Materiały źródłowe

• #1 Trichotillomania and Skin-Picking Disorder: An Update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9063575/

  Trichotillomania (hair pulling disorder) and skin-picking (excoriation) disorder are common neuropsychiatric disorders (each with a point prevalence of around 2%) but are underrecognized by professionals. […] Behavioral therapy currently appears to be the most effective treatment for both. Pharmacotherapy, in the form of N-acetylcysteine or olanzapine, may also play a role in treatment. […] The evidence base for psychotherapy for trichotillomania and skin-picking disorder is small but suggests the use of behavioral therapy for both disorders. Behavioral therapy for trichotillomania and skin-picking disorder has generally used habit reversal therapy (HRT) and may include components of acceptance and commitment therapy (ACT) and dialectical behavior therapy, as well as more traditional cognitive-behavioral therapy (CBT) elements using cognitive restructuring.

• #2 Skin picking disorder | Tidsskrift for Den norske legeforening

  https://tidsskriftet.no/en/2021/12/clinical-review/skin-picking-disorder

  Skin picking disorder is an under-recognised mental disorder that typically starts during adolescence and leads to considerable emotional distress and/or reduced functioning in important areas of life. […] SSRIs and n-acetylcysteine may be beneficial, but cognitive behavioural therapy is probably more effective. […] This article is based on clinical experience and research and aims to give healthcare professionals a starting point for understanding, identifying and initiating treatment measures for skin picking disorder. […] Cognitive behavioural therapy for skin picking disorder generally involves habit reversal training or elements of this. Habit reversal training consists of awareness training concerning picking urges and picking situations, education about competing response and modification of physical circumstances.

• #3 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. Understanding its role in the OCD cycle can help break the pattern with treatments like habit-reversal training (HRT) and/or exposure and response prevention (ERP) therapy. […] BFRBs like skin picking disorder are typically difficult to identify or stop on your own, which is why it’s important to speak with a mental health professional to gain clarity on what’s going on. […] One of the most effective therapies for skin picking disorder—and any BFRB, for that matter—is habit-reversal training (HRT). HRT involves tracking specific details about when you’re most likely to engage in a habit so that you can gather as much information as possible about when it occurs.

• #4 Excoriation Disorder Treatment & Management: Approach Considerations, Pharmacologic Therapy, Hypnosis

  https://emedicine.medscape.com/article/1122042-treatment

  The patients denial of psychic distress and the possible negative feelings aroused in health care personnel make management of excoriation (skin-picking) disorder difficult. It is has been estimated that about 20% of patients with excoriation (skin-picking) disorder look for treatment. This is thought to be due to the belief that the condition is untreatable or considering it a bad habit or due to fear of social embarrassment. A dermatologist rather than a psychiatrist or psychologist often first sees those that do seek treatment. […] Setting limits for the protection of both the physician and patient; creating an accepting, empathic, and nonjudgmental environment; and closely supervising symptomatic dermatologic care permit the development of a therapeutic relationship in which psychological issues may be gradually introduced, which may occasionally permit referral to a psychiatrist. Issues of etiology should be sidestepped because confrontation is counterproductive.

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

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

  Dermatillomania, also known as skin picking disorder or excoriation disorder, is a mental health condition where you compulsively pick at your skin. This condition is often treatable with a combination of medication and therapy. […] Treating dermatillomania usually involves a combination of medication and therapy. Research shows that combining the two tends to help more than just one type of treatment alone. […] Psychotherapy can help treat this condition in various ways, depending on the therapy method used. […] Habit reversal therapy. This method involves helping you become more aware of your behaviors and activity patterns. By helping you become more aware, this therapy teaches you to break habits like skin picking. […] Cognitive behavioral therapy (CBT). This method involves teaching coping mechanisms and strategies to help change behavior.

• #6 Trichotillomania and Skin-Picking Disorder: An Update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9063575/

  On the basis of controlled studies, HRT appears to be superior to waitlist and minimal attention control. […] HRT has shown benefit in many different frequencies formats (i.e. weekly to several times per week), and anywhere from four to 22 sessions (usually 60 minutes long) may be helpful. […] Although in practice many clinicians use a combination of HRT and more traditional cognitive therapy, the empirical data support HRT as the first-line psychotherapy treatment for these disorders. […] In terms of pharmacotherapy, there is little evidence that SSRIs are beneficial, although they can play a role in treating comorbid conditions for some patients. On the basis of our clinical experience, we find that N-acetylcysteine in doses of as much as 3,000 mg a day has been quite helpful in reducing urges to pick and pull in adults and probably should be considered as the initial pharmacotherapy treatment.

• #7 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: […] Yes. Research suggests that the most effective treatment for skin picking is cognitive behavioral therapy (CBT), including the specific types of CBT called Habit Reversal Training (HRT) and the Comprehensive Behavioral Model (ComB). Acceptance and commitment therapy (ACT) may also be helpful in treating skin picking disorder. Research also suggests that skin picking may be effectively treated with medications such as SSRI’s (selective serotonin reuptake inhibitors). SSRI’s include: fluoxetine, fluvoxamine, and escitalopram. Some research suggests that the anti-seizure medicine lamotrigine may also be helpful in treating skin picking disorder. Unfortunately, because many people do not know that there is help for skin picking disorder, many people with the disorder continue to suffer with it.

• #8 Excoriation Disorder Treatment & Management: Approach Considerations, Pharmacologic Therapy, Hypnosis

  https://emedicine.medscape.com/article/1122042-treatment

  If the patient refuses referral to a psychiatrist, psychotropic drug therapy prescribed by dermatologists is helpful and appropriate. The upper dose range of selective serotonin reuptake inhibitors (SSRIs) or low-dose atypical antipsychotic agents may be effective. […] Using hypnosis to facilitate resolution of psychogenic excoriations in acne excorie has been reported. […] A meta analysis of 9 studies examined the efficacy of various psychiatric treatments available for excoriation disorder including cognitive-behavioral therapy (CBT), acceptance and commitment therapy (ACT), and habit reversal training (HRT). The overall findings suggest that behavioral treatments were associated with large reductions in severity of excoriation disorder from baseline to post treatment. […] Excoriation disorder can be associated with anxiety disorders, low self-confidence, generalized apprehension, meticulousness, depressive mood, and hypersensitivity to perceived self-negativism. Thus, the intervention of a psychiatrist or other trained mental health care professionals can be useful. Patients can benefit from psychotherapy and other forms of counseling.

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

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

  Practically, CBT for clients with excoriation disorder is focused on using cognitive restructuring to counter dysfunctional thoughts (Schuck et al., 2011). Before engaging in CBT techniques, a counselor should ascertain the nature and location of the picking and provide clients with psychoeducation regarding the etiological and maintenance factors related to their disorder. Socratic questioning is one CBT technique used to help clients recognize their fundamental beliefs and automatic thoughts surrounding skin picking (Kress Paylo, 2015). When applying this technique, the counselor generates a hypothesis about the clients thoughts (that lead to skin picking), but leads the client to the information rather than suggesting it. The client is led to insight through a series of questions regarding the topic of interest. For example, the counselor might believe that a clients skin picking obsessions become stronger when personal and professional obligations become overwhelming. The counselor might ask, What feelings do you have when picking? What time of day do you typically pick? Are there ever days when you do not pick? The counselor would use reflections to organize and expand upon the clients responses until they gain new insight about their thoughts, patterns and beliefs regarding this behavior.

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

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

  When using CBT, irrational thoughts are examined for validity and replaced with more rational thoughts and behaviors (Kress Paylo, 2015). For example, an individual tempted to engage in skin picking after an argument with a spouse would challenge the need to pick with more rational thoughts, such as, Even if I become anxious, I can tolerate the anxiety. Instead of picking, I can clean the house or exercise. This type of change occurs over a period of time, and counselors and clients should celebrate small victories, such as delayed or reduced skin picking, as the more rational thoughts begin to become more salient. […] CBT not only involves cognitive interventions, but also includes behavioral interventions such as homework, preventative measures, activity replacement and relapse prevention (Capriotti et al., 2015; Kress Paylo, 2015; Schuck et al., 2011). Counselors may assign homework such as CBT thought logs to help clients track picking behaviors. While reviewing the logs in session, counselors can assist clients in developing preventative measures, such as wearing gloves or bandages to hinder skin picking, and activity replacement such as reading a book, cleaning or watching television instead of skin picking. CBT also places a heavy emphasis on relapse prevention, or the preparation to prevent future urges to pick.

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

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

  Dermatillomania, also known as skin picking disorder or excoriation disorder, is a mental health condition where you compulsively pick at your skin. This condition is often treatable with a combination of medication and therapy. […] Treating dermatillomania usually involves a combination of medication and therapy. Research shows that combining the two tends to help more than just one type of treatment alone. […] Psychotherapy can help treat this condition in various ways, depending on the therapy method used. […] Habit reversal therapy. This method involves helping you become more aware of your behaviors and activity patterns. By helping you become more aware, this therapy teaches you to break habits like skin picking. […] Cognitive behavioral therapy (CBT). This method involves teaching coping mechanisms and strategies to help change behavior.

• #12 Skin Picking Disorder / Dermatillomania – OCD Center of L.A.

  https://ocdla.com/compulsiveskinpicking

  The primary treatment modality for Skin Picking Disorder / Dermatillomania is a combination of various types of Cognitive-Behavioral Therapy (CBT). Perhaps the most important of these is called Habit Reversal Training (HRT). HRT is based on the principle that skin picking is a conditioned response to specific situations and events, and that the individual with Dermatillomania is frequently unaware of these triggers. HRT challenges Dermatillomania in a two-fold process. First, the individual learns how to become more consciously aware of situations and events that trigger skin picking episodes. Second, the individual learns to utilize alternative behaviors in response to these situations and events. […] Other Cognitive-Behavioral Therapy techniques can be used as adjuncts to HRT in the treatment of Skin Picking Disorder. Among these are Stimulus Control techniques and Cognitive Restructuring. Stimulus Control techniques involve utilizing specific physical items as habit blockers to restrict the ability to pick skin, while Cognitive Restructuring helps an individual with Dermatillomania learn to think differently in response to the urge to pick their skin.

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

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

  Habit reversal training (HRT) is an effective strategy for working with clients who have excoriation disorder (Capriotti et al., 2015; Grant et al., 2012; Teng, Woods, Twohig, 2006). HRT is a behavioral approach that involves helping clients gain awareness of their skin picking and then replace the picking with more adaptive behaviors (Grant et al., 2012; Ravindran et al., 2009; Snorrason Bjorgvinsson, 2012; Teng et al., 2006). The first step of treatment is awareness training, which helps clients who are often unaware of their skin picking to associate factors, such as time of day and specific situations, to skin picking behavior (Teng et al., 2006). To facilitate this awareness, a counselor may point out in-session skin picking behavior. After developing an awareness of antecedent situations (i.e., the situations that precede picking incidents), the counselor and client collaboratively develop a competing response, or another behavior that is inconsistent with skin picking, to substitute for the skin picking behaviors (Teng et al. 2006). An example of an alternative behavior would be clenching ones fist each time a client notices that he or she is picking. This competing response, which should be one that is easily applicable in a number of situations, diminishes the urge or reduces its intensity.

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

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

  The next step in HRT is the establishment of a contingency management system or token economy involving rewards and punishments. This type of treatment approach allows the clients behaviors to be rewarded as they make successive approximations toward the goal. Rewards and punishments must be meaningful to clients, and they also must be specific and timely. At first, rewards are extrinsic, such as verbal praise or toys with children. As target behaviors are reached (e.g., reduced skin picking), clients begin to access more intrinsic reinforcers (e.g., an increased sense of self-esteem, feelings of belonging within the community/society). Finally, clients are coached to consistently implement these operant conditioning strategies outside of session and to eventually apply them to new behaviors (Capriotti et al., 2015; Teng et al., 2006). The client gradually realizes that skin picking is not a necessary coping skill, as other, more adaptive behaviors can be used to effectively reduce stress.

• #15 Trichotillomania and Skin-Picking Disorder: An Update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9063575/

  On the basis of controlled studies, HRT appears to be superior to waitlist and minimal attention control. […] HRT has shown benefit in many different frequencies formats (i.e. weekly to several times per week), and anywhere from four to 22 sessions (usually 60 minutes long) may be helpful. […] Although in practice many clinicians use a combination of HRT and more traditional cognitive therapy, the empirical data support HRT as the first-line psychotherapy treatment for these disorders. […] In terms of pharmacotherapy, there is little evidence that SSRIs are beneficial, although they can play a role in treating comorbid conditions for some patients. On the basis of our clinical experience, we find that N-acetylcysteine in doses of as much as 3,000 mg a day has been quite helpful in reducing urges to pick and pull in adults and probably should be considered as the initial pharmacotherapy treatment.

