What Is Excoriated Acne And How To Treat Them?

Excoriated acne is a specific kind of acne with a unique cause. As the word excoriated implies; it tears and causes an urge to scratch the skin. You have an uncontrolled desire to pop and pick on the pimples continuously. This results in red marks and scars, which may even become permanent. People may even use certain tools to pick on the acne, like pluckers, tweezers, knives, pin or even a nail filer. This may also be due to behavioural disorders of an individual.

What Is Acne Excoriee? (Skin Picking Disorder)

Acne excoriee is a result of acne lesions being compulsively squeezed or scratched, which scars the affected area. It is also called as picker’s acne since the urge to pick on acne prompts this condition. It is common with adolescent kids and is often associated with depression and anxiety, as it not just scars the skin but quashes their confidence levels too.

Acne is caused by multiple factors, which ultimately result in the skin producing excess sebum under the influence of hormones. And, lack of exfoliation of dead skin cells clogs the pores of the skin and results in inflammation of hair follicles due to an increase in skin bacteria. It is a vicious circle – as the more the acne, the more the scratching. Thus, the idea is to minimize the breakouts, to minimize permanent scarring.

People often fall in the habit of picking on their acne lesions in order to get rid of them, but this results in scars/scabs and can also infect the acne, causing inflammation and more breakouts. All these inflammatory lesions that were picked on or squeezed, are acne excoriee.

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Some of the other names for this condition are –

• Compulsive Skin Picking Acne Disorder
• Excoriated Acne
• Picker’s Acne

People who are prone to this condition have certain behavioural issues like –

• Body dysmorphic disorder (bodily focused anxiety)
• Obsessive-compulsive disorder
• Anxiety disorders
• Individuals who are habituated to pick on their skin.

In fact, any individual with acne is at risk of acne excoriee. It is important to understand that just by relating to one of these risk factors may not necessarily mean you would possibly be affected by this condition. Thus, it is recommended to consult a dermatologist, so that you can take appropriate action for its treatment.

What Are The Causes Of Acne Excoriee?

Acne excoriee is caused by constantly picking on acne lesions, and thus anyone who suffers from acne can be a probable candidate for treating excoriated acne. It is typically more common with women than it is with men.  It is caused by constant picking and squeezing of acne, that results in oozing of pus, bleeding, and has the ability to lead to deep scars on the skin.

Some people with emotional/ psychological issues like OCD and anxiety disorders are habituated of subjecting their acne to the constant physical trauma of compulsively picking on their skin with pins, tweezers, or finger nails (even minor lesions). The picking is usually caused due to the itching sensation that acne causes, or sometimes, even by its appearances, and it flares the acne up and causes acne excoriee.

Signs And Symptoms Of Acne Excoriee

Acne is of different kinds – mild, moderate, and severe; and usually appear on the face, neck, back, and arms, and compulsively picking on these acne lesions can lead to deep scars, scabs, or shallow sores. These, typically appear as depressions in the skin or are in the form of hyper pigmentation.

The following are few signs and symptoms that work as indicators to acne excoriee:

• Oozing of pus or bleeding of acne skin lesions
• The growth of fungal infection or secondary bacterial infection
• Mild to severe disfiguration in the appearance of acne
• Deep scars and permanent pitting of the skