Excoriation Disorder

Excoriation disorder, also known as chronic dermatillomania or skin-picking is a condition in which one performs in the act of repeated picking at one’s own skin. This usually results in skin lesions and disrupts one’s life significantly.

Excoriation disorder is serious condition that can lead to long-term social and occupational impairment (ex: loss of control, shame, embarrassment), caused by the prolonged picking at skin. Skin-picking can be directed at healthy skin, minor skin irregularities, legions such as calluses or pimples, or scabs from previous picking. Individuals with excoriation disorder find it difficult to stop this addictive habit.  

Did you know that the word dermatillomania stand for:  

  • Derma: skin  
  • Tillo: pulling or picking  
  • Mania: excessive behavior or activity  

Symptoms

  • Skin-picking can involve fingernails, fingertips, biting with your teeth, or sharp items like tweezers or pins  
  • Recurrent skin picking (common sites: face, arm, hands) that results in skin lesions  
  • Feelings of significant clinical distress in important areas of functioning such as social, occupational, and relational life aspects  
  • Repeated attempts to stop the behavior of skin picking  

Prevalence

Excoriation disorder is estimated to have a prevalence rate of 2.1 % of the population. Skin picking usually has an onset during adolescence and is more common among women than men.

Prognosis

Appropriate treatment can manage symptoms of dermatillomania and reduce its effect on one’s life. Generally, a poor prognosis for curing excoriation disorder is given as the conditions tends to wax and wane (come and go) depending on the person’s circumstances.

When to seek help

We encourage you to seek help as soon as you suspect that you, or someone you know have similar symptoms of excoriation disorder. The sooner we understand the nature of these symptoms, the better it’ll be in managing them and reducing the impact it might have later on. If you already know someone with dermatillomania, we recommend professional treatment with a mental health provider. They can help create a better, livable, constructive lives and manage symptoms accordingly. Lastly, we know that sometimes people tend to read symptoms associated with a certain disorder and claim that “I do that, I have this etc.”. When this happens, just remember that although we may share similar features with the symptoms listed, they have to be recurrent, persistent, and affect everyday job tasks greatly to be diagnosed as a disorder. They are rare and chronic, but help is always reachable and effective.

Treatment

Treating dermatillomania usually involves one of the two or a combination of therapy and medication to effectively reduce symptoms of excoriation disorder.  

Psychotherapy

  1. Cognitive-behavioral therapy (CBT) helps individuals understand and change their faulty thoughts and behaviors such as the repetitive skin picking behavior. People here can learn ways to change their thoughts so that they can reduce or avoid picking at their skin.  

  1. Habit reversal training is a kind of therapy technique where individuals are taught to try to identify the situations or stresses that trigger skin picking in the first place so that later on, the behavior can be changed from skin picking to for example squeezing a rubber ball instead.  

  1. Stimulus control is another kind of therapy that involves making changing to one’s environment to help reduce skin-picking. For example: wearing gloves or band-aids to prevent feeling the skin and getting the urge to start picking at it.  

Medications

Medications such as selective serotonin reuptake inhibitors (SSRIs)- a type of antidepressants- are the most common for treating excoriation disorder.