin. […] Genetics. You are more likely to have dermatillomania if your parents, siblings, or children also have the condition. […] You may be more likely to get skin picking disorder if you have: Trouble regulating your emotions, Low impulse control, Increased skin sensitivity, Low tolerance for skin irregularity. […] Skin picking is a mental health condition that’s related to OCD. Skin picking can be triggered by feelings of anxiety.

• #42 Treatment and Healing for Skin Picking Disorder

  https://mavamedical.com/control-the-skin-picking-disorder/

  Some people choose to cope with dullness or relaxation by skin picking. Such self-mutilation becomes soothing, and soothing traces of self-harm through repetition are performed. […] Some individuals show greater sensitivity than normal. For example, feeling an overwhelming urge to pick at bumps, scabs, or other imperfections may demonstrate a sensitivity to the skin’s surface. […] Some compulsive behaviors, such as skin picking, tend to occur in conjunction with some degree of neurotransmitter imbalance in one’s brain, such as a deficit of serotonin. […] Minor irritants or stress factors may trigger an episode of skin picking, but like most tendencies, it can be a habit over time.

• #43 Dermatillomania: A Case Report and Literature Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7910222/

  Certain syndromes such as Prader- Willi syndrome, Lesch-Nyhan syndrome, Smith-Magenis syndrome and Tourette syndrome are also reported to be associated. […] Dermatillomania has been associated with OCDs, body dysmorphic disorders, trichotillomania and anxiety. […] There are multiple triggers involved that cause skin picking or dermatillomania, including stress, anxiety, anger, boredom and even the sense of unevenness of the skin or skin discoloration. […] Patients describe uncontrollable pruritus before a skin picking episode; however, some patients also report skin sensations such as warmth, burning, pain and dryness. […] Continuous picking eventually leads to lesions in various stages of healing along with post-inflammatory hyperpigmentation and scarring. […] Treatment of dermatillomania is a multipronged approach and should include the treatment of the underlying disease, treatment for pruritus, treatment of the underlying psychiatric illness and topical treatment of the lesions.

• #44 Compulsive skin picking, neurotic excoriations

  https://dermnetnz.org/topics/compulsive-skin-picking

  Individuals with compulsive skin picking often have a co-existing psychiatric disorder. The most common co-existing psychiatric conditions are major depression and anxiety disorders, especially obsessive-compulsive disorder (OCD). In one study, 52% of patients with compulsive skin picking were also diagnosed with OCD. […] An organic disease such as anaemia, uraemia or liver disease may also cause compulsive skin picking. It is essential for the doctor to consider all possible causes. […] In many sufferers of compulsive skin picking, skin picking is preceded or accompanied by a high level of tension, anxiety or stress and a strong urge to itch or scratch. Often certain events or situations trigger skin-picking episodes. For some, the act of skin picking provides a feeling of relief or pleasure. Skin-picking episodes can be a conscious response to anxiety or may be done as an unconscious habit. […] Compulsive skin picking appears to be more common in women than in men, and often starts in adolescence. […] It may also be associated with methamphetamine or cocaine abuse.

• #45 Skin Picking and Autoimmune Diseases: Signs and How to Treat

  https://www.healthline.com/health/skin-picking-and-autoimmune-disorders

  Excoriation disorder, also known as dermatillomania, is a skin-picking condition. […] But skin picking can be a symptom of autoimmune conditions, too. The symptoms of some autoimmune conditions create a situation where skin picking becomes a regular habit. […] Autoimmune conditions that affect your skin can cause excoriation disorder to develop. This is more likely if you already have a history of other mental health or psychological conditions. […] Rheumatoid arthritis (RA) is an autoimmune condition linked to inflammation in your joints. This inflammation can lead to itching on your skin at the site of the affected areas. Itching from RA can then progress to skin picking. […] Lupus is an autoimmune condition that causes inflammation. If you have lupus, you can develop lesions on your lower legs or the ends of your fingers and toes. These lesions may be itchy, and scratching them can become a compulsive behavior.

• #46 Skin Picking and Autoimmune Diseases: Signs and How to Treat

  https://www.healthline.com/health/skin-picking-and-autoimmune-disorders

  Psoriasis is an autoimmune condition that causes patches of raised scales on your skin. Inflammation causes these scales. They can be itchy and discolored. The urge to pick off these scales can become excoriation disorder. […] Type 1 diabetes is caused by an autoimmune response to cells in your pancreas. This type of diabetes often causes lesions to develop on your skin. Picking at these lesions can become a compulsion. […] Autoimmune disorders have been linked to excoriation disorder, a type of OCD. Underlying inflammation, itching, and rashes can lead to skin picking, which then progresses to compulsive behavior. For people who already have mental health conditions that put them at risk, autoimmune symptoms can trigger excoriation disorder.

• #47 Skin Picking and Autoimmune Disorders

  https://www.verywellhealth.com/skin-picking-and-autoimmune-disorders-5324089

  Skin-picking disorder (dermatillomania or excoriation disorder) and autoimmune disorders often go together. […] In some people with autoimmune diseases, skin-picking symptoms may become a habit and a sign of a mental health disorder. […] Research suggests that skin picking is associated with certain mental health disorders such as anxiety and depression. It can also happen with autoimmune conditions. […] Some research suggests itchiness is a persistent symptom of many autoimmune connective-tissue diseases and is under-recognized and undertreated. This could make them prone to triggering excoriation. […] Skin picking disorder is related to several autoimmune diseases, including rheumatoid arthritis, psoriasis, lupus, MS, and type 1 diabetes. Skin picking disorder involves an urge to pick, scratch, scrape, or pull the skin and an inability to stop these behaviors.

• #48 Skin Picking and Autoimmune Disorders

  https://www.verywellhealth.com/skin-picking-and-autoimmune-disorders-5324089

  Skin-picking disorder (dermatillomania or excoriation disorder) and autoimmune disorders often go together. […] In some people with autoimmune diseases, skin-picking symptoms may become a habit and a sign of a mental health disorder. […] Research suggests that skin picking is associated with certain mental health disorders such as anxiety and depression. It can also happen with autoimmune conditions. […] Some research suggests itchiness is a persistent symptom of many autoimmune connective-tissue diseases and is under-recognized and undertreated. This could make them prone to triggering excoriation. […] Skin picking disorder is related to several autoimmune diseases, including rheumatoid arthritis, psoriasis, lupus, MS, and type 1 diabetes. Skin picking disorder involves an urge to pick, scratch, scrape, or pull the skin and an inability to stop these behaviors.

• #49 Excoriation (Skin-Picking) Disorder | Abnormal Psychology

  https://courses.lumenlearning.com/wm-abnormalpsych/chapter/excoriation-skin-picking-disorder/

  Excoriation disorder is an obsessive-compulsive spectrum disorder that is characterized by the repeated urge or impulse to pick at ones own skin to the extent that either psychological or physical damage is caused. […] Episodes of skin picking are often preceded or accompanied by tension, anxiety, or stress. In some cases, following picking, the affected person may feel depressed. […] Skin picking often occurs as a result of some other triggering cause. Some common triggers are feeling or examining irregularities on the skin and feeling anxious or other negative feelings. […] There have been many different theories regarding the causes of excoriation disorder including biological and environmental factors. A common hypothesis is that excoriation disorder is often a coping mechanism to deal with elevated levels of turmoil, arousal, or stress within the individual, and that the individual has an impaired stress response.

• #50 Excoriation Disorder: Assessment, Diagnosis and Treatment – The Professional Counselor

  https://tpcjournal.nbcc.org/excoriation-disorder-assessment-diagnosis-and-treatment/

  Another common theory regarding the onset and maintenance of excoriation disorder is that skin picking behaviors can help regulate emotions and can become a behaviorally-reinforced coping mechanism used to manage elevated levels of anxiety, stress and arousal. Individuals who skin pick often display elevated stress responses to normal stimuli, and skin picking appears to temporarily soothe such stress. Additionally, obsessive thoughts about skin imperfections and anxiety over not picking can be temporarily relieved by completing the behaviors. As such, there is a behavioral component in addition to the genetic and biological components of the disorder that must be considered when understanding the etiology, assessment, diagnosis and treatment of excoriation disorder.

• #51 Excoriation (Skin-Picking) Disorder – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/obsessive-compulsive-and-related-disorders/excoriation-skin-picking-disorder

  Patients with excoriation disorder repeatedly pick at or scratch their skin; the picking is not triggered by appearance or health concerns (eg, to remove a lesion that they perceive as unattractive or possibly cancerous). […] However, the skin picking may be preceded by a feeling of tension or anxiety that is relieved by the picking, which often is also accompanied by a feeling of gratification. […] Many people with excoriation disorder also have other mental health disorders, such as obsessive-compulsive disorder or major depressive disorder. […] In excoriation (skin-picking) disorder, skin picking is not triggered by obsessions or concerns about appearance but may be preceded by a feeling of tension or anxiety that is relieved by the skin picking, often followed by a feeling of gratification.

• #52 Excoriation (Skin-Picking) Disorder – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/obsessive-compulsive-and-related-disorders/excoriation-skin-picking-disorder

  Patients with excoriation disorder repeatedly pick at or scratch their skin; the picking is not triggered by appearance or health concerns (eg, to remove a lesion that they perceive as unattractive or possibly cancerous). […] However, the skin picking may be preceded by a feeling of tension or anxiety that is relieved by the picking, which often is also accompanied by a feeling of gratification. […] Many people with excoriation disorder also have other mental health disorders, such as obsessive-compulsive disorder or major depressive disorder. […] In excoriation (skin-picking) disorder, skin picking is not triggered by obsessions or concerns about appearance but may be preceded by a feeling of tension or anxiety that is relieved by the skin picking, often followed by a feeling of gratification.