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

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

  Acceptance and commitment therapy. This therapy method helps people change behaviors like skin picking by accepting negative feelings that fuel the behavior. Mindfulness and other positive coping mechanisms also play a role. […] People with severe damage to their skin or their tissue underneath may need additional medical treatment and care. Your healthcare provider is the best person to explain the treatments they recommend, which might include surgery and skin grafting, antibiotics and more.

• #17 Therapy for Dermatillomania (Skin-Picking Disorder) in New York and Florida

  https://www.ekmentalhealthcounseling.com/therapies-for-dermatilomania/

  Habit Reversal Training (HRT) is a specific form of therapy that focuses on replacing the urge to pick with alternative behaviors that provide the same sense of relief without harm. […] Acceptance and Commitment Therapy (ACT) helps you accept the discomfort and urges without giving in to them or judging yourself harshly. Instead of fighting the urge, youll learn to respond in a way that aligns with your values and long-term goals. […] Learning to be kinder to yourself is an essential part of healing. Therapy can help you practice mindfulness to stay grounded in the moment and develop self-compassion, which can reduce shame and empower you to make progress. […] Connecting with others who understand what youre going through can remind you that youre not alone. Support groups both in person and online can provide encouragement, accountability, and shared experiences. […] Dermatillomania doesnt define who you are its something youre facing, not a reflection of your worth or strength. Progress may take time, but small steps can lead to big changes.

• #18 Excoriation (Skin Picking) Disorder – Center for OCD and Related Disorders

  https://mghocd.org/excoriation/

  Clinicians may also use other treatment approaches to augment HRT and stimulus control. One such approach is Acceptance and Commitment Therapy (ACT). The goal of ACT is to teach skin pickers that when one is feeling the urge to pick or experiences a negative emotion associated with picking, one can accept the urge or emotion without having to respond to it. Dialectic Behavior Therapy (DBT) is also often used to supplement CBT. DBT teaches pickers emotion regulation strategies, as well as methods to tolerate uncomfortable emotions and urges. […] Research exploring the efficacy of psychopharmacological interventions in the treatment of skin picking disorder is limited and few randomized control trials exist. The serotonin reuptake inhibitors (SRIs), widely used in the treatment of depression, anxiety, and obsessive-compulsive disorder, may be effective in the treatment of skin picking. […] For more general information regarding treatment, please read our Treatment Approaches page on our website. […] Our center specializes in evidence-based treatment for Excoriation (Skin Picking) Disorder with cognitive behavioral therapy (CBT) and medication.

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

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

  Acceptance and commitment therapy (ACT), when used in conjunction with HRT, demonstrates clinical promise in treating those who have excoriation disorder (Capriotti et al., 2015; Flessner, Busch, Heideman, Woods, 2008). Capriotti et al. (2015), through the use of multiple clinical case studies, demonstrated that Acceptance-Enhanced Behavioral Therapy (i.e., ACT plus HRT) decreased excoriation symptomology in three of four participants in their case study research. These results support the findings of a similar case study done by Flessner et al. (2008), which demonstrated decreased symptomatology of excoriation disorder when ACT was incorporated with HRT. […] If pharmacotherapy is used to treat excoriation disorder, it should be used in conjunction with counseling; medication can control physical symptoms, but contributing mental health factors must be addressed in order to holistically help the client make enduring behavior changes (Grant et al., 2012). Selective serotonin reuptake inhibitors, specifically Fluoxetine (Prozac), have been shown to be effective in treating excoriation disorder and other BFRB (Grant et al., 2012; Simeon et al., 1997). However, this effect has not been consistent across clients (Grant Odlaug, 2009). Therefore, additional research on the effectiveness of medication is needed. Counselors should provide intentional treatments for clients while taking into account unique client considerations.

• #20 What Causes a Skin Picking Disorder and How to Treat It

  https://lightfully.com/what-causes-a-skin-picking-disorder-and-how-to-treat-it/

  What causes a skin picking disorder and how to treat it […] Five potential ways to treat skin picking disorder are: […] Cognitive behavioral therapy is one of the most effective ways to treat OCD spectrum disorders, such as skin-picking disorder. […] Another type of therapy method that can be beneficial for the disorder is habit reversal training. […] Comprehensive behavioral treatment analyzes what occurs internally and externally before, during, and after a repetitive behavior like skin picking. […] At Lightfully, we offer four programs that can help you address your skin picking disorder: residential treatment, Virtual Intensive Outpatient Program (vIOP), Intensive Outpatient Program (IOP), and Partial Hospitalization Program (PHP), also called our Day Treatment Program.

• #21 International OCD Foundation | Comprehensive Behavioral (ComB) Treatment for Skin Picking and Hair Pulling Disorders

  https://iocdf.org/expert-opinions/comprehensive-behavioral-comb-treatment-for-skin-picking-and-hair-pulling-disorders/

  As ComB treatment is uniquely tailored to the individual needs of each patient, the treatment process is expected to be both creative and fluid rather than rigidly applied. […] The ComB approach addresses this complexity by providing a systematic framework that guides therapists as they design and implement a treatment plan that uniquely fits each patient. […] In the final phase of formal treatment, the client is encouraged to continue with ongoing assessments of progress and to modify the use of interventions as needed. […] The ComB conceptual model comes from established behavioral principles and decades of laboratory and clinical research, and employs proven behavioral, cognitive, and CBT techniques. […] The last several decades have seen much progress toward understanding and treating BFRBs.

• #22 Excoriation (Skin Picking) Disorder – Dallas CBT

  https://dallascbt.com/what-we-treat/excoriation-skin-picking-disorder/

  Dallas CBT provides specialized treatment for skin picking and other body-focused repetitive behaviors in children and adults. […] Therapy at Dallas CBT is based on the Comprehensive Behavioral Model (ComB), which is a modern therapeutic approach for skin picking and other repetitive body-focused behaviors based on CBT principles. […] The ComB model is a short-term treatment approach that involves identifying cues or triggers for skin picking, such as certain environments, activities, or emotional states, and the unique functions that picking serves for the individual. Therapy helps clients increase awareness and understanding of their behaviors and urges, identify important factors contributing to the behavior, assess the purpose of the behavior, and establish a set of personalized strategies to minimize and replace skin picking.

