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Skin Picking Disorder (Excoriation Disorder): Signs & Symptoms

Skin Picking Disorder is similar to hair pulling, sharing many of the same characteristics in both symptoms and treatment options. Research into skin picking is relatively new, and we are still learning how it's both alike, and different, from hair pulling.

Skin picking, like trichotillomania, may at times resemble Obsessive-Compulsive Disorder in the feelings of compulsion and repetitive behavior, but the two disorders have different symptoms and require different treatments.

According to the DSM5, Skin Picking Disorder is most commonly characterized by:

  • Recurrent skin picking resulting in skin lesions.
  • Repeated attempts to decrease or stop skin picking.
  • The skin picking causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
  • The skin picking is not attributable to the physiological effects of a substance (e.g., cocaine) or another medical condition (e.g., scabies).
  • The skin picking is not better explained by symptoms of another mental disorder (e.g., delusions or tactile hallucinations in a psychotic disorder, attempts to improve a perceived defect or flaw in appearance in body dysmorphic disorder, stereotypies in stereotypic movement disorder, or intention to harm oneself in nonsuicidal self-injury).


When is skin picking a serious problem?

There is no universally agreed-upon standard as to when skin picking becomes a serious problem. In more serious cases, though, the picking is generally time-consuming, results in noticeable tissue damage, and causes emotional distress. When it is even more severe, people often suffer impairment in social, occupational, and physical functioning. This can include avoiding social activities such as going to the pool, gym or beach; being late for work or other events because of the time it takes to cover up the picking; and avoiding contact with anyone who may notice bleeding, scars, or sores.

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