• #53 Excoriation (Skin-Picking) Disorder | Abnormal Psychology

  https://courses.lumenlearning.com/wm-abnormalpsych/chapter/excoriation-skin-picking-disorder/

  Excoriation disorder is an obsessive-compulsive spectrum disorder that is characterized by the repeated urge or impulse to pick at ones own skin to the extent that either psychological or physical damage is caused. […] Episodes of skin picking are often preceded or accompanied by tension, anxiety, or stress. In some cases, following picking, the affected person may feel depressed. […] Skin picking often occurs as a result of some other triggering cause. Some common triggers are feeling or examining irregularities on the skin and feeling anxious or other negative feelings. […] There have been many different theories regarding the causes of excoriation disorder including biological and environmental factors. A common hypothesis is that excoriation disorder is often a coping mechanism to deal with elevated levels of turmoil, arousal, or stress within the individual, and that the individual has an impaired stress response.

• #54 Prevalence of and Risk Factors for Skin Picking Disorder Symptoms Among Adults in an Arab Middle Eastern Population: A Cross-Sectional Study

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9725924/

  Skin Picking Disorder (SPD) is a skin-related disease, also recognized as psychogenic excoriation, dermatillomania, or excoriation disorder. SPD is defined as a habitual picking of skin, which in turn harms skin tissue. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has formally classified SPD as a category of obsessive-compulsive (OCD) related disorder. SPD has been of particular interest to researchers because of the recent attention this disorder has received as well as its relatively high prevalence, morbidity, and comorbidity. Studies in community samples indicate that skin picking is common and often occurs in conjunction with other psychiatric disorders. Initially, its occurrence is focused and conscious, which after a certain time, becomes automatic and unconscious. This progression is similar to the features of grooming disorder and trichotillomania. In addition, SPD should be approached as a heterogenous spectrum in terms of presentation. Skin picking is usually triggered by stress, boredom, anxiety, or physical sensations (unevenness of the skin). Difficulties with emotional regulation and reactivity have also been shown to escalate picking behavior to control anxiety, depression, and other disturbing emotions.

• #55 Excoriation Disorder: Assessment, Diagnosis and Treatment – The Professional Counselor

  https://tpcjournal.nbcc.org/excoriation-disorder-assessment-diagnosis-and-treatment/

  In terms of psychological factors, skin picking behaviors help regulate uncomfortable emotions and can become a behaviorally-reinforced coping mechanism used to manage negative feelings. Some researchers suggest that excoriation disorder is rooted in higher levels of emotional impulsivity and that this characteristic supports and encourages the development of the disorder. Those with excoriation disorder experience obsessive thoughts about skin picking and engage in more impulsive, sensation-seeking behaviors (e.g., picking, rubbing) than those without the disorder. Those with excoriation disorder often have a greater difficulty with response inhibition and an increased difficulty suppressing an already initiated response as compared to control participants. For example, it might be more difficult for those with excoriation disorder to retract their hand if they already started reaching for an object to use to excoriate. This elevated level of impulsivity may be rooted in brain abnormalities; however, further research is necessary to clearly establish this connection.

• #56 Excoriation Disorder: Assessment, Diagnosis and Treatment – The Professional Counselor

  https://tpcjournal.nbcc.org/excoriation-disorder-assessment-diagnosis-and-treatment/

  In terms of psychological factors, skin picking behaviors help regulate uncomfortable emotions and can become a behaviorally-reinforced coping mechanism used to manage negative feelings. Some researchers suggest that excoriation disorder is rooted in higher levels of emotional impulsivity and that this characteristic supports and encourages the development of the disorder. Those with excoriation disorder experience obsessive thoughts about skin picking and engage in more impulsive, sensation-seeking behaviors (e.g., picking, rubbing) than those without the disorder. Those with excoriation disorder often have a greater difficulty with response inhibition and an increased difficulty suppressing an already initiated response as compared to control participants. For example, it might be more difficult for those with excoriation disorder to retract their hand if they already started reaching for an object to use to excoriate. This elevated level of impulsivity may be rooted in brain abnormalities; however, further research is necessary to clearly establish this connection.

• #57 Excoriation Disorder: Assessment, Diagnosis and Treatment – The Professional Counselor

  https://tpcjournal.nbcc.org/excoriation-disorder-assessment-diagnosis-and-treatment/

  Another common theory regarding the onset and maintenance of excoriation disorder is that skin picking behaviors can help regulate emotions and can become a behaviorally-reinforced coping mechanism used to manage elevated levels of anxiety, stress and arousal. Individuals who skin pick often display elevated stress responses to normal stimuli, and skin picking appears to temporarily soothe such stress. Additionally, obsessive thoughts about skin imperfections and anxiety over not picking can be temporarily relieved by completing the behaviors. As such, there is a behavioral component in addition to the genetic and biological components of the disorder that must be considered when understanding the etiology, assessment, diagnosis and treatment of excoriation disorder.

• #58 What is Excoriation (Skin Picking) Disorder? — Talkspace

  https://www.talkspace.com/mental-health/conditions/excoriation-disorder/

  Excoriation disorder, commonly known as the skin picking disorder, is a psychiatric condition that is characterized by the repetitive and sometimes aggressive picking of ones own skin. […] While skin picking disorder hasnt been linked to a specific cause, several factors make people more likely to develop it. […] Skin conditions, such as acne or eczema, are potential triggers for the onset of excoriation disorder symptoms. […] Excoriation disorder is related to the compulsive behavior of picking at your skin. There are several theories of what can cause this diagnosis. […] People may begin picking at their skin in response to various emotions, such as anxiety, anger, or boredom. […] Research shows a link between excoriation disorder occurring comorbidly with other mental health conditions.

• #59 Skin picking disorder – NHS

  https://www.nhs.uk/mental-health/conditions/skin-picking-disorder/

  Skin picking disorder is related to obsessive compulsive disorder, where the person cannot stop themselves carrying out a particular action. […] It can be triggered by: boredom, stress or anxiety, negative emotions, such as guilt or shame, skin conditions, such as acne or eczema, other blemishes that the person wants to get rid of (these may not be noticeable to other people). […] It’s sometimes called a body-focused repetitive behaviour and is similar to repetitive hair pulling disorder (trichotillomania). […] It’s also related to other obsessive compulsive disorders, such as body dysmorphic disorder, where the person is excessively preoccupied with their appearance. […] People with skin picking disorder often also have other obsessive compulsive disorders. These may require their own assessment and treatment.

• #60 Skin Picking Disorder (Dermatillomania)

  https://www.mentalhealth.com/library/dermatillomania

  At this point, the cause of excoriation is unknown. It’s classified in the DSM-V with obsessive-compulsive disorders, so it could have a similar cause, such as a serotonin imbalance in the brain, which is thought to be a possible cause of OCD. […] Generally speaking, though, skin picking disorder is like any other human behavior and is likely the result of genetic factors, environmental factors, or a combination of the two. […] Having said that, some risk factors might lead to the development of dermatillomania. These include: Boredom – Some people with this disorder begin picking at their skin simply because they have nothing else to occupy their attention. […] Presence of anxiety or stress – Skin picking is used by some people to cope with stressful situations. […] Experiencing negative emotions – Emotions like shame and guilt are uncomfortable to deal with, so some people might cope with these emotions by picking at their skin.

• #61 Excoriation (Skin Picking) Disorder: What Is It?

  https://www.healthline.com/health/skin-disorders/excoriation

  Skin-picking disorder is classified as a type of OCD. The compulsive urge to pick is often too powerful for many people to stop on their own. The more a person picks at their skin, the less control they have over the behavior. […] It’s unclear what causes a person to develop this disorder. […] The disorder often begins after one of two events or stimuli: An infection, injury, or wound starts healing and creates a scab. The itching causes the person to scratch and pick. The new wound or lesion starts to heal and creates another scab. That begins the cycle of picking. […] The behavior is a stress relief habit during a time of stress. The repetitive action and control that skin picking gives may provide relief from other events that can’t be controlled. […] Skin-picking disorder occurs in both children and adults. It can begin at almost any age, but it typically appears first in adolescence or at the onset of puberty. Women are more likely to develop it than men.

• #62 Excoriation (Skin Picking) Disorder – PsychDB

  https://www.psychdb.com/ocd/excoriation

  Excoriation (Skin-Picking) Disorder is an obsessive-compulsive and related disorder characterized by the repeated urge to pick at one’s own skin, often to the extent that significant skin damage is caused. […] From a psychopathology perspective, skin picking may help regulate emotional states or stressful events. Skin picking may function as a means of escaping from or avoiding aversive experiences, and provide temporary relief from negative emotions. These behaviours may be maintained through a negative reinforcement cycle. […] Excoriation disorder is more common in individuals with obsessive-compulsive disorder (OCD) and their first-degree family members.

• #63 Compulsive skin picking, neurotic excoriations

  https://dermnetnz.org/topics/compulsive-skin-picking

  Individuals with compulsive skin picking often have a co-existing psychiatric disorder. The most common co-existing psychiatric conditions are major depression and anxiety disorders, especially obsessive-compulsive disorder (OCD). In one study, 52% of patients with compulsive skin picking were also diagnosed with OCD. […] An organic disease such as anaemia, uraemia or liver disease may also cause compulsive skin picking. It is essential for the doctor to consider all possible causes. […] In many sufferers of compulsive skin picking, skin picking is preceded or accompanied by a high level of tension, anxiety or stress and a strong urge to itch or scratch. Often certain events or situations trigger skin-picking episodes. For some, the act of skin picking provides a feeling of relief or pleasure. Skin-picking episodes can be a conscious response to anxiety or may be done as an unconscious habit. […] Compulsive skin picking appears to be more common in women than in men, and often starts in adolescence. […] It may also be associated with methamphetamine or cocaine abuse.