• #23 International OCD Foundation | Comprehensive Behavioral (ComB) Treatment for Skin Picking and Hair Pulling Disorders

  https://iocdf.org/expert-opinions/comprehensive-behavioral-comb-treatment-for-skin-picking-and-hair-pulling-disorders/

  As ComB treatment is uniquely tailored to the individual needs of each patient, the treatment process is expected to be both creative and fluid rather than rigidly applied. […] The ComB approach addresses this complexity by providing a systematic framework that guides therapists as they design and implement a treatment plan that uniquely fits each patient. […] In the final phase of formal treatment, the client is encouraged to continue with ongoing assessments of progress and to modify the use of interventions as needed. […] The ComB conceptual model comes from established behavioral principles and decades of laboratory and clinical research, and employs proven behavioral, cognitive, and CBT techniques. […] The last several decades have seen much progress toward understanding and treating BFRBs.

• #24

  https://www.termedia.pl/Exploring-skin-picking-disorder-aetiology-treatment-r-nand-future-directions,7,54674,1,1.html

  Other medications, such as tricyclic antidepressants (TCAs), naltrexone, and N-acetylcysteine (NAC), have also been investigated for the treatment of SPD. […] While pharmacotherapy may provide symptom relief for some individuals with SPD, it is important to carefully consider this possible advantage in light of the potential side effects and negative medication interactions. […] In addition to traditional psychotherapy and pharmacotherapy, several alternative and complementary therapies have been explored as potential treatments for skin picking disorder. […] Mindfulness-based interventions, such as mindfulness meditation and acceptance and commitment therapy (ACT), aim to encourage a person to be present in the moment and therefore be accepting of emotions as they occur, including urges to pick. […] Dialectical behaviour therapy (DBT) uses a combination of cognitive-behavioural techniques with mindfulness practices to improve emotional regulation, better tolerate and handle unpleasant emotions, and increase social functioning.

• #25 Skin Excoriation Therapy | Treat Skin Picking in Philadelphia

  https://anxietyocdphilly.com/skin-excoriation-therapy-philadelphia/

  Dialectical Behavior Therapy (DBT): equips clients with skills to manage intense emotions and urges and navigate emotional and life problems that may fuel skin-picking. […] In addition to adults, our center offers specialized care for children and teenagers grappling with this condition and their families. […] If you’re ready to confront compulsive skin-picking and embark on a path toward recovery, contact us for a personalized consultation. […] Our team is here to provide exceptional, empathetic care tailored to your unique experience with skin excoriation disorder. […] For a comprehensive selection of websites, books, and specially designed therapy worksheets including tools for tracking BFRBs, make sure to explore our Skin Excoriation and BFRB Resources Page. […] If you’re set to address skin excoriation disorder and regain command of your life, our team is here to assist you. […] Reach out to us today for further information about skin excoriation therapy options.

• #26 Dermatillomania (Skin Picking) Treatment | NYC – Dr. Ori Shinar

  https://psychologistsnyc.com/skin-picking-treatment-nyc/

  Cognitive Behavior Therapy CBT is a therapeutic approach that focuses on identifying thoughts, feelings, and behaviors that are problematic and teaches individuals how to change these elements to lead to reduced stress and more productive functioning. An emphasis is placed on matching the treatment to the unique symptoms of the individual. […] There are a number of different treatment approaches for BFRBs that fall under the umbrella of CBT: habit reversal training (HRT) and comprehensive behavioral treatment (ComB). […] Acceptance and commitment therapy (ACT) and dialectical behavior therapy (DBT) are two treatment approaches that may bolster the effectiveness of other cognitive behavior therapies. […] The goal of weekly treatment is to reduce your skin-picking behaviors and replace them with healthier alternatives. With those who are highly motivated, significant improvements can be seen within the first couple of months of treatment.

• #27

  https://www.termedia.pl/Exploring-skin-picking-disorder-aetiology-treatment-r-nand-future-directions,7,54674,1,1.html

  Exposure and response prevention (ERP) is another intervention that involves gradual exposure to situations or stimuli that trigger skin picking urges while refraining from engaging in the behaviour. […] Several studies have demonstrated that CBT that includes HRT and ERP components is effective in reducing skin picking symptoms and improving overall functioning among individuals with SPD. […] Pharmacotherapy may be considered as an adjunctive treatment for skin picking disorder, particularly in cases where psychotherapy alone is insufficient or when comorbid conditions require pharmacological management. […] Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine and sertraline, are the main prescription medicines used to treat SPD due to their efficacy in also treating accompanying conditions such as obsessive-compulsive disorder (OCD) and anxiety disorders.

• #28 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). […] The good news is that therapy, medication, and dermatologic treatments can help. […] Cognitive behavioral therapy (CBT) is a structured type of psychotherapy that aims to produce healthier behaviors and beliefs by identifying unhelpful thoughts and behaviors. 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.

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

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

  Skin picking disorder is usually treated with a combination of medicine and cognitive behavioral therapy. […] The most helpful medicines include: Antidepressants, usually with selective serotonin reuptake inhibitors (SSRIs). SSRIs that have been tested in people with dermatillomania include citalopram (Celexa), fluoxetine (Prozac), fluvoxamine (Luvox, Faverin), and sertraline (Zoloft). […] Several kinds of therapy may be helpful, including: Cognitive behavioral therapy, which teaches you coping strategies to help change your behaviors. […] Habit reversal therapy, which helps you become more aware of your behaviors so that you can break bad habits. […] Acceptance and commitment therapy, which helps you accept negative emotions and teaches you positive coping mechanisms. […] If you have severe damage to your skin or your tissue underneath, your doctor may send you to a specialist to talk about surgery and skin grafts. […] Treatment usually involves a combination of medicine and therapy. It is a lifelong condition, but with treatment, you can go into remission. This means that you won’t feel the urge to pick or can avoid doing it for long periods.

• #30 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: […] Yes. Research suggests that the most effective treatment for skin picking is cognitive behavioral therapy (CBT), including the specific types of CBT called Habit Reversal Training (HRT) and the Comprehensive Behavioral Model (ComB). Acceptance and commitment therapy (ACT) may also be helpful in treating skin picking disorder. Research also suggests that skin picking may be effectively treated with medications such as SSRI’s (selective serotonin reuptake inhibitors). SSRI’s include: fluoxetine, fluvoxamine, and escitalopram. Some research suggests that the anti-seizure medicine lamotrigine may also be helpful in treating skin picking disorder. Unfortunately, because many people do not know that there is help for skin picking disorder, many people with the disorder continue to suffer with it.

