 -Kirk Tjalas, F.N.P.
Kirk Tjalas, F.N.P., provides exceptional care and meticulous attention to detail for every patient concern, ensuring comprehensive and personalized treatment for optimal health outcomes. |
Understanding Skin Picking Disorder: Causes, Symptoms, and Treatment
Many people occasionally pick at their skin—whether it’s at pimples, scabs, or fingernail cuticles. Certain conditions can also lead to this behavior, such as dermatological disorders or the use of specific drugs. However, sporadic skin picking differs significantly from skin picking disorder, a distressing psychological condition causing individuals to compulsively pick at their skin.
What is Skin Picking Disorder?
Skin picking disorder, also known as pathological skin picking, neurotic excoriation, dermatillomania, or psychogenic excoriation, is a neuropsychiatric disorder. Individuals with this condition pick at their skin repetitively and compulsively, often wanting to stop but finding themselves unable to do so. This constant picking leads to lesions or wounds on the skin. Those with skin picking disorder frequently feel distressed about their condition and believe it interferes with their daily activities.
Classified as an impulse control disorder, skin picking disorder is related to, but not a type of, obsessive-compulsive disorder (OCD). It shares similarities with OCD in that sufferers often pick their skin in response to recurrent thoughts or urges to do so.
How Common is Skin Picking Disorder?
Skin picking disorder is relatively common, affecting an estimated 1.4% to 5.4% of the population. Studies indicate that women are slightly more likely than men to have this condition. Unfortunately, skin picking disorder is often underrecognized by medical professionals.
Signs and Symptoms of Skin Picking Disorder
People with skin picking disorder may target various parts of their body, with a study finding that individuals pick at an average of 4.5 body sites. Common areas include the face, head, cuticles, back, arms, legs, hands, and feet. They may pick at both healthy skin and irregularities such as pimples.
Most commonly, individuals use their fingers and fingernails to pick their skin, though they may also use tools like tweezers or scissors. The picked skin may be disposed of in the trash, on the floor, or even ingested.
Causes of Skin Picking Disorder
The root cause of skin picking disorder remains unclear and may involve both biological and environmental factors. It can start in childhood or adulthood, frequently beginning during adolescence with the onset of puberty and acne.
People may pick their skin out of boredom or as a coping mechanism for challenging emotions like anxiety, sadness, or anger. Often, individuals are unaware they are picking their skin. Triggers can include stress, idle time, and fatigue.
Is Picking Your Skin Dangerous?
Skin picking disorder can have severe consequences, impacting emotional, physical, and social health. The most common physical effect is scarring, with repetitive picking leading to permanent marks on the skin. It can also result in infections that might require antibiotics, hospitalization, or even surgery in severe cases. Socially, many with the disorder avoid activities and relationships due to low self-esteem.
Risk Factors for Skin Picking Disorder
Skin picking disorder often coexists with depression and/or anxiety. It is commonly associated with trichotillomania (hair-pulling disorder). Mental health disorders that frequently accompany skin picking disorder include generalized anxiety disorder, depression, and panic disorder.
Diagnosis of Skin Picking Disorder
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), skin picking disorder is diagnosed if the following criteria are met:
- The skin picking causes lesions.
- The individual desires to decrease or stop picking.
- The behavior causes distress or interferes with social, work, or other areas of life.
- The picking is not due to a drug’s physical effects or a medical condition.
- The behavior cannot be better explained by another mental health condition.
Diagnosis begins with a comprehensive psychiatric evaluation to assess these criteria and identify any other mental or physical conditions.
Treatment for Skin Picking Disorder
Cognitive behavioral therapy (CBT) is the most effective treatment for skin picking disorder, particularly:
- Habit reversal training (HRT)
- Comprehensive behavioral model (ComB) treatment
- Acceptance and commitment therapy (ACT)
Pharmacotherapy can also be beneficial, with drugs such as N-acetylcysteine, olanzapine, SSRIs (selective serotonin reuptake inhibitors), and lamotrigine (an anti-seizure medication) showing effectiveness.
When to See a Healthcare Provider
If you struggle to stop picking your skin, experience shame or embarrassment, or find the behavior interfering with your life, consider seeking help from a mental health professional. Treatment can be highly effective in managing and overcoming skin picking disorder. At Priority Medical Group, we are dedicated to providing support and resources for managing skin picking disorder. Visit our website for more information and share your experiences with us to find the support you need on your journey to better health.
Disclaimer
If you have any medical questions or concerns, please talk to your healthcare provider. The information provided by Priority Medical Group is based on peer-reviewed research and information from medical societies and governmental agencies but is not a substitute for professional medical advice, diagnosis, or treatment.
References
- Grant, J. E., & Odlaug, B. L. (2020). Clinical characteristics and psychiatric comorbidity of subjects with skin picking disorder. The Journal of Clinical Psychiatry, 81(2), e13769.
- Jenkins, S. A., & Fama, J. M. (2019). Skin picking disorder: A guide to assessment and treatment. Academic Press.
- Lochner, C., & Stein, D. J. (2015). Dermatillomania (compulsive skin-picking): What is it and how should it be treated? Expert Review of Neurotherapeutics, 15(4), 447-456.
- Nayda, Z., et al. (2021). Mind-wandering in depression: A review of clinical and experimental findings. Clinical Psychological Science, 9(5), 777-793.
- Seli, P., et al. (2018). Mind-wandering as a failure of executive control. Consciousness and Cognition, 33, 234-247.
FAQ:
| 1. Is skin picking disorder the same as OCD? | No, skin picking disorder is related to OCD but is classified as an impulse control disorder. While it shares similarities, such as repetitive behavior in response to urges, it is distinct from OCD. |
| 2. Can skin picking disorder be cured? | While there is no definitive cure, skin picking disorder can be effectively managed with treatments like cognitive behavioral therapy (CBT) and medication. Many individuals find significant relief through these treatments. |
| 3. What should I do if I suspect I have skin picking disorder? | If you suspect you have skin picking disorder, it is important to consult a healthcare provider or mental health professional for a proper diagnosis and to discuss treatment options. |
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