Skin Picking Disorder
Skin Picking Disorder, also known as excoriation or dermatillomania, is one of five disorders classified as Obsessive Compulsive and Related Disorders in the DSM V (Diagnostics and Statistics Manual). It is a stand alone disorder that can also be found comorbid with OCD.
It is a disorder typified by the repeated urge to pick one’s own skin, often causing damage. It is defined by the habitual and excessive picking of skin lesions or the excessive scratching, picking, gouging or squeezing or otherwise healthy skin. It is closely related to trichotillomania, which is the compulsive pulling of hair.
Although there appears to be no obsessions involved with Skin Picking Disorder, it is similar to OCD in that there are repetitive behaviors with diminishing control in both Skin Picking Disorder and OCD.
Episodes of skin picking are usually preceded by or accompanied by moments of stress, tension or anxiety. During these moments, there is commonly a compulsive urge to pick, squeeze, or scratch at a surface or region of the body, often at the location of a perceived skin defect.
The most commonly picked region is the face. Other frequently picked areas include the arms, legs, back, gums, lips, shoulders, scalp, stomach, chest and extremities such as fingernails, cuticles and toenails. Most patients have a primary place on their bodies that is picked but they will switch to another area in order to allow the primary area to heal.
The most common way to pick is to use the fingers/fingernails but some patients will use implements such as tweezers or needles.Infection is a real risk at the site of picking. Picking can result in bleeding, bruising and permanent disfigurement of the skin. Skin picking disorder can cause feelings of helplessness, guilt, shame and embarrassment in individuals, which can lead to self harm.
Those suffering from Skin Picking Disorder will often try to hide their areas picked with clothing or makeup. Skin Picking Disorder is most often treated with medications and/or some kind of behavioral therapy.