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

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

  Skin picking disorder is usually treated with a combination of medicine and cognitive behavioral therapy. […] The most helpful medicines include: Antidepressants, usually with selective serotonin reuptake inhibitors (SSRIs). SSRIs that have been tested in people with dermatillomania include citalopram (Celexa), fluoxetine (Prozac), fluvoxamine (Luvox, Faverin), and sertraline (Zoloft). […] Several kinds of therapy may be helpful, including: Cognitive behavioral therapy, which teaches you coping strategies to help change your behaviors. […] Habit reversal therapy, which helps you become more aware of your behaviors so that you can break bad habits. […] Acceptance and commitment therapy, which helps you accept negative emotions and teaches you positive coping mechanisms. […] If you have severe damage to your skin or your tissue underneath, your doctor may send you to a specialist to talk about surgery and skin grafts. […] Treatment usually involves a combination of medicine and therapy. It is a lifelong condition, but with treatment, you can go into remission. This means that you won’t feel the urge to pick or can avoid doing it for long periods.

• #32 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: […] Yes. Research suggests that the most effective treatment for skin picking is cognitive behavioral therapy (CBT), including the specific types of CBT called Habit Reversal Training (HRT) and the Comprehensive Behavioral Model (ComB). Acceptance and commitment therapy (ACT) may also be helpful in treating skin picking disorder. Research also suggests that skin picking may be effectively treated with medications such as SSRI’s (selective serotonin reuptake inhibitors). SSRI’s include: fluoxetine, fluvoxamine, and escitalopram. Some research suggests that the anti-seizure medicine lamotrigine may also be helpful in treating skin picking disorder. Unfortunately, because many people do not know that there is help for skin picking disorder, many people with the disorder continue to suffer with it.

• #33 Excoriation Disorder Treatment & Management: Approach Considerations, Pharmacologic Therapy, Hypnosis

  https://emedicine.medscape.com/article/1122042-treatment

  If the patient refuses referral to a psychiatrist, psychotropic drug therapy prescribed by dermatologists is helpful and appropriate. The upper dose range of selective serotonin reuptake inhibitors (SSRIs) or low-dose atypical antipsychotic agents may be effective. […] Using hypnosis to facilitate resolution of psychogenic excoriations in acne excorie has been reported. […] A meta analysis of 9 studies examined the efficacy of various psychiatric treatments available for excoriation disorder including cognitive-behavioral therapy (CBT), acceptance and commitment therapy (ACT), and habit reversal training (HRT). The overall findings suggest that behavioral treatments were associated with large reductions in severity of excoriation disorder from baseline to post treatment. […] Excoriation disorder can be associated with anxiety disorders, low self-confidence, generalized apprehension, meticulousness, depressive mood, and hypersensitivity to perceived self-negativism. Thus, the intervention of a psychiatrist or other trained mental health care professionals can be useful. Patients can benefit from psychotherapy and other forms of counseling.

• #34 Trichotillomania and Skin-Picking Disorder: An Update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9063575/

  On the basis of controlled studies, HRT appears to be superior to waitlist and minimal attention control. […] HRT has shown benefit in many different frequencies formats (i.e. weekly to several times per week), and anywhere from four to 22 sessions (usually 60 minutes long) may be helpful. […] Although in practice many clinicians use a combination of HRT and more traditional cognitive therapy, the empirical data support HRT as the first-line psychotherapy treatment for these disorders. […] In terms of pharmacotherapy, there is little evidence that SSRIs are beneficial, although they can play a role in treating comorbid conditions for some patients. On the basis of our clinical experience, we find that N-acetylcysteine in doses of as much as 3,000 mg a day has been quite helpful in reducing urges to pick and pull in adults and probably should be considered as the initial pharmacotherapy treatment.

• #35 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). […] The good news is that therapy, medication, and dermatologic treatments can help. […] Cognitive behavioral therapy (CBT) is a structured type of psychotherapy that aims to produce healthier behaviors and beliefs by identifying unhelpful thoughts and behaviors. 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.

• #36 Skin-Picking (Excoriation) Disorder – Mental Health Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/mental-health-disorders/obsessive-compulsive-and-related-disorders/skin-picking-excoriation-disorder

  Cognitive-behavioral therapy (habit reversal therapy) that specifically focuses on skin-picking disorder and certain antidepressants or N-acetylcysteine or memantine may help lessen symptoms. […] Cognitive-behavioral therapyin particular, habit-reversal therapy that specifically focuses on skin-picking disorderis the therapy of choice. For habit-reversal therapy, people are taught to do the following: […] N-acetylcysteine (NAC) and memantine both act on the glutamatergic system, and may reduce skin-picking. Treatment with selective serotonin reuptake inhibitors (a type of antidepressant) or clomipramine may also be useful and may improve the symptoms of any coexisting depression or anxiety disorders.

• #37 Trichotillomania and Skin-Picking Disorder: An Update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9063575/

  On the basis of controlled studies, HRT appears to be superior to waitlist and minimal attention control. […] HRT has shown benefit in many different frequencies formats (i.e. weekly to several times per week), and anywhere from four to 22 sessions (usually 60 minutes long) may be helpful. […] Although in practice many clinicians use a combination of HRT and more traditional cognitive therapy, the empirical data support HRT as the first-line psychotherapy treatment for these disorders. […] In terms of pharmacotherapy, there is little evidence that SSRIs are beneficial, although they can play a role in treating comorbid conditions for some patients. On the basis of our clinical experience, we find that N-acetylcysteine in doses of as much as 3,000 mg a day has been quite helpful in reducing urges to pick and pull in adults and probably should be considered as the initial pharmacotherapy treatment.

• #38 Skin-Picking Disorder: A Guide to Diagnosis and Management – PubMed

  https://pubmed.ncbi.nlm.nih.gov/30877621/

  Skin-picking disorder, also known as excoriation disorder or psychogenic skin excoriations, is an obsessive-compulsive and related disorder that is classified with other body-focused repetitive-behavior disorders in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). […] There is no specific or recommended treatment option, but cognitive-behavioral therapy, particularly habit-reversal therapy and acceptance and commitment therapy have shown promise. […] Various pharmacological interventions have also been described to treat this condition in case reports and open and controlled trials. Specific classes of agents implemented include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors, antipsychotics, and glutaminergic-modulating agents. SSRIs and N-acetylcysteine have been shown to be the most effective of the pharmacological interventions.

