Almost everyone picks at their skin or scabs at some point. However, some people have a serious condition known as excoriation, or skin picking disorder, that goes above and beyond occasional picking of scabs. People with the disorder can pick at their skin, especially around the nails, or any scabs to such an extent that it causes sores, bleeding and scars. Skin picking disorder can be a serious mental health condition requiring treatment in order to overcome, and is associated with obsessive compulsive disorder (OCD).
What are the Symptoms?
Some people develop this disorder as a way to remove a perceived imperfection on the skin. They will scratch and pick at their skin until it causes injury and a wound. Other people develop the disorder due to a nervous habit of picking at their skin, although for some people this nervous habit does not cause problems. To be diagnosed with the condition, the skin picking must be disruptive to a person’s life, either personally or professionally. Some people with the disorder avoid places because of the scars or wounds, or they spend a significant amount of time covering up the sores or scars before going out. They also feel upset about how often they pick at their skin.
How Does the Disorder Develop?
Excoriation can develop in a few different ways, but it can happen to anyone at any age. For some people, it begins when they get a rash, small injury or skin infection that causes a scab. The person picks at the scab or rash, which then causes more injury and leads to a continual cycle of picking and continued injury. It can also develop during stressful times, becoming a stress relief habit. This habit can become a compulsive behavior, which is why it is classified as a disorder related to OCD.
How Can it Cause Scarring?
Skin picking disorder can cause scarring because of the repeated injury to the skin. When the skin undergoes trauma, it acts quickly to heal itself. The rapid growth of new skin cells can cause scarring, as can the damaged cells. When the skin is repeatedly injured through being picked, it does not have the chance to heal appropriately. The continual damage to the skin cells causes the area to appear differently and increases the risk of scarring.
How Can it be Treated?
Skin picking disorder is typically treated with therapy – especially cognitive behavioral therapy – and possibly medication, typically SSRIs (selective serotonin reuptake inhibitors). The two main types of psychotherapy used on this disorder are habit reversal training and stimulus control. Habit reversal training helps a person understand the triggers for the skin picking and then provides the person with alternative, healthier habits. Stimulus control prevents skin picking by altering the environment to avoid skin picking. This could be wearing gloves, wearing band-aids, or covering mirrors.
If you believe that you or someone you know might have skin picking disorder, it is best to seek help from a professional to work on the underlying issues that contribute to the condition. Even if you do not have the disorder, you should be very careful not to pick your skin, as this can lead to further damage and scarring.
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The information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. Please speak to your doctor to treat any medical condition. Information on this site is not intended to be patient education, does not create any patient-physician relationship, and should not be used as a substitute for professional diagnosis and treatment.
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