• #64 Compulsive skin picking, neurotic excoriations

  https://dermnetnz.org/topics/compulsive-skin-picking

  Individuals with compulsive skin picking often have a co-existing psychiatric disorder. The most common co-existing psychiatric conditions are major depression and anxiety disorders, especially obsessive-compulsive disorder (OCD). In one study, 52% of patients with compulsive skin picking were also diagnosed with OCD. […] An organic disease such as anaemia, uraemia or liver disease may also cause compulsive skin picking. It is essential for the doctor to consider all possible causes. […] In many sufferers of compulsive skin picking, skin picking is preceded or accompanied by a high level of tension, anxiety or stress and a strong urge to itch or scratch. Often certain events or situations trigger skin-picking episodes. For some, the act of skin picking provides a feeling of relief or pleasure. Skin-picking episodes can be a conscious response to anxiety or may be done as an unconscious habit. […] Compulsive skin picking appears to be more common in women than in men, and often starts in adolescence. […] It may also be associated with methamphetamine or cocaine abuse.

• #65 Dermatillomania: Symptoms, Causes, and Treatment | Psych Central

  https://psychcentral.com/ocd/dermatillomania

  Dermatillomania is characterized by repetitive skin picking that results in soft tissue damage. […] The exact cause of dermatillomania is unknown. […] The disorder may be linked to genetics, since it tends to run in families. A 2012 study found that of 60 people with skin picking disorder, 28.3% of their close family members also had the disorder. […] Research from 2017 suggests that dermatillomania has significant comorbidity with other BFRB disorders. The most common of these is trichotillomania (hair pulling disorder). […] Obsessive-compulsive disorder (OCD) and body dysmorphic disorder (BDD) are also more common in people with dermatillomania than in the general population. In fact, research suggests that 28% of those with BDD have dermatillomania. […] Overall, several mental health disorders and syndromes have been linked to skin picking: trichotillomania, OCD, obsessive-compulsive personality disorder, Tourette syndrome, BDD, anxiety disorder, alcohol dependence, mood disorder, borderline personality disorder, autism spectrum disorder, Prader-Willi syndrome, Lesch-Nyhan syndrome, Smith-Magenis syndrome.

• #66 Skin picking disorder – NHS

  https://www.nhs.uk/mental-health/conditions/skin-picking-disorder/

  Skin picking disorder is related to obsessive compulsive disorder, where the person cannot stop themselves carrying out a particular action. […] It can be triggered by: boredom, stress or anxiety, negative emotions, such as guilt or shame, skin conditions, such as acne or eczema, other blemishes that the person wants to get rid of (these may not be noticeable to other people). […] It’s sometimes called a body-focused repetitive behaviour and is similar to repetitive hair pulling disorder (trichotillomania). […] It’s also related to other obsessive compulsive disorders, such as body dysmorphic disorder, where the person is excessively preoccupied with their appearance. […] People with skin picking disorder often also have other obsessive compulsive disorders. These may require their own assessment and treatment.

• #67 Dermatillomania: A Case Report and Literature Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7910222/

  Skin picking disorder, also termed dermatillomania is a condition that leads to repetitive picking of their skin ending up in skin and soft tissue damage. […] It is classified in Diagnostic and Statistical Manual of Mental Disorder Fifth edition under the „obsessive compulsive and related disorders” section. […] Often associated with other psychiatric conditions like autism, alcohol abuse, obsessive compulsive, body dysmorphic, mood, anxiety and borderline personality disorders, it is a disorder that is quite often underreported. […] Several psychiatric co-morbidities have been found to be associated with skin picking leading to self-injury such as obsessive compulsive disorder (OCD), alcohol abuse or dependence, body dysmorphic disorder, mood disorder, anxiety disorder, borderline personality disorder and obsessive compulsive personality disorder.

• #68 Dermatillomania: A Case Report and Literature Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7910222/

  Skin picking disorder, also termed dermatillomania is a condition that leads to repetitive picking of their skin ending up in skin and soft tissue damage. […] It is classified in Diagnostic and Statistical Manual of Mental Disorder Fifth edition under the „obsessive compulsive and related disorders” section. […] Often associated with other psychiatric conditions like autism, alcohol abuse, obsessive compulsive, body dysmorphic, mood, anxiety and borderline personality disorders, it is a disorder that is quite often underreported. […] Several psychiatric co-morbidities have been found to be associated with skin picking leading to self-injury such as obsessive compulsive disorder (OCD), alcohol abuse or dependence, body dysmorphic disorder, mood disorder, anxiety disorder, borderline personality disorder and obsessive compulsive personality disorder.

• #69 Dermatillomania: A Case Report and Literature Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7910222/

  Skin picking disorder, also termed dermatillomania is a condition that leads to repetitive picking of their skin ending up in skin and soft tissue damage. […] It is classified in Diagnostic and Statistical Manual of Mental Disorder Fifth edition under the „obsessive compulsive and related disorders” section. […] Often associated with other psychiatric conditions like autism, alcohol abuse, obsessive compulsive, body dysmorphic, mood, anxiety and borderline personality disorders, it is a disorder that is quite often underreported. […] Several psychiatric co-morbidities have been found to be associated with skin picking leading to self-injury such as obsessive compulsive disorder (OCD), alcohol abuse or dependence, body dysmorphic disorder, mood disorder, anxiety disorder, borderline personality disorder and obsessive compulsive personality disorder.

• #70 Skin picking (excoriation disorder): Causes and treatment

  https://www.medicalnewstoday.com/articles/325925

  The exact cause of skin picking disorder remains unknown. That said, it may develop alongside other health conditions, such as obsessive-compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), or autism. […] Although skin picking has no specific cause, it may result from biological and environmental factors. […] Skin picking disorder can develop alongside OCD or another mental health condition. […] People with ADHD may develop skin picking disorder in response to their hyperactivity or low impulse control. […] The behavioral symptoms of ASD can manifest as repetitive behavior, such as skin picking, that often includes self-injury.

• #71 Skin picking (excoriation disorder): Causes and treatment

  https://www.medicalnewstoday.com/articles/325925

  The exact cause of skin picking disorder remains unknown. That said, it may develop alongside other health conditions, such as obsessive-compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), or autism. […] Although skin picking has no specific cause, it may result from biological and environmental factors. […] Skin picking disorder can develop alongside OCD or another mental health condition. […] People with ADHD may develop skin picking disorder in response to their hyperactivity or low impulse control. […] The behavioral symptoms of ASD can manifest as repetitive behavior, such as skin picking, that often includes self-injury.

• #72 Dermatillomania: A Case Report and Literature Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7910222/

  Certain syndromes such as Prader- Willi syndrome, Lesch-Nyhan syndrome, Smith-Magenis syndrome and Tourette syndrome are also reported to be associated. […] Dermatillomania has been associated with OCDs, body dysmorphic disorders, trichotillomania and anxiety. […] There are multiple triggers involved that cause skin picking or dermatillomania, including stress, anxiety, anger, boredom and even the sense of unevenness of the skin or skin discoloration. […] Patients describe uncontrollable pruritus before a skin picking episode; however, some patients also report skin sensations such as warmth, burning, pain and dryness. […] Continuous picking eventually leads to lesions in various stages of healing along with post-inflammatory hyperpigmentation and scarring. […] Treatment of dermatillomania is a multipronged approach and should include the treatment of the underlying disease, treatment for pruritus, treatment of the underlying psychiatric illness and topical treatment of the lesions.

• #73 Dermatillomania (Skin Picking): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/22706-dermatillomania-skin-picking

  Dermatillomania is a mental health condition where a person compulsively picks or scratches their skin, causing injuries or scarring. […] There aren’t any confirmed causes of dermatillomania, but experts suspect a few different factors might play a role, including genetics, changes in brain structure, and stress, anxiety or other conditions. […] People with dermatillomania are much more likely to have at least one first-degree family member who also has this condition. […] People with dermatillomania are more likely to have some key differences in the structure of brain areas that control how they learn and form habits. […] Dermatillomania might be a coping mechanism for other issues or mental health conditions.

• #74 Skin Picking Disorder (Excoriation): Symptoms, Treatment, and Causes

  https://www.webmd.com/mental-health/skin-picking-disorder

  Skin picking disorder is when you repeatedly and uncontrollably pick at your skin, sometimes resulting in injury and scarring. […] There’s probably no one cause for dermatillomania. Experts think several factors play a role, including: […] Differences in brain structure. People with dermatillomania may have differences in the area of their brain that controls how they learn habits. […] Stress, anxiety, or other conditions. Some people with stress, anxiety, or depression may soothe themselves by picking at their skin. […] Genetics. You are more likely to have dermatillomania if your parents, siblings, or children also have the condition. […] You may be more likely to get skin picking disorder if you have: Trouble regulating your emotions, Low impulse control, Increased skin sensitivity, Low tolerance for skin irregularity. […] Skin picking is a mental health condition that’s related to OCD. Skin picking can be triggered by feelings of anxiety.

• #75 Excoriation (Skin-Picking) Disorder | Abnormal Psychology

  https://courses.lumenlearning.com/wm-abnormalpsych/chapter/excoriation-skin-picking-disorder/

  Clinical studies have posited that there is a strong link between traumatic childhood events and excoriation disorder. […] Studies have shown a linkage between dopamine and the urge to pick. […] There may be another neurological explanation for excoriation disorder: individuals with the condition have less motor-inhibitory control, but show no sign of difference in cognitive flexibility, when compared to individuals without the condition. […] In some patients, excoriation disorder begins with the onset of acne in adolescence, but the compulsion continues even after the acne has gone away. Skin conditions such as keratosis pilaris, psoriasis, and eczema can also provoke the behavior. […] Certain stressful events including marital conflicts, deaths of friends or family, and unwanted pregnancies have been linked to the onset of the condition. […] Traumatic childhood events may initiate the behavior.

• #76 Dermatillomania | Types, symptoms, diagnosis, treatment & effects

  https://cpdonline.co.uk/knowledge-base/mental-health/dermatillomania/

  Psychological factors like stress, depression and anxiety are commonly associated with dermatillomania. Its believed that skin picking behaviours may serve as a coping mechanism or a way of relieving tension and anxiety in some people. […] Environmental factors such as trauma, neglect or abuse may contribute to the development of dermatillomania. Skin picking could be a coping mechanism for individuals to help them cope with past trauma or to gain a sense of control in their lives. […] Ultimately, the causes of dermatillomania are likely to be multifactorial and will vary from person to person. As such, treatment also needs to have a comprehensive approach.