• #39 New study: drug option for hair-pulling, skin-picking disorders – UChicago Medicine

  https://www.uchicagomedicine.org/forefront/research-and-discoveries-articles/2023/march/new-research-points-to-drug-option-for-hair-pulling-skin-picking-disorders

  New research at the University of Chicago Medicine has found that a drug commonly used to treat symptoms of Alzheimers disease effectively reduced symptoms of adults who experience compulsive hair-pulling and skin-picking. […] Treatment with the drug memantine was associated with significant improvements compared to a placebo for patients with trichotillomania (a disorder where individuals cannot resist the urge to pull out their hair) and skin-picking disorder (also known as excoriation disorder). […] Cognitive behavioral therapy is a first-line treatment, but finding therapists well-versed in the disorders can be difficult, he said. […] An analysis found that memantine is more effective than other treatments studied thus far, including behavioral therapy, the drug olanzapine (used to treat schizophrenia and bipolar disorder), the drug clomipramine (used to treat obsessive-compulsive disorder), and N-acetylcysteine (an over-the-counter supplement).

• #40 New study: drug option for hair-pulling, skin-picking disorders – UChicago Medicine

  https://www.uchicagomedicine.org/forefront/research-and-discoveries-articles/2023/march/new-research-points-to-drug-option-for-hair-pulling-skin-picking-disorders

  The comparisons suggest that memantine might be considered a first-line treatment equal to behavioral therapy in the treatment process for these conditions, according to the study. […] Grant said the results point to several additional areas for research, including combining memantine with behavioral therapy or with N-acetylcysteine, which showed promise in previous studies led by Grant.

• #41 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

  Cognitive-behavioral therapy (usually habit reversal training) […] Cognitive-behavioral therapy that is tailored to treat the specific symptoms of excoriation disorder is the psychotherapy of choice. Habit reversal training, a predominantly behavioral therapy, has been best studied; it includes the following: Awareness training (eg, self-monitoring, identification of triggers for the behavior) […] SSRIs or clomipramine may be useful for coexisting depression or anxiety disorders, and limited evidence suggests that these medications can also reduce skin picking […] The glutamate modulators N-acetylcysteine and memantine appear to help reduce symptom severity, but more data are needed to support the long-term efficacy and safety of these approaches. […] Treat using cognitive-behavioral therapy that is tailored to treat specific excoriation symptoms (including habit reversal training) and/or an SSRI, clomipramine, N-acetylcysteine, or memantine.

• #42 Excoriation Disorder Medication: Antidepressants, TCAs, Anxiolytics, Nonbenzodiazepine, Antidepressant, SSRIs, Corticosteroids, Topical, Anticonvulsants, Other

  https://emedicine.medscape.com/article/1122042-medication

  Excoriation (skin-picking) disorder is treated with a variety of psychotropic medications. Attempts to treat it with a variety of psychotropic medication classes include antipsychotic agents, antianxiety agents, antidepressant agents, topical cortisone agents, and antiepileptic agents. […] Antipsychotic agents decrease the urge to scratch and relieve anxiety. […] Antianxiety agents are used to reduce the level of anxiety in patients who experience pruritus. […] Antidepressants may be used to improve mood and to restore normal sleep patterns in patients who experience pruritus. […] Topical corticosteroids have anti-inflammatory properties and cause profound and varied metabolic effects. […] Antiepileptic agents decrease impulsiveness.

• #43 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: […] Yes. Research suggests that the most effective treatment for skin picking is cognitive behavioral therapy (CBT), including the specific types of CBT called Habit Reversal Training (HRT) and the Comprehensive Behavioral Model (ComB). Acceptance and commitment therapy (ACT) may also be helpful in treating skin picking disorder. Research also suggests that skin picking may be effectively treated with medications such as SSRI’s (selective serotonin reuptake inhibitors). SSRI’s include: fluoxetine, fluvoxamine, and escitalopram. Some research suggests that the anti-seizure medicine lamotrigine may also be helpful in treating skin picking disorder. Unfortunately, because many people do not know that there is help for skin picking disorder, many people with the disorder continue to suffer with it.

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

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

  Topiramate appears to be a promising agent in the treatment of skin-picking symptoms. […] Nonpharmacologic treatments such as habit-reversal therapy, Internet-based treatments, and acceptance-enhanced behavior therapy have shown minimal effectiveness so far. […] A trial of topiramate may help patients with skin-picking disorder. […] Current literature suggests that most pharmacologic treatments for skin-picking disorder have shown limited success. […] Further studies need to be conducted in a larger population sample to validate our findings.

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

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

  Topiramate appears to be a promising agent in the treatment of skin-picking symptoms. […] Nonpharmacologic treatments such as habit-reversal therapy, Internet-based treatments, and acceptance-enhanced behavior therapy have shown minimal effectiveness so far. […] A trial of topiramate may help patients with skin-picking disorder. […] Current literature suggests that most pharmacologic treatments for skin-picking disorder have shown limited success. […] Further studies need to be conducted in a larger population sample to validate our findings.

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

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

  Dermatillomania, also known as skin picking disorder or excoriation disorder, is a mental health condition where you compulsively pick at your skin. This condition is often treatable with a combination of medication and therapy. […] Treating dermatillomania usually involves a combination of medication and therapy. Research shows that combining the two tends to help more than just one type of treatment alone. […] Psychotherapy can help treat this condition in various ways, depending on the therapy method used. […] Habit reversal therapy. This method involves helping you become more aware of your behaviors and activity patterns. By helping you become more aware, this therapy teaches you to break habits like skin picking. […] Cognitive behavioral therapy (CBT). This method involves teaching coping mechanisms and strategies to help change behavior.

• #47 Trichotillomania and Skin-Picking Disorder: An Update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9063575/

  Psychotherapeutic and pharmacological treatments have documented evidence of their effectiveness as monotherapies as well as in a combined treatment strategy. […] When diagnosed early and appropriately treated, however, as many as 50% of individuals may experience symptom reduction, at least for the short term (36 months).

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

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

  Acceptance and commitment therapy. This therapy method helps people change behaviors like skin picking by accepting negative feelings that fuel the behavior. Mindfulness and other positive coping mechanisms also play a role. […] People with severe damage to their skin or their tissue underneath may need additional medical treatment and care. Your healthcare provider is the best person to explain the treatments they recommend, which might include surgery and skin grafting, antibiotics and more.

