Skin picking disorder

Also called dermatillomania or excoriation disorder, skin picking disorder is where you can't stop picking at your skin. There are things you can try to help yourself, but some people may need professional treatment.

Check if you have skin picking disorder

Most people pick at their skin from time to time, but you may have skin picking disorder if you:

  • can't stop picking your skin
  • cause cuts, bleeding or bruising by picking your skin
  • pick moles, freckles, spots or scars to try to "smooth" or "perfect" them
  • don't always realise you are picking your skin or do it when you are asleep
  • pick your skin when you feel anxious or stressed

You may pick your skin with your fingers, fingernails, teeth, or with tools like tweezers, pins or scissors.

Things you can try to stop you picking your skin

Do

  • keep your hands busy – try squeezing a soft ball or putting on gloves
  • identify when and where you most commonly pick your skin and try to avoid these triggers
  • try to resist for longer and longer each time you feel the urge to pick
  • care for you skin when you get the urge to pick it – for example, by applying moisturiser
  • tell other people – they can help you recognise when you are picking
  • keep your skin clean to avoid infection

Don't

  • let your nails grow long – keep them trimmed
  • keep things like tweezers and pins where you can easily get at them

See a GP if:

  • you can't stop picking your skin
  • you're causing serious damage to your skin by picking it – like cuts that don't heal within a few days
  • picking your skin is causing you emotional distress or affecting your daily life

What happens at your appointment

Your GP will ask you about your skin picking behaviour and look at your skin.

If they think you have skin picking disorder they may refer you to a specialist for diagnosis and possible treatment. This could be with a type of talking therapy or with medication.

They may also refer you to a skin specialist (dermatologist), if your skin is badly damaged or you have any underlying skin conditions that may be triggering your skin picking, like acne or eczema.

Talking therapy for skin picking disorder

Talking therapy is currently thought to be an effective treatment to help change skin picking behaviour. If you're offered this, it will usually be given through community mental health services.

The most common type of talking therapy offered for skin picking disorder is cognitive behavioural therapy and may include a technique called habit reversal training.

Habit reversal training works by helping you:

  • recognise and be more aware of your skin picking and what is triggering it
  • replace skin picking with a less harmful behaviour

OCD Action offers more information and support for people with skin picking disorder.

Medication for skin picking disorder

Your doctors may recommend some types of medication to help you control your skin picking behaviour.

This may be prescribed by your GP but more often it will be prescribed by a specialist (psychiatrist).

Causes of skin picking disorder

Skin picking disorder is related to obsessive compulsive disorder, where the person can't stop themselves carrying out a particular action.

It can be triggered by:

  • boredom
  • stress or anxiety
  • negative emotions, such as guilt or shame
  • skin conditions, such as acne or eczema
  • other blemishes that the person wants to get rid of – these may not be noticeable to other people

It is sometimes called a "body-focused repetitive behaviour" and is similar to repetitive hair pulling disorder (trichotillomania).

It is also related to other obsessive compulsive disorders such as body dysmorphic disorder, where the person is excessively preoccupied with their appearance.

People with skin picking disorder often also have other obsessive compulsive disorders. These may require their own assessment and treatment.

Page last reviewed: 18/01/2018
Next review due: 18/01/2021

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