• #77 Dermatillomania | Types, symptoms, diagnosis, treatment & effects

  https://cpdonline.co.uk/knowledge-base/mental-health/dermatillomania/

  Psychological factors like stress, depression and anxiety are commonly associated with dermatillomania. Its believed that skin picking behaviours may serve as a coping mechanism or a way of relieving tension and anxiety in some people. […] Environmental factors such as trauma, neglect or abuse may contribute to the development of dermatillomania. Skin picking could be a coping mechanism for individuals to help them cope with past trauma or to gain a sense of control in their lives. […] Ultimately, the causes of dermatillomania are likely to be multifactorial and will vary from person to person. As such, treatment also needs to have a comprehensive approach.

• #78 Excoriation (skin-picking) Disorder: Causes, Symptoms, Treatment DSM-5 698.4 (l98.1)

  https://thriveworks.com/blog/excoriation-skin-picking-disorder/

  Excoriation Disorder is also associated with traumatic experiences when the individual was a child and as the result of stress in adults. […] The following are a few of the causes of Excoriation Disorder. […] Its thought that dopamine (neurotransmitter that helps to control the brains reward and pleasure centers) is involved in Skin-Picking. […] Skin-Picking has brought about anger that has been covered up in children in order to cope with very domineering parents. […] Abnormal way to cope with stress or anxiety. […] Many people pick because theyre certain their skin is contaminated.

• #79 Excoriation (Skin-Picking) Disorder | Abnormal Psychology

  https://courses.lumenlearning.com/wm-abnormalpsych/chapter/excoriation-skin-picking-disorder/

  Clinical studies have posited that there is a strong link between traumatic childhood events and excoriation disorder. […] Studies have shown a linkage between dopamine and the urge to pick. […] There may be another neurological explanation for excoriation disorder: individuals with the condition have less motor-inhibitory control, but show no sign of difference in cognitive flexibility, when compared to individuals without the condition. […] In some patients, excoriation disorder begins with the onset of acne in adolescence, but the compulsion continues even after the acne has gone away. Skin conditions such as keratosis pilaris, psoriasis, and eczema can also provoke the behavior. […] Certain stressful events including marital conflicts, deaths of friends or family, and unwanted pregnancies have been linked to the onset of the condition. […] Traumatic childhood events may initiate the behavior.

• #80 Skin picking disorder – NHS

  https://www.nhs.uk/mental-health/conditions/skin-picking-disorder/

  Skin picking disorder is related to obsessive compulsive disorder, where the person cannot stop themselves carrying out a particular action. […] It can be triggered by: boredom, stress or anxiety, negative emotions, such as guilt or shame, skin conditions, such as acne or eczema, other blemishes that the person wants to get rid of (these may not be noticeable to other people). […] It’s sometimes called a body-focused repetitive behaviour and is similar to repetitive hair pulling disorder (trichotillomania). […] It’s also related to other obsessive compulsive disorders, such as body dysmorphic disorder, where the person is excessively preoccupied with their appearance. […] People with skin picking disorder often also have other obsessive compulsive disorders. These may require their own assessment and treatment.

• #81 Skin Picking Disorder (Dermatillomania)

  https://www.mentalhealth.com/library/dermatillomania

  At this point, the cause of excoriation is unknown. It’s classified in the DSM-V with obsessive-compulsive disorders, so it could have a similar cause, such as a serotonin imbalance in the brain, which is thought to be a possible cause of OCD. […] Generally speaking, though, skin picking disorder is like any other human behavior and is likely the result of genetic factors, environmental factors, or a combination of the two. […] Having said that, some risk factors might lead to the development of dermatillomania. These include: Boredom – Some people with this disorder begin picking at their skin simply because they have nothing else to occupy their attention. […] Presence of anxiety or stress – Skin picking is used by some people to cope with stressful situations. […] Experiencing negative emotions – Emotions like shame and guilt are uncomfortable to deal with, so some people might cope with these emotions by picking at their skin.

• #82 Skin picking disorder – NHS

  https://www.nhs.uk/mental-health/conditions/skin-picking-disorder/

  Skin picking disorder is related to obsessive compulsive disorder, where the person cannot stop themselves carrying out a particular action. […] It can be triggered by: boredom, stress or anxiety, negative emotions, such as guilt or shame, skin conditions, such as acne or eczema, other blemishes that the person wants to get rid of (these may not be noticeable to other people). […] It’s sometimes called a body-focused repetitive behaviour and is similar to repetitive hair pulling disorder (trichotillomania). […] It’s also related to other obsessive compulsive disorders, such as body dysmorphic disorder, where the person is excessively preoccupied with their appearance. […] People with skin picking disorder often also have other obsessive compulsive disorders. These may require their own assessment and treatment.

• #83 Excoriation (skin-picking) disorder: a systematic review of treatment | NDT

  https://www.dovepress.com/excoriation-skin-picking-disorder-a-systematic-review-of-treatment-opt-peer-reviewed-fulltext-article-NDT

  Excoriation (skin-picking) disorder (ED), also known as dermatillomania, psychogenic excoriation, or neurotic excoriation, is characterized by recurrent picking of skin, leading to skin lesions and significant distress or functional impairment. […] Dermatological conditions such as acne or eczema often trigger the onset of ED. Skin-picking triggers can be multiple, and may vary across individuals, but include emotions such as stress, anger, and anxiety, sedentary activities such as watching television and reading, and boredom and feeling tired. […] The severity of skin-picking ranges from mild to severe; in subclinical cases, intervention may not be needed, whereas when diagnostic criteria for ED are met, treatment is indicated. […] It has been suggested that less than a fifth of patients seek treatment for their skin-picking.

• #84 Skin picking disorder – NHS

  https://www.nhs.uk/mental-health/conditions/skin-picking-disorder/

  Skin picking disorder is related to obsessive compulsive disorder, where the person cannot stop themselves carrying out a particular action. […] It can be triggered by: boredom, stress or anxiety, negative emotions, such as guilt or shame, skin conditions, such as acne or eczema, other blemishes that the person wants to get rid of (these may not be noticeable to other people). […] It’s sometimes called a body-focused repetitive behaviour and is similar to repetitive hair pulling disorder (trichotillomania). […] It’s also related to other obsessive compulsive disorders, such as body dysmorphic disorder, where the person is excessively preoccupied with their appearance. […] People with skin picking disorder often also have other obsessive compulsive disorders. These may require their own assessment and treatment.

• #85 Skin picking disorder – NHS

  https://www.nhs.uk/mental-health/conditions/skin-picking-disorder/

  Skin picking disorder is related to obsessive compulsive disorder, where the person cannot stop themselves carrying out a particular action. […] It can be triggered by: boredom, stress or anxiety, negative emotions, such as guilt or shame, skin conditions, such as acne or eczema, other blemishes that the person wants to get rid of (these may not be noticeable to other people). […] It’s sometimes called a body-focused repetitive behaviour and is similar to repetitive hair pulling disorder (trichotillomania). […] It’s also related to other obsessive compulsive disorders, such as body dysmorphic disorder, where the person is excessively preoccupied with their appearance. […] People with skin picking disorder often also have other obsessive compulsive disorders. These may require their own assessment and treatment.

• #86 Excoriation (skin-picking) disorder: a systematic review of treatment | NDT

  https://www.dovepress.com/excoriation-skin-picking-disorder-a-systematic-review-of-treatment-opt-peer-reviewed-fulltext-article-NDT

  Excoriation (skin-picking) disorder (ED), also known as dermatillomania, psychogenic excoriation, or neurotic excoriation, is characterized by recurrent picking of skin, leading to skin lesions and significant distress or functional impairment. […] Dermatological conditions such as acne or eczema often trigger the onset of ED. Skin-picking triggers can be multiple, and may vary across individuals, but include emotions such as stress, anger, and anxiety, sedentary activities such as watching television and reading, and boredom and feeling tired. […] The severity of skin-picking ranges from mild to severe; in subclinical cases, intervention may not be needed, whereas when diagnostic criteria for ED are met, treatment is indicated. […] It has been suggested that less than a fifth of patients seek treatment for their skin-picking.

• #87 Skin picking disorder – NHS

  https://www.nhs.uk/mental-health/conditions/skin-picking-disorder/

  Skin picking disorder is related to obsessive compulsive disorder, where the person cannot stop themselves carrying out a particular action. […] It can be triggered by: boredom, stress or anxiety, negative emotions, such as guilt or shame, skin conditions, such as acne or eczema, other blemishes that the person wants to get rid of (these may not be noticeable to other people). […] It’s sometimes called a body-focused repetitive behaviour and is similar to repetitive hair pulling disorder (trichotillomania). […] It’s also related to other obsessive compulsive disorders, such as body dysmorphic disorder, where the person is excessively preoccupied with their appearance. […] People with skin picking disorder often also have other obsessive compulsive disorders. These may require their own assessment and treatment.

• #88 Excoriation (skin-picking) disorder: a systematic review of treatment | NDT

  https://www.dovepress.com/excoriation-skin-picking-disorder-a-systematic-review-of-treatment-opt-peer-reviewed-fulltext-article-NDT

  Excoriation (skin-picking) disorder (ED), also known as dermatillomania, psychogenic excoriation, or neurotic excoriation, is characterized by recurrent picking of skin, leading to skin lesions and significant distress or functional impairment. […] Dermatological conditions such as acne or eczema often trigger the onset of ED. Skin-picking triggers can be multiple, and may vary across individuals, but include emotions such as stress, anger, and anxiety, sedentary activities such as watching television and reading, and boredom and feeling tired. […] The severity of skin-picking ranges from mild to severe; in subclinical cases, intervention may not be needed, whereas when diagnostic criteria for ED are met, treatment is indicated. […] It has been suggested that less than a fifth of patients seek treatment for their skin-picking.