• #49 Excoriation Disorder Treatment & Management: Approach Considerations, Pharmacologic Therapy, Hypnosis

  https://emedicine.medscape.com/article/1122042-treatment

  Lesions can be kept to a minimum, the patient can be protected from unnecessary and intrusive studies, and society can be protected from escalating and unnecessary expenditure of medical resources if, rather than discharging the patient, the dermatologist continues to see the patient on an ongoing basis for supervision and support, regardless of whether lesions are present. […] Physical barriers (eg, an Unna sleeve) can be an effective treatment for neurotic excoriations.

• #50 Excoriation Disorder Treatment & Management: Approach Considerations, Pharmacologic Therapy, Hypnosis

  https://emedicine.medscape.com/article/1122042-treatment

  Lesions can be kept to a minimum, the patient can be protected from unnecessary and intrusive studies, and society can be protected from escalating and unnecessary expenditure of medical resources if, rather than discharging the patient, the dermatologist continues to see the patient on an ongoing basis for supervision and support, regardless of whether lesions are present. […] Physical barriers (eg, an Unna sleeve) can be an effective treatment for neurotic excoriations.

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

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

  There are of course some things you can do to help yourself whilst waiting for talking therapy, for example: Keep your hands busy try squeezing a stress toy or putting on gloves to help you identify when and where you most commonly pick your skin. Resist picking for longer and longer each time you feel the urge to pick. Take extra care with your skin when you pick it applying moisturiser may help. Tell loved ones you to tell you when you are picking to help you recognise when you’re picking. Keep your skin clean to avoid infection. Don’t let your nails grow too long. Don’t keep tweezers and picking implements in an easy to access location.

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

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

  Engaging in regular physical activity can help keep the mind occupied and lessen the urge to do body-focused repetitive behavior like hair pulling or skin picking. […] Practicing mindfulness can also help in dealing with excoriation disorder. […] Developing healthy rules and rituals to control anxiety, which often contributes to body-focused repetitive behavior. […] Building a strong support system made up of close friends and family is crucial for anyone dealing with excoriation disorder. […] It can be challenging, but its important for people dealing with excoriation disorder to reach out and communicate with family and friends about their condition. […] Either in-person or online therapy can also be an excellent place to speak up and ask questions about why someone might pick at their skin and what they can do to stop.

• #53 Skin Picking (Excoriation) | Symptoms & Treatments | Zencare — Zencare

  https://zencare.co/mental-health/skin-picking

  Find a therapist who has experience and specialized training in the treatment of skin picking, and specifically Habit Reversal Therapy, as this is an evidence-based therapy approach for this condition. […] The best way to judge how you might feel about a therapist is to ask for a preliminary phone call. This also allows you to ask about their experience and what therapy with them will be like. Try to speak to a few different therapists before deciding on a provider.

• #54 Skin Picking (Excoriation) | Symptoms & Treatments | Zencare — Zencare

  https://zencare.co/mental-health/skin-picking

  Find a therapist who has experience and specialized training in the treatment of skin picking, and specifically Habit Reversal Therapy, as this is an evidence-based therapy approach for this condition. […] The best way to judge how you might feel about a therapist is to ask for a preliminary phone call. This also allows you to ask about their experience and what therapy with them will be like. Try to speak to a few different therapists before deciding on a provider.

• #55 Excoriation disorder – Wikipedia

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

  There are several different classes of pharmacological treatment agents that have some support for treating excoriation disorder: SSRIs; opioid antagonists; anti-epileptic agents; and glutamatergic agents. In addition to these classes of drugs, some other pharmacological products have been tested in small trials as well. […] Treatments include cognitive-behavioral therapy, acceptance-enhanced behavior therapy, and acceptance and commitment therapy (ACT). Several studies have shown that habit reversal training associated with awareness training reduces skin-picking behavior in those individuals with excoriation disorder that do not have psychological problems. […] In an absence of longitudinal data which follows patients with Psychiatric referrals as a result of ED, little is known for the reasons patients do not follow through with the referral, or what more is needed to ensure access to care. Overall, less than 25% of participants in this study achieved long term results, highlighting the need for a collaborative team approach to treatment across several disciplines to include PCP, dermatology, psychology and psychiatry as needed.

• #56 What Causes a Skin Picking Disorder and How to Treat It

  https://lightfully.com/what-causes-a-skin-picking-disorder-and-how-to-treat-it/

  What causes a skin picking disorder and how to treat it […] Five potential ways to treat skin picking disorder are: […] Cognitive behavioral therapy is one of the most effective ways to treat OCD spectrum disorders, such as skin-picking disorder. […] Another type of therapy method that can be beneficial for the disorder is habit reversal training. […] Comprehensive behavioral treatment analyzes what occurs internally and externally before, during, and after a repetitive behavior like skin picking. […] At Lightfully, we offer four programs that can help you address your skin picking disorder: residential treatment, Virtual Intensive Outpatient Program (vIOP), Intensive Outpatient Program (IOP), and Partial Hospitalization Program (PHP), also called our Day Treatment Program.

• #57 Effective approach to skin picking and hair pulling disorders brings patients relief | Rogers Behavioral Health

  https://rogersbh.org/blog/effective-approach-skin-picking-and-hair-pulling-disorders-brings-patients-relief/

  The first step in determining how skin picking and hair pulling should be addressed is figuring out the function the behavior has for a patient, says Dr. Brenda Bailey, clinical supervisor of OCD and Anxiety treatment in Oconomowoc. […] When seeking treatment, Dr. Bailey recommends finding someone with experience in habit reversal training, which is the main approach Rogers uses for addressing skin picking and hair pulling. […] Habit reversal involves assessment, awareness training, and competing response training, according to Dr. Bailey. […] Dr. Bailey says that someone should reach out for a higher level of care for skin picking or hair pulling if symptoms haven’t improved after traditional outpatient care, or if the habits are causing significant impairment of daily life. […] While these disorders can develop into serious medical concerns, they are both highly treatable.

• #58 Skin Picking Disorder | Get Treatment for Excoriation Disorder

  https://anxietyocdbala.com/what-we-treat/skin-picking-excoriation-disorder/

  Skin picking disorder tends to be chronic, and can wax and wane over time. […] There is empirical evidence supporting Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) as effective treatments for skin picking disorder. Research also suggests that SSRIs (Selective Serotonin Reuptake Inhibitors) may help.

