Excoriation (skin picking) disorder, also known as dermatillomania, is a mental illness that involves individuals obsessively picking at their skin, leading to irritation, swollen or inflamed skin, and mental or emotional distress.
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Skin picking is a body-focused repetitive behavior (BFRB), like hair-pulling (trichotillomania). It is related to obsessive-compulsive disorder (OCD), as it involves a preoccupation and compulsive behavior. Situations that may trigger excoriation disorder include: 1
Individuals with skin excoriation disorder may pick at areas of healthy skin, pimples, blisters, scabs, and other regions of irregular skin. People with excoriation disorder often go through phases in which they pick less and phases where they pick more, sometimes due to stressful life changes or anxiety. If left untreated, the condition can be chronic, lasting for months or years at a time. 2
Excoriation disorder symptoms include: 3
Because skin-picking is a form of obsessive behavior, some may wonder, is excoriation disorder OCD? Skin-picking, alone, is not an OCD trait. Many people pick at scabs or pimples, which does not mean they have OCD or excoriation disorder. When picking becomes a compulsion or something a person feels they have no control over, is when it becomes a skin-picking disorder.
It is important to note that people with excoriation disorder often have other co-occurring mental health conditions, including OCD. In cases where a person deals with OCD skin picking, OCD and dermatillomania likely occur simultaneously. However, it is possible to have excoriation disorder on its own, without it being OCD skin picking. 4
Excoriation disorder and OCD are two separate disorders, but they do have similarities. These will be detailed below.
Both skin excoriation and OCD cause distress for individuals with the conditions. This can include emotional distress, mental health concerns, and other troubling symptoms.
People with OCD lack control over their thoughts and compulsions; similarly, people with skin excoriation disorder feel a lack of control over their urge to pick.
Both disorders can lead to impairment in individuals’ lives. People who struggle with obsessive picking of skin may create scabs or lesions on their skin, which can lead to pain, embarrassment, and social isolation. Similarly, those with OCD may face significant impairment in areas of life affected by their OCD.
People with skin picking obsession and those with OCD may withdraw from friends and family if their conditions are severe. They may isolate to engage in compulsive behaviors, or they may isolate due to anxiety and depression associated with their disorder.
There are several differences between skin excoriation and OCD. OCD is considered an anxiety disorder, while skin picking is a behavioral disorder. Additionally, people with OCD often engage in compulsive behaviors to “prevent” bad things from happening. People with dermatillomania, pick at their skin to soothe anxiety. Additional differences include:
Sometimes, people with constant skin picking are unaware of what they are doing—it can be an unconscious habit. This stands in contrast to OCD thoughts and behaviors, often at the forefront of the individual’s mind.
Most people with OCD do not have to seek medical care for their obsessive and compulsive behaviors unless they cause harm to themselves or others. People with excoriation disorder do need medical attention in some instances if they cause damage to their skin.
With excoriation disorder, obsessions are not always involved in the skin-picking, though they can be (obsession with skin or appearance, for example). With OCD, obsessions must be present for it to be considered OCD.
With OCD, compulsions are carried out because individuals believe they can prevent something bad from happening. With skin-picking, the compulsive behavior is carried out as stress relief.
Someone with a skin-picking obsession may feel ashamed, hopeless, and unsure how to stop. Fortunately, there are several treatment options available to people living with excoriation disorder, including:
If you’re looking for skin picking treatment, Essence Health and Wellness has the tools to help you recover. We understand that coming to treatment can be a difficult choice, so we emphasize a quick recovery that gets you back to your loved ones as soon as possible.
You can feel safe knowing your treatment is highly individualized, with a treatment plan that fits your needs. Our staff is trained to provide treatment methods like meditation, 12-step programs, family systems therapy, cognitive behavioral therapy, music therapy, and more—whichever therapy works best for you and your needs.
Treatment doesn’t have to be a long and challenging process, and Essence Health and Wellness emphasizes the importance of having fun while healing. This means you can focus on recovery and participate in activities like beach days, hiking, bowling, family dinners, and more.
Offering top-of-the-line mental health care from compassionate, dedicated, and highly trained professionals, Essence makes your wellness our priority. Reach out today at (800) 426-9829 to learn more.
At EHW, we accept health insurance plans from most providers. If you are covered by a private or commercial insurance policy, your plan may cover your substance use and mental health treatment costs.