• #89 Excoriation (skin-picking) disorder: a systematic review of treatment | NDT

  https://www.dovepress.com/excoriation-skin-picking-disorder-a-systematic-review-of-treatment-opt-peer-reviewed-fulltext-article-NDT

  Excoriation (skin-picking) disorder (ED), also known as dermatillomania, psychogenic excoriation, or neurotic excoriation, is characterized by recurrent picking of skin, leading to skin lesions and significant distress or functional impairment. […] Dermatological conditions such as acne or eczema often trigger the onset of ED. Skin-picking triggers can be multiple, and may vary across individuals, but include emotions such as stress, anger, and anxiety, sedentary activities such as watching television and reading, and boredom and feeling tired. […] The severity of skin-picking ranges from mild to severe; in subclinical cases, intervention may not be needed, whereas when diagnostic criteria for ED are met, treatment is indicated. […] It has been suggested that less than a fifth of patients seek treatment for their skin-picking.

• #90

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=acm2897

  Skin picking (excoriation) disorder is a mental health condition. […] This condition is related to obsessive-compulsive disorder. But it can also be seen with other conditions. Stress, anxiety, and anger can make skin picking worse. Some people may also pick at their skin when they’re bored or tired.

• #91 Excoriation (Skin Picking) Disorder: What Is It?

  https://www.healthline.com/health/skin-disorders/excoriation

  Skin-picking disorder is classified as a type of OCD. The compulsive urge to pick is often too powerful for many people to stop on their own. The more a person picks at their skin, the less control they have over the behavior. […] It’s unclear what causes a person to develop this disorder. […] The disorder often begins after one of two events or stimuli: An infection, injury, or wound starts healing and creates a scab. The itching causes the person to scratch and pick. The new wound or lesion starts to heal and creates another scab. That begins the cycle of picking. […] The behavior is a stress relief habit during a time of stress. The repetitive action and control that skin picking gives may provide relief from other events that can’t be controlled. […] Skin-picking disorder occurs in both children and adults. It can begin at almost any age, but it typically appears first in adolescence or at the onset of puberty. Women are more likely to develop it than men.

• #92 Skin Picking Disorder (aka. Excoriation Disorder) : Ottawa-Carleton, ON : eMentalHealth.ca

  https://primarycare.ementalhealth.ca/Ottawa-Carleton/Skin-Picking-Disorder-aka-Excoriation-Disorder/index.php?m=article&ID=52635

  Skin picking disorder (also known as excoriation disorder) is a condition where a person picks their skin over and over again, to the point where it can cause infection and scarring of the skin, and it causes distress and problems with school, work, home and other activities. […] The exact causes are not known, however: People often report that the skin picking started after an infection or injury to their skin, and after that, they had a scab that they began to pick. […] Stress with work, school or relationships can make skin picking worse.

• #93 Dermatillomania (Skin Picking): Symptoms & Treatment

  https://www.jagrutirehab.org/disorder/dermatillomania-skin-picking-disorder.html

  Excoriation disorder is a psychological condition in which a patient has a compulsive urge to pick or scratch the skin. The disorder is categorised under Obsessive Compulsive Disorder (OCD) and usually stems from stress, anxiety, or other kinds of emotional triggers. […] Dermatillomania is related to physiological changes in the brain, which makes it more than a simple bad habit. […] This disorder is an impulse control disorder and is categorised under OCD. Therefore, picking skin can cause skin problems, but skin problems do not cause dermatillomania. […] Excoriation disorder can be caused by many reasons. Here is a comprehensive list of reasons: […] Skin picking can casually start as a gradual response to having a rash or an injury. The itching or discomfort during healing may lead to picking at these scars, causing new wounds. This creates a cycle of picking, bleeding, and scab formation, making it a habitual behaviour.

• #94 Excoriation (skin-picking) disorder: a systematic review of treatment | NDT

  https://www.dovepress.com/excoriation-skin-picking-disorder-a-systematic-review-of-treatment-opt-peer-reviewed-fulltext-article-NDT

  Excoriation (skin-picking) disorder (ED), also known as dermatillomania, psychogenic excoriation, or neurotic excoriation, is characterized by recurrent picking of skin, leading to skin lesions and significant distress or functional impairment. […] Dermatological conditions such as acne or eczema often trigger the onset of ED. Skin-picking triggers can be multiple, and may vary across individuals, but include emotions such as stress, anger, and anxiety, sedentary activities such as watching television and reading, and boredom and feeling tired. […] The severity of skin-picking ranges from mild to severe; in subclinical cases, intervention may not be needed, whereas when diagnostic criteria for ED are met, treatment is indicated. […] It has been suggested that less than a fifth of patients seek treatment for their skin-picking.

• #95 What is Excoriation (Skin Picking) Disorder? — Talkspace

  https://www.talkspace.com/mental-health/conditions/excoriation-disorder/

  Excoriation disorder, commonly known as the skin picking disorder, is a psychiatric condition that is characterized by the repetitive and sometimes aggressive picking of ones own skin. […] While skin picking disorder hasnt been linked to a specific cause, several factors make people more likely to develop it. […] Skin conditions, such as acne or eczema, are potential triggers for the onset of excoriation disorder symptoms. […] Excoriation disorder is related to the compulsive behavior of picking at your skin. There are several theories of what can cause this diagnosis. […] People may begin picking at their skin in response to various emotions, such as anxiety, anger, or boredom. […] Research shows a link between excoriation disorder occurring comorbidly with other mental health conditions.

• #96 Excoriation (Skin-Picking) Disorder | Abnormal Psychology

  https://courses.lumenlearning.com/wm-abnormalpsych/chapter/excoriation-skin-picking-disorder/

  Clinical studies have posited that there is a strong link between traumatic childhood events and excoriation disorder. […] Studies have shown a linkage between dopamine and the urge to pick. […] There may be another neurological explanation for excoriation disorder: individuals with the condition have less motor-inhibitory control, but show no sign of difference in cognitive flexibility, when compared to individuals without the condition. […] In some patients, excoriation disorder begins with the onset of acne in adolescence, but the compulsion continues even after the acne has gone away. Skin conditions such as keratosis pilaris, psoriasis, and eczema can also provoke the behavior. […] Certain stressful events including marital conflicts, deaths of friends or family, and unwanted pregnancies have been linked to the onset of the condition. […] Traumatic childhood events may initiate the behavior.

• #97 Dermatillomania: Understand The Risks Of Skin-Picking | The Well by Northwell

  https://thewell.northwell.edu/skin-health/skin-picking-disorder

  Excoriation disordermore commonly known as dermatillomania or skin picking disorder (SPD)is a mental disorder classified as part of the obsessive-compulsive disorder spectrum. […] Although the expression of dermatillomania is physical, Septon reiterates that its often due to underlying mental or emotional triggers. It often starts subconsciously with patients picking at their skin as a sublimation of their anxiety or other uncomfortable emotions. […] Instead of processing the emotion, they engage in compulsive manipulation of the skin, says Septon. […] However, while skin picking is predominantly a mental disorder, Septon explains there are cases which have purely physical causes. […] For some, the scratching becomes not enough, and can trigger the urge to pick and further injure the skin. In these cases things can progress to compulsive picking.

• #98 Reddit – The heart of the internet

  https://www.reddit.com/r/Dermatillomania/comments/11saef8/why_do_you_pick_your_skin/

  Whenever I research 'skin picking disorder’ I often see the same causes; anxiety, boredom, stress, etc. […] For me, it’s a mixture of the following reasons: […] I don’t like the feeling of texture on my skin. My mind genuinely believes that removing the scab is 'better’ because it means the surface will be soft and smooth again. […] I find it very satisfying to pick off scabs. Since I’ve had eczema and dermotillomania for +20 years, you eventually become familiar with what each scab looks like and how it would feel to remove it. I shamefully do have 'favourite’ scabs to remove.

• #99 Dermatillomania: A Case Report and Literature Review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7910222/

  Certain syndromes such as Prader- Willi syndrome, Lesch-Nyhan syndrome, Smith-Magenis syndrome and Tourette syndrome are also reported to be associated. […] Dermatillomania has been associated with OCDs, body dysmorphic disorders, trichotillomania and anxiety. […] There are multiple triggers involved that cause skin picking or dermatillomania, including stress, anxiety, anger, boredom and even the sense of unevenness of the skin or skin discoloration. […] Patients describe uncontrollable pruritus before a skin picking episode; however, some patients also report skin sensations such as warmth, burning, pain and dryness. […] Continuous picking eventually leads to lesions in various stages of healing along with post-inflammatory hyperpigmentation and scarring. […] Treatment of dermatillomania is a multipronged approach and should include the treatment of the underlying disease, treatment for pruritus, treatment of the underlying psychiatric illness and topical treatment of the lesions.

• #100 Compulsive skin picking, neurotic excoriations

  https://dermnetnz.org/topics/compulsive-skin-picking

  Individuals with compulsive skin picking often have a co-existing psychiatric disorder. The most common co-existing psychiatric conditions are major depression and anxiety disorders, especially obsessive-compulsive disorder (OCD). In one study, 52% of patients with compulsive skin picking were also diagnosed with OCD. […] An organic disease such as anaemia, uraemia or liver disease may also cause compulsive skin picking. It is essential for the doctor to consider all possible causes. […] In many sufferers of compulsive skin picking, skin picking is preceded or accompanied by a high level of tension, anxiety or stress and a strong urge to itch or scratch. Often certain events or situations trigger skin-picking episodes. For some, the act of skin picking provides a feeling of relief or pleasure. Skin-picking episodes can be a conscious response to anxiety or may be done as an unconscious habit. […] Compulsive skin picking appears to be more common in women than in men, and often starts in adolescence. […] It may also be associated with methamphetamine or cocaine abuse.