• #59 Trichotillomania and Skin-Picking Disorder: An Update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9063575/

  Psychotherapeutic and pharmacological treatments have documented evidence of their effectiveness as monotherapies as well as in a combined treatment strategy. […] When diagnosed early and appropriately treated, however, as many as 50% of individuals may experience symptom reduction, at least for the short term (36 months).

• #60 Dermatillomania (Skin Picking) Treatment | NYC – Dr. Ori Shinar

  https://psychologistsnyc.com/skin-picking-treatment-nyc/

  Most clients will reduce picking behaviors by 50% in the first month and up to 75% in the second month of treatment. Clients typically find that the final handful of picks per week is the most stubborn, but once they reach zero picks for 5-6 consecutive weeks, we can reduce treatment frequency from weekly to biweekly sessions. […] Skin picking treatment switches over to relapse prevention to help reduce the likelihood of relapse. If the client continues to be pick-free, we reduce to monthly booster sessions until we both decide it is time to terminate treatment. […] Several clients decide at this point to continue weekly sessions to work on reaching other personal/psychological goals, i.e. anxiety reduction, ADD-related executive function skills, and strategies, depression reduction, social anxiety treatment, career goals, and/or relationship issues.

• #61 OCD Types | Excoriation Disorder | Compulsive Skin Picking

  https://www.ocdtypes.com/skin-picking.php

  Excoriation Disorder is also called compulsive skin-picking, a body-focused repetitive behavior that results in the destruction of one’s own skin. […] Fortunately, Excoriation Disorder responds well to behavioral therapy. […] The medications mainly used to treat skin-picking are the same group as those used for OCD, including antidepressants (SSRIs). […] Medication should never be considered an end in itself, but a tool to help with therapy. […] Cognitive-behavior therapy has been studied as a means of treating skin-picking and related disorders. […] These techniques are all temporary means of helping the person learn to resist the urge to pick. […] Although therapy typically lasts from 10-12 weeks, it can take up to 12 months for the urge to pick to finally fade away. […] Treatment for skin-picking is a type of therapy that requires a specialized protocol that includes Habit Reversal Therapy.

• #62 Dermatillomania (Skin Picking) Treatment | NYC – Dr. Ori Shinar

  https://psychologistsnyc.com/skin-picking-treatment-nyc/

  Most clients will reduce picking behaviors by 50% in the first month and up to 75% in the second month of treatment. Clients typically find that the final handful of picks per week is the most stubborn, but once they reach zero picks for 5-6 consecutive weeks, we can reduce treatment frequency from weekly to biweekly sessions. […] Skin picking treatment switches over to relapse prevention to help reduce the likelihood of relapse. If the client continues to be pick-free, we reduce to monthly booster sessions until we both decide it is time to terminate treatment. […] Several clients decide at this point to continue weekly sessions to work on reaching other personal/psychological goals, i.e. anxiety reduction, ADD-related executive function skills, and strategies, depression reduction, social anxiety treatment, career goals, and/or relationship issues.

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

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

  Skin picking disorder is usually treated with a combination of medicine and cognitive behavioral therapy. […] The most helpful medicines include: Antidepressants, usually with selective serotonin reuptake inhibitors (SSRIs). SSRIs that have been tested in people with dermatillomania include citalopram (Celexa), fluoxetine (Prozac), fluvoxamine (Luvox, Faverin), and sertraline (Zoloft). […] Several kinds of therapy may be helpful, including: Cognitive behavioral therapy, which teaches you coping strategies to help change your behaviors. […] Habit reversal therapy, which helps you become more aware of your behaviors so that you can break bad habits. […] Acceptance and commitment therapy, which helps you accept negative emotions and teaches you positive coping mechanisms. […] If you have severe damage to your skin or your tissue underneath, your doctor may send you to a specialist to talk about surgery and skin grafts. […] Treatment usually involves a combination of medicine and therapy. It is a lifelong condition, but with treatment, you can go into remission. This means that you won’t feel the urge to pick or can avoid doing it for long periods.

• #64 Excoriation Disorder Treatment | YLP – Brooklyn, NY

  https://yourlocalpsychiatrist.nyc/diseases/excoriation-disorder-treatment/

  Professional treatment plays a crucial role in helping individuals with excoriation disorder achieve lasting recovery. Mental health professionals, such as psychiatrists and therapists, are trained to provide evidence-based interventions that target the specific challenges associated with the disorder. […] A comprehensive treatment plan for excoriation disorder often includes cognitive-behavioral therapy (CBT), which helps individuals identify and modify the thoughts and behaviors that contribute to their skin-picking compulsions. In some cases, medication may be prescribed to help manage symptoms of excoriation disorder or co-occurring mental health conditions. Selective serotonin reuptake inhibitors (SSRIs) and N-acetylcysteine (NAC) have shown promise in reducing skin-picking behaviors and associated distress.

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

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

  Skin picking disorder is usually treated with a combination of medicine and cognitive behavioral therapy. […] The most helpful medicines include: Antidepressants, usually with selective serotonin reuptake inhibitors (SSRIs). SSRIs that have been tested in people with dermatillomania include citalopram (Celexa), fluoxetine (Prozac), fluvoxamine (Luvox, Faverin), and sertraline (Zoloft). […] Several kinds of therapy may be helpful, including: Cognitive behavioral therapy, which teaches you coping strategies to help change your behaviors. […] Habit reversal therapy, which helps you become more aware of your behaviors so that you can break bad habits. […] Acceptance and commitment therapy, which helps you accept negative emotions and teaches you positive coping mechanisms. […] If you have severe damage to your skin or your tissue underneath, your doctor may send you to a specialist to talk about surgery and skin grafts. […] Treatment usually involves a combination of medicine and therapy. It is a lifelong condition, but with treatment, you can go into remission. This means that you won’t feel the urge to pick or can avoid doing it for long periods.

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

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

  Engaging in regular physical activity can help keep the mind occupied and lessen the urge to do body-focused repetitive behavior like hair pulling or skin picking. […] Practicing mindfulness can also help in dealing with excoriation disorder. […] Developing healthy rules and rituals to control anxiety, which often contributes to body-focused repetitive behavior. […] Building a strong support system made up of close friends and family is crucial for anyone dealing with excoriation disorder. […] It can be challenging, but its important for people dealing with excoriation disorder to reach out and communicate with family and friends about their condition. […] Either in-person or online therapy can also be an excellent place to speak up and ask questions about why someone might pick at their skin and what they can do to stop.

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