Skin Picking OCD (Signs, Symptoms & Treatment)

Disclaimer: This article is for educational purposes only and does not replace expert medical or mental health advice. Skin picking disorder or OCD requires a comprehensive physical and psychiatric evaluation by a qualified clinician. So, always refer to a licensed mental health specialist for diagnosis and treatment.

Skin picking is not necessarily an uncommon behavior - we all might do it sometimes. But imagine being in a never-ending cycle where you cannot stop picking at your skin to the point that it leads to wounds and even tissue damage. This is what is known as skin picking disorder (excoriation disorder). It is a mental health condition, as it leads to significant distress and impacts daily life and functioning.

However, is skin picking a type of obsessive-compulsive disorder (OCD) or a symptom? No. Skin picking disorder is not OCD, but it is classified under obsessive-compulsive and related disorders. While both conditions involve repetitive behaviors, OCD is driven by intrusive thoughts (obsessions), whereas skin picking may happen in response to tension, emotional distress, or habit.

Skin picking disorder, also known as dermatillomania or excoriation disorder, falls under the category of obsessive-compulsive and related disorders, where people repeatedly pick their skin with their fingers or fingernails. Some may even go as far as to bite or use scissors. So, this condition can often lead to wounds and tissue damage.

Why people pick at their skin varies - it can be out of anxiety, habit, or even boredom. Many times, it happens unconsciously.

Dr. Ryan Peterson, a highly experienced physician at the NuView Treatment Center, says, “We all pick at our skin sometimes. I know I do. But skin picking disorder is different, as it leads to a significant amount of distress and shame. In fact, skin picking disorder can also lead to other complications like social withdrawal, anxiety, and depression.”

Skin picking disorder is classified as an obsessive-compulsive and related disorder and shares certain behavioral features with OCD.

OCD is characterized by obsessions (intrusive thoughts) that lead to compulsive behaviors that provide temporary relief. For instance, repeated handwashing provides temporary relief from intrusive thoughts about contamination. Similarly, skin picking can be a response to obsessions about picking at your skin, and it can offer relief. However, this is not true for every case. In fact, skin picking disorder shares more characteristics with the compulsive symptoms of OCD.

Skin picking disorder in itself is not OCD. It is called dermatillomania, a Greek term where “derma” is skin, “tillo” is picking, and “mania” is increased activity. It is also known as body focused repetitive behavior and sometimes categorized as an obsessive-compulsive spectrum disorder. It must also be noted that dermatillomania often co-exists with OCD.

The signs and symptoms of skin picking disorder are:

• Intrusive urges to touch or pick at skin
• Repeated rubbing, scratching, squeezing, or digging at the skin
• Automatic (outside of awareness) and focused (intentional) skin picking
• Common skin picking regions are the head and limbs, but it can happen anywhere
• Temporary relief after picking at the skin
• Skin and tissue damage
• Significantly impacts daily life and functioning.

There is no one definitive risk factor for skin picking disorder, but experts have suggested a few of them, such as:

• Genetics: Family studies have suggested that a first-degree relative with skin picking disorder may increase the likelihood of this condition by 10% - 20%.
• Biological Factors: Brain imaging studies have suggested that the activity in the bilateral dorsal striatum, bilateral anterior cingulate, and right medial frontal regions is different among those with this condition.
• Gender: Skin picking disorder occurs in 2% - 3% of the population, but gender differences reveal that it is more common among women than in men.
• Underlying Mental Health Conditions: Underlying conditions like stress, anxiety, depression, and OCD can also lead to skin picking disorder. It can serve as an unhealthy coping mechanism.

Skin picking disorder is treated with psychotherapy and medication.

Habit reversal therapy, cognitive behavioral therapy, and acceptance and commitment therapy are the commonly used therapeutic modalities to treat this condition:

• Habit Reversal Therapy: This therapy focuses on drawing your focus to your behaviors and actions, and equips you with skills and tools to proactively break away from habits like skin picking.
• Cognitive Behavioral Therapy: CBT identifies and changes the underlying thinking patterns leading to skin picking and equips you with productive coping tools to handle life’s challenges.
• Acceptance and Commitment Therapy: ACT seeks to mitigate skin picking behaviors by making you come to terms with the negative feelings they give rise to.

Medications can also be used to treat skin picking disorder. Commonly, selective serotonin reuptake inhibitors (SSRIs) are used. However, lamotrigine, an anti-seizure medication, has also been suggested to be effective by a 2007 open-label study published in the National Library of Medicine (NLM).

Meanwhile, skin picking disorder also leads to significant skin and tissue damage if not treated early. Therefore, the right level of medical attention must also be provided to prevent infection, sepsis, and other complications. Commonly, antibiotics are prescribed. In severe cases, skin grafting or surgery can also be suggested.

Dr. Peterson says, “Unfortunately, even if dermatillomania is treatable, less than 20% seek treatment for this condition, as the awareness is really low. However, a significant majority of those who seek treatment go on to achieve healing. In fact, early diagnosis and intervention can lead to better outcomes.”

If you or a loved one is struggling with skin picking disorder or dermatillomania, we understand how challenging it can be for you. However, you do not have to navigate this alone. Reach out to NuView today - we offer personalized treatment options for your recovery and a brighter future.

Please do not hesitate to call us at (323) 307-7997 to connect with our experts today!

1. Is skin picking disorder the same as OCD?

No, skin picking disorder shares more compulsive characteristics of OCD than the obsessive characteristics of OCD, so it is not OCD but is often categorized as an obsessive-compulsive spectrum disorder.

2. What is the difference between dermatillomania and trichotillomania?

Dermatillomania is characterized by compulsive skin picking, while trichotillomania is characterized by compulsive hair pulling behaviors. While these two conditions are different, they can co-exist an estimated 38% of the time.

3. Can skin picking disorder be treated?

Yes, skin picking disorder can be effectively treated with psychotherapy and medication. Other treatments may also be required to heal any skin-related damage.

4. How long does it take to recover from skin picking behaviors?

While we cannot put a time on this, it can take anywhere between a few weeks and a few months to achieve remission.

5. How much does treatment for skin picking disorder cost?

Treatment cost for skin picking disorder varies based on the treatment center and duration, but the treatment for skin picking disorder and related damage can be covered by insurance. Please call NuView at (323) 307-7997 to verify your insurance coverage today!