• #101 Drugs That Cause Skin Picking: Treatment & Prevention

  https://www.verywellhealth.com/drugs-that-cause-skin-picking-treatment-and-prevention-5498681

  Skin picking occurs when a person repeatedly picks at their skin, causing damage to the tissue. […] Misuse of certain drugs can result in skin picking as well. This is because some drugs, including both recreational (or illicit) drugs and prescription drugs, cause skin picking as a side effect. […] Skin-picking disorder is known as excoriation or dermatillomania, and it is a mental disorder on its own—not just something that happens because of drug use. […] Ongoing methamphetamine use, particularly methamphetamine-induced psychosis, can cause a neurological symptom in which the user feels the sensation of bugs crawling on or under the skin (also known as „meth mites”). […] Cocaine use, particularly cocaine-induced psychosis, can also cause the sensation of bugs crawling on or under the skin (also known as „coke bugs” or formication).

• #102 Drugs That Cause Skin Picking: Treatment & Prevention

  https://www.verywellhealth.com/drugs-that-cause-skin-picking-treatment-and-prevention-5498681

  Skin picking occurs when a person repeatedly picks at their skin, causing damage to the tissue. […] Misuse of certain drugs can result in skin picking as well. This is because some drugs, including both recreational (or illicit) drugs and prescription drugs, cause skin picking as a side effect. […] Skin-picking disorder is known as excoriation or dermatillomania, and it is a mental disorder on its own—not just something that happens because of drug use. […] Ongoing methamphetamine use, particularly methamphetamine-induced psychosis, can cause a neurological symptom in which the user feels the sensation of bugs crawling on or under the skin (also known as „meth mites”). […] Cocaine use, particularly cocaine-induced psychosis, can also cause the sensation of bugs crawling on or under the skin (also known as „coke bugs” or formication).

• #103 Drugs That Cause Skin Picking: Treatment & Prevention

  https://www.verywellhealth.com/drugs-that-cause-skin-picking-treatment-and-prevention-5498681

  Heroin use releases histamines in the body—leading to feelings of extreme itchiness. […] Some prescription medications can cause skin picking as a side effect. A common example is stimulant medications used for attention deficit hyperactivity disorder (ADHD) treatment. […] If skin picking is due to drug use and/or misuse, seeing your healthcare provider is necessary to find the right support and treatment. […] Treatment for skin picking will depend on the cause. […] Avoiding or stopping using the drugs that cause skin picking is a way to prevent skin picking in the future. […] Skin picking can be caused by consuming substances like methamphetamines, cocaine, heroin, and even prescription medications taken as directed.

• #104 Drugs That Cause Skin Picking: Treatment & Prevention

  https://www.verywellhealth.com/drugs-that-cause-skin-picking-treatment-and-prevention-5498681

  Heroin use releases histamines in the body—leading to feelings of extreme itchiness. […] Some prescription medications can cause skin picking as a side effect. A common example is stimulant medications used for attention deficit hyperactivity disorder (ADHD) treatment. […] If skin picking is due to drug use and/or misuse, seeing your healthcare provider is necessary to find the right support and treatment. […] Treatment for skin picking will depend on the cause. […] Avoiding or stopping using the drugs that cause skin picking is a way to prevent skin picking in the future. […] Skin picking can be caused by consuming substances like methamphetamines, cocaine, heroin, and even prescription medications taken as directed.

• #105 Compulsive Skin Picking – Therapy & Counseling for OCD & Eating Disorders

  https://kimberleyquinlan-lmft.com/compulsive-skin-picking/

  There is no one exact cause of Excoriation disorder. However, one important step of learning how to stop picking your skin involves identifying the stressors and triggers that cause your urges. […] Common reasons people engage in skin picking, lip biting, and nail biting include: As a response to stress, anxiety, or panic […] Some medication can cause the onset of these symptoms. For those who are on medication for ADD or ADHD skin picking may be the result. […] Some may also engage in OCD skin picking. OCD Skin Picking involves skin picking that is done as a compulsion to remove the anxiety, uncertainty, doubt or disgust.

• #106 Excoriation Disorder/ Dermatillomania/ Skin-picking Disorder: Symptoms, Causes, and Treatment – Los Angeles Outpatient Center

  https://laopcenter.com/mental-health/disorder/skin-picking/

  Environmental factors are external influences that can contribute to developing and maintaining excoriation disorder. These include a history of abuse or neglect, peer pressure, societal beauty standards, and media influence. […] Therefore, combining these factors plays a role in the development of excoriation disorder. It is essential to understand that this disorder is not caused by personal weakness or character flaws but rather by a complex interplay of biological, psychological, and environmental factors.

• #107 Dermatillomania (Skin Picking): Symptoms & Treatment

  https://www.jagrutirehab.org/disorder/dermatillomania-skin-picking-disorder.html

  At certain times, picking skin is a coping mechanism, as it is a way to expend ones energy to release the stress within. […] Patients who feel they do not look perfect might resort to skin-picking to fix those issues. […] People who have ancestors who were suffering from any kind of OCD are more susceptible to suffering from excoriation disorder. […] Other mental health conditions like depression, anxiety, and stress can also make a person pick at his skin as a way to relieve stress.

• #108 Compulsive skin picking causes and how to stop

  https://www.treatmyocd.com/blog/compulsive-skin-picking

  Compulsive skin picking isn’t just a bad habit; it can be part of a cycle that temporarily eases distress but ultimately leads to more frustration and skin damage. […] Skin picking disorder, also known as excoriation disorder or dermatillomania, is a mental health condition characterized by compulsive picking, squeezing, or scratching areas of your skin, such as scabs or pimples. […] Skin picking disorder is a body-focused repetitive behavior (BFRB), which are a group of disorders that involve self-grooming to the point of causing significant damage. […] You might engage in BFRBs like compulsive skin picking for various reasons. Some people might pick their skin in response to anxiety or stress, while others may pick to fill a void. […] Compulsive skin picking can be an effect of an obsession with your appearance, as you might pick at perceived flaws in your skin.

• #109 What Is Excoriation Disorder? Stop Compulsive Skin Picking!

  https://counselingnow.com/excoriation-disorder/

  Some evidence shows that excoriation disorder, like any form of obsessive-compulsive disorder, may be linked to genetics. Alternatively, it might be related to one’s upbringing at home. For instance, growing up in a household where nail biting is tolerated, kids may deem the behavior normal and adopt it as they grow up.

• #110 Excoriation Disorder (skin picking disorder) | OCD-UK

  https://www.ocduk.org/related-disorders/skin-picking/

  Skin Picking Disorder is frequently linked to Obsessive-Compulsive Disorder, partly because of the compulsive similarities between the two which may be why Excoriation Disorder, to give it is formal name, is actually listed as a sub-category in both the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM) clinical classification manuals under the main heading of Obsessive Compulsive and Related Disorders. […] It is thought that those with excoriation disorder and skin picking problems often also have OCD, and for some this may be the case. […] Whereas OCD is considered an anxiety disorder, arguably skin picking is more of an impulse control disorder. So whilst there are some compulsive and ritualistic similarities between the two there are also important differences. Primarily, OCD is driven by unwanted intrusive thoughts (the obsessions), for example fears of bad things happening where the compulsions are carried out in an attempt to prevent bad things happening. Whereas skin picking is characterised primarily by body-focused repetitive behaviour (skin picking) to reduce tension/stress, rather than being initiated by an unwanted intrusive thought.

• #111 Excoriation Disorder (skin picking disorder) | OCD-UK

  https://www.ocduk.org/related-disorders/skin-picking/

  Skin Picking Disorder is frequently linked to Obsessive-Compulsive Disorder, partly because of the compulsive similarities between the two which may be why Excoriation Disorder, to give it is formal name, is actually listed as a sub-category in both the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM) clinical classification manuals under the main heading of Obsessive Compulsive and Related Disorders. […] It is thought that those with excoriation disorder and skin picking problems often also have OCD, and for some this may be the case. […] Whereas OCD is considered an anxiety disorder, arguably skin picking is more of an impulse control disorder. So whilst there are some compulsive and ritualistic similarities between the two there are also important differences. Primarily, OCD is driven by unwanted intrusive thoughts (the obsessions), for example fears of bad things happening where the compulsions are carried out in an attempt to prevent bad things happening. Whereas skin picking is characterised primarily by body-focused repetitive behaviour (skin picking) to reduce tension/stress, rather than being initiated by an unwanted intrusive thought.

• #112 Excoriation Disorder (skin picking disorder) | OCD-UK

  https://www.ocduk.org/related-disorders/skin-picking/

  There are many other differences too: There are not always obsessions in skin picking. Compulsions in OCD are usually carried out to prevent harm, where in skin picking they’re done to reduce tension/stress (sometimes to reduce/prevent blemishes) or because of guilt. In OCD the obsessions and compulsions can be about a huge range of worries and topics, whereas skin picking is almost always about tension and/or appearance.

• #113 Excoriation Disorder (skin picking disorder) | OCD-UK

  https://www.ocduk.org/related-disorders/skin-picking/

  There are many other differences too: There are not always obsessions in skin picking. Compulsions in OCD are usually carried out to prevent harm, where in skin picking they’re done to reduce tension/stress (sometimes to reduce/prevent blemishes) or because of guilt. In OCD the obsessions and compulsions can be about a huge range of worries and topics, whereas skin picking is almost always about tension and/or appearance.

• #114 Excoriation Disorder (skin picking disorder) | OCD-UK

  https://www.ocduk.org/related-disorders/skin-picking/

  There are many other differences too: There are not always obsessions in skin picking. Compulsions in OCD are usually carried out to prevent harm, where in skin picking they’re done to reduce tension/stress (sometimes to reduce/prevent blemishes) or because of guilt. In OCD the obsessions and compulsions can be about a huge range of worries and topics, whereas skin picking is almost always about tension and/or appearance.

• #115 Excoriation Disorder (skin picking disorder) | OCD-UK

  https://www.ocduk.org/related-disorders/skin-picking/

  Skin Picking Disorder is frequently linked to Obsessive-Compulsive Disorder, partly because of the compulsive similarities between the two which may be why Excoriation Disorder, to give it is formal name, is actually listed as a sub-category in both the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM) clinical classification manuals under the main heading of Obsessive Compulsive and Related Disorders. […] It is thought that those with excoriation disorder and skin picking problems often also have OCD, and for some this may be the case. […] Whereas OCD is considered an anxiety disorder, arguably skin picking is more of an impulse control disorder. So whilst there are some compulsive and ritualistic similarities between the two there are also important differences. Primarily, OCD is driven by unwanted intrusive thoughts (the obsessions), for example fears of bad things happening where the compulsions are carried out in an attempt to prevent bad things happening. Whereas skin picking is characterised primarily by body-focused repetitive behaviour (skin picking) to reduce tension/stress, rather than being initiated by an unwanted intrusive thought.

• #116 Excoriation Disorder: Assessment, Diagnosis and Treatment – The Professional Counselor

  https://tpcjournal.nbcc.org/excoriation-disorder-assessment-diagnosis-and-treatment/

  Another common theory regarding the onset and maintenance of excoriation disorder is that skin picking behaviors can help regulate emotions and can become a behaviorally-reinforced coping mechanism used to manage elevated levels of anxiety, stress and arousal. Individuals who skin pick often display elevated stress responses to normal stimuli, and skin picking appears to temporarily soothe such stress. Additionally, obsessive thoughts about skin imperfections and anxiety over not picking can be temporarily relieved by completing the behaviors. As such, there is a behavioral component in addition to the genetic and biological components of the disorder that must be considered when understanding the etiology, assessment, diagnosis and treatment of excoriation disorder.

• #117 Skin Picking Disorder Test (Dermatillomania)

  https://peachtreewellnessmh.com/online-mental-health-assessments/skin-picking-disorder-test/

  Psychological Factors: Perfectionism, anxiety sensitivity, and body-focused awareness often underlie picking behaviors. Many individuals report that skin picking temporarily reduces negative emotions, creating a reinforcement cycle that strengthens the behavior pattern over time. The disorder may function as a maladaptive self-soothing mechanism or emotion regulation strategy. […] Comorbid Conditions: Excoriation Disorder frequently co-occurs with other mental health conditions, including anxiety disorders, depression, OCD, body dysmorphic disorder, and trichotillomania. These conditions may share underlying mechanisms and can exacerbate skin picking behaviors. […] Understanding the multifaceted nature of Excoriation Disorder is essential for developing comprehensive treatment approaches.

• #118 Excoriation Disorder: Assessment, Diagnosis and Treatment – The Professional Counselor

  https://tpcjournal.nbcc.org/excoriation-disorder-assessment-diagnosis-and-treatment/

  Another common theory regarding the onset and maintenance of excoriation disorder is that skin picking behaviors can help regulate emotions and can become a behaviorally-reinforced coping mechanism used to manage elevated levels of anxiety, stress and arousal. Individuals who skin pick often display elevated stress responses to normal stimuli, and skin picking appears to temporarily soothe such stress. Additionally, obsessive thoughts about skin imperfections and anxiety over not picking can be temporarily relieved by completing the behaviors. As such, there is a behavioral component in addition to the genetic and biological components of the disorder that must be considered when understanding the etiology, assessment, diagnosis and treatment of excoriation disorder.

• #119 Skin Picking Disorder Test (Dermatillomania)

  https://peachtreewellnessmh.com/online-mental-health-assessments/skin-picking-disorder-test/

  Psychological Factors: Perfectionism, anxiety sensitivity, and body-focused awareness often underlie picking behaviors. Many individuals report that skin picking temporarily reduces negative emotions, creating a reinforcement cycle that strengthens the behavior pattern over time. The disorder may function as a maladaptive self-soothing mechanism or emotion regulation strategy. […] Comorbid Conditions: Excoriation Disorder frequently co-occurs with other mental health conditions, including anxiety disorders, depression, OCD, body dysmorphic disorder, and trichotillomania. These conditions may share underlying mechanisms and can exacerbate skin picking behaviors. […] Understanding the multifaceted nature of Excoriation Disorder is essential for developing comprehensive treatment approaches.

• #120 Excoriation (Skin-Picking) Disorder – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/obsessive-compulsive-and-related-disorders/excoriation-skin-picking-disorder

  Patients with excoriation disorder repeatedly pick at or scratch their skin; the picking is not triggered by appearance or health concerns (eg, to remove a lesion that they perceive as unattractive or possibly cancerous). […] However, the skin picking may be preceded by a feeling of tension or anxiety that is relieved by the picking, which often is also accompanied by a feeling of gratification. […] Many people with excoriation disorder also have other mental health disorders, such as obsessive-compulsive disorder or major depressive disorder. […] In excoriation (skin-picking) disorder, skin picking is not triggered by obsessions or concerns about appearance but may be preceded by a feeling of tension or anxiety that is relieved by the skin picking, often followed by a feeling of gratification.

• #121 Prevalence of and Risk Factors for Skin Picking Disorder Symptoms Among Adults in an Arab Middle Eastern Population: A Cross-Sectional Study

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9725924/

  Skin Picking Disorder (SPD) is a skin-related disease, also recognized as psychogenic excoriation, dermatillomania, or excoriation disorder. SPD is defined as a habitual picking of skin, which in turn harms skin tissue. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has formally classified SPD as a category of obsessive-compulsive (OCD) related disorder. SPD has been of particular interest to researchers because of the recent attention this disorder has received as well as its relatively high prevalence, morbidity, and comorbidity. Studies in community samples indicate that skin picking is common and often occurs in conjunction with other psychiatric disorders. Initially, its occurrence is focused and conscious, which after a certain time, becomes automatic and unconscious. This progression is similar to the features of grooming disorder and trichotillomania. In addition, SPD should be approached as a heterogenous spectrum in terms of presentation. Skin picking is usually triggered by stress, boredom, anxiety, or physical sensations (unevenness of the skin). Difficulties with emotional regulation and reactivity have also been shown to escalate picking behavior to control anxiety, depression, and other disturbing emotions.

• #122 Compulsive skin picking causes and how to stop

  https://www.treatmyocd.com/blog/compulsive-skin-picking

  Compulsive skin picking isn’t just a bad habit; it can be part of a cycle that temporarily eases distress but ultimately leads to more frustration and skin damage. […] Skin picking disorder, also known as excoriation disorder or dermatillomania, is a mental health condition characterized by compulsive picking, squeezing, or scratching areas of your skin, such as scabs or pimples. […] Skin picking disorder is a body-focused repetitive behavior (BFRB), which are a group of disorders that involve self-grooming to the point of causing significant damage. […] You might engage in BFRBs like compulsive skin picking for various reasons. Some people might pick their skin in response to anxiety or stress, while others may pick to fill a void. […] Compulsive skin picking can be an effect of an obsession with your appearance, as you might pick at perceived flaws in your skin.

• #123 Compulsive skin picking causes and how to stop

  https://www.treatmyocd.com/blog/compulsive-skin-picking

  Compulsive skin picking isn’t just a bad habit; it can be part of a cycle that temporarily eases distress but ultimately leads to more frustration and skin damage. […] Skin picking disorder, also known as excoriation disorder or dermatillomania, is a mental health condition characterized by compulsive picking, squeezing, or scratching areas of your skin, such as scabs or pimples. […] Skin picking disorder is a body-focused repetitive behavior (BFRB), which are a group of disorders that involve self-grooming to the point of causing significant damage. […] You might engage in BFRBs like compulsive skin picking for various reasons. Some people might pick their skin in response to anxiety or stress, while others may pick to fill a void. […] Compulsive skin picking can be an effect of an obsession with your appearance, as you might pick at perceived flaws in your skin.

• #124 White Matter Abnormalities in Skin Picking Disorder: A Diffusion Tensor Imaging Study | Neuropsychopharmacology

  https://www.nature.com/articles/npp2012241

  The current data implicate disconnectivity in white-matter tracts connecting neural regions involved in motor generation and suppression. […] These findings add considerable support to the notion that in addition to the phenomenological and comorbid overlap between SPD and trichotillomania, these disorders likely share overlapping neurobiology. […] The aim of this study was to assess the integrity of white-matter tracts in subjects with SPD compared with healthy control subjects. […] It was hypothesized that SPD would be associated with reduced fractional anisotropy (FA), thought to be characteristic of disorganized and/or damaged white-matter tracts, in regions implicated in top-down response suppression and in trichotillomania. […] The key finding was that SPD was associated with reduced integrity of distributed white-matter tracts connecting the anterior cingulate cortices to other neural nodes bilaterally. […] Future work should use diffusion tensor imaging in conjunction with functional imaging to explore the relationship between white-matter tract disorganization and dysfunction of particular nodes within the networks responsible for habit suppression.

• #125 White Matter Abnormalities in Skin Picking Disorder: A Diffusion Tensor Imaging Study | Neuropsychopharmacology

  https://www.nature.com/articles/npp2012241

  Skin picking disorder (SPD) is characterized by the repetitive and compulsive picking of skin, resulting in tissue damage. […] Neurocognitive findings in SPD implicate difficulty with response inhibition (suppression of pre-potent motor responses). […] It was hypothesized that SPD would be associated with reduced fractional anisotropy in regions implicated in top-down response suppression, particularly white-matter tracts in proximity of the bilateral anterior cingulate and right frontal (especially orbitofrontal and inferior frontal) cortices. […] These findings implicate disorganization of white-matter tracts involved in motor generation and suppression in the pathophysiology of SPD, findings remarkably similar to those previously reported in trichotillomania. […] Given this overlapping familiality between SPD and trichotillomania, and that these conditions are associated with pathological habits that are difficult to suppress, it has been suggested that SPD can be viewed as a pathological grooming disorder alongside trichotillomania.

• #126 Prevalence of and Risk Factors for Skin Picking Disorder Symptoms Among Adults in an Arab Middle Eastern Population: A Cross-Sectional Study

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9725924/

  Skin Picking Disorder (SPD) is a skin-related disease, also recognized as psychogenic excoriation, dermatillomania, or excoriation disorder. SPD is defined as a habitual picking of skin, which in turn harms skin tissue. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has formally classified SPD as a category of obsessive-compulsive (OCD) related disorder. SPD has been of particular interest to researchers because of the recent attention this disorder has received as well as its relatively high prevalence, morbidity, and comorbidity. Studies in community samples indicate that skin picking is common and often occurs in conjunction with other psychiatric disorders. Initially, its occurrence is focused and conscious, which after a certain time, becomes automatic and unconscious. This progression is similar to the features of grooming disorder and trichotillomania. In addition, SPD should be approached as a heterogenous spectrum in terms of presentation. Skin picking is usually triggered by stress, boredom, anxiety, or physical sensations (unevenness of the skin). Difficulties with emotional regulation and reactivity have also been shown to escalate picking behavior to control anxiety, depression, and other disturbing emotions.

• #127 Excoriation disorder – Wikipedia

  https://en.wikipedia.org/wiki/Excoriation_disorder

  Excoriation disorder, more commonly known as dermatillomania, is a mental disorder on the obsessive-compulsive spectrum that is characterized by the repeated urge or impulse to pick at one’s own skin, to the extent that either psychological or physical damage is caused. The exact causes of this disorder are unclear but are believed to involve a combination of genetic, psychological, and environmental factors, including stress and underlying mental health conditions such as anxiety or obsessive-compulsive disorder (OCD). […] A common hypothesis is that excoriation disorder is often a coping mechanism to deal with elevated levels of turmoil, boredom, anxiety, or stress within the individual, and that the individual has an impaired stress response. […] There is limited knowledge regarding the neurobiology that drives excoriation disorder, and there have been few neuroimaging studies of those with excoriation disorder. […] Studies have shown a linkage between dopamine and the urge to pick. […] There is significant evidence to suggest that skin picking disorders are due to inherited traits or genes.

• #128 Excoriation Disorder/ Dermatillomania/ Skin-picking Disorder: Symptoms, Causes, and Treatment – Los Angeles Outpatient Center

  https://laopcenter.com/mental-health/disorder/skin-picking/

  Environmental factors are external influences that can contribute to developing and maintaining excoriation disorder. These include a history of abuse or neglect, peer pressure, societal beauty standards, and media influence. […] Therefore, combining these factors plays a role in the development of excoriation disorder. It is essential to understand that this disorder is not caused by personal weakness or character flaws but rather by a complex interplay of biological, psychological, and environmental factors.

• #129 International OCD Foundation | What is Skin Picking Disorder?

  https://iocdf.org/about-ocd/related-disorders/skin-picking-disorder/

  Skin picking disorder (or „Excoriation”) is a disorder where a person: […] The exact causes of skin picking disorder are unknown. It may be that both biological and environmental factors play a role in skin picking disorder. […] Skin picking disorder is currently classified as an impulse control disorder. Skin picking disorder is also sometimes referred to as a “body focused repetitive behavior.” It is also sometimes referred to as an “obsessive compulsive spectrum disorder” (or “OC spectrum disorder”) because it shares features of OCD.

• #130 Excoriation Disorder/ Dermatillomania/ Skin-picking Disorder: Symptoms, Causes, and Treatment – Los Angeles Outpatient Center

  https://laopcenter.com/mental-health/disorder/skin-picking/

  Dermatillomania is diagnosed based on the individuals symptoms and behavior patterns. A mental health professional will conduct an evaluation and use criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to make a diagnosis. […] The exact cause of Dermatillomania is unknown but linked to genetic, environmental, and psychological factors; according to Okumu, H. G., Akdemir, Ds 2023 study about Body-Focused Repetitive Behavior Disorders, individuals with a family history of obsessive-compulsive disorder (OCD) or body-focused repetitive behaviors (BFRBs) may have a higher risk of developing this disorder. […] The causes of excoriation disorder are biological and are categorized into three main factors: biological, psychological, and environmental, according to Farhat LC et al.s 2023 review titled A Systematic Review and Meta-Analysis, published in the Journal of Psychiatry.

• #131 Excoriation Disorder/ Dermatillomania/ Skin-picking Disorder: Symptoms, Causes, and Treatment – Los Angeles Outpatient Center

  https://laopcenter.com/mental-health/disorder/skin-picking/

  Biological factors are the factors that directly influence the development of excoriation disorder. These factors include genetics, neuroimaging, and neurotransmitter abnormalities. According to Okan Ibilolu A et al.s 2016 study A Case of Skin Picking Disorder of a Patient with a History of Childhood Abuse, published in the Archives of Neuropsychiatry Journal, individuals with a family history of excoriation disorder are more likely to develop the disorder themselves. […] Psychological factors refer to the mental and emotional aspects that may contribute to the development of excoriation disorder. These include underlying mental health issues such as anxiety, OCD, or depression, as reviewed by Murayama Ks 2020 study titled Impacts of Stressful Life Events and Traumatic Experiences on Onset of Obsessive-Compulsive Disorder, published in the Front Psychiatry Journal, traumatic experiences or stressful life events trigger the onset of excoriation disorder in some individuals.

• #132 Excoriation (Skin-Picking) Disorder | Abnormal Psychology

  https://courses.lumenlearning.com/wm-abnormalpsych/chapter/excoriation-skin-picking-disorder/

  Excoriation disorder is an obsessive-compulsive spectrum disorder that is characterized by the repeated urge or impulse to pick at ones own skin to the extent that either psychological or physical damage is caused. […] Episodes of skin picking are often preceded or accompanied by tension, anxiety, or stress. In some cases, following picking, the affected person may feel depressed. […] Skin picking often occurs as a result of some other triggering cause. Some common triggers are feeling or examining irregularities on the skin and feeling anxious or other negative feelings. […] There have been many different theories regarding the causes of excoriation disorder including biological and environmental factors. A common hypothesis is that excoriation disorder is often a coping mechanism to deal with elevated levels of turmoil, arousal, or stress within the individual, and that the individual has an impaired stress response.

• #133 Excoriation (Skin Picking) Disorder: What Is It?

  https://www.healthline.com/health/skin-disorders/excoriation

  Skin-picking disorder is classified as a type of OCD. The compulsive urge to pick is often too powerful for many people to stop on their own. The more a person picks at their skin, the less control they have over the behavior. […] It’s unclear what causes a person to develop this disorder. […] The disorder often begins after one of two events or stimuli: An infection, injury, or wound starts healing and creates a scab. The itching causes the person to scratch and pick. The new wound or lesion starts to heal and creates another scab. That begins the cycle of picking. […] The behavior is a stress relief habit during a time of stress. The repetitive action and control that skin picking gives may provide relief from other events that can’t be controlled. […] Skin-picking disorder occurs in both children and adults. It can begin at almost any age, but it typically appears first in adolescence or at the onset of puberty. Women are more likely to develop it than men.

• #134 Picking your skin? Learn four tips to break the habit – Harvard Health

  https://www.health.harvard.edu/blog/picking-your-skin-learn-four-tips-to-break-the-habit-2018112815447

  If you cant stop picking your skin, you may have a very common condition called skin picking disorder (SPD). […] A diagnosis of SPD, also known as excoriation disorder, is made when there are repeated attempts to stop picking, and the skin picking is either distressing or interfering with social or work functioning. […] SPD is one of a group of disorders that is related to obsessive-compulsive disorder (OCD). […] Understanding your triggers can be a first step in deciding which treatments to pursue. […] If, however, your picking is triggered by depression, anxiety, or more of an urge, you should consult with a mental health professional with expertise in skin picking. […] A specialized type of CBT has been developed for SPD. […] Clinical trials have demonstrated that skin-picking for CBT can be extremely effective. […] While no medication has been formally approved by the FDA to treat excoriation disorder, there is evidence to suggest that selective serotonin reuptake inhibitor (SSRI) antidepressants and N-acetylcysteine (NAC), an antioxidant supplement, can be helpful.

• #135 Excoriation (skin-picking) disorder: a systematic review of treatment | NDT

  https://www.dovepress.com/excoriation-skin-picking-disorder-a-systematic-review-of-treatment-opt-peer-reviewed-fulltext-article-NDT

  In terms of treatment, there is a paucity of data. Nevertheless, management currently relies on a comprehensive psychiatric examination, behavioral therapy, and medication. […] The literature systematically reviewed here, and previous meta-analyses, emphasize the relatively sparse evidence base, but also point to the benefit of behavioral treatments. […] SSRIs have been a mainstay of pharmacotherapy, but there is now evidence from a RCT that NAC should also be considered as a potential intervention.

• #136 White Matter Abnormalities in Skin Picking Disorder: A Diffusion Tensor Imaging Study | Neuropsychopharmacology

  https://www.nature.com/articles/npp2012241

  The current data implicate disconnectivity in white-matter tracts connecting neural regions involved in motor generation and suppression. […] These findings add considerable support to the notion that in addition to the phenomenological and comorbid overlap between SPD and trichotillomania, these disorders likely share overlapping neurobiology. […] The aim of this study was to assess the integrity of white-matter tracts in subjects with SPD compared with healthy control subjects. […] It was hypothesized that SPD would be associated with reduced fractional anisotropy (FA), thought to be characteristic of disorganized and/or damaged white-matter tracts, in regions implicated in top-down response suppression and in trichotillomania. […] The key finding was that SPD was associated with reduced integrity of distributed white-matter tracts connecting the anterior cingulate cortices to other neural nodes bilaterally. […] Future work should use diffusion tensor imaging in conjunction with functional imaging to explore the relationship between white-matter tract disorganization and dysfunction of particular nodes within the networks responsible for habit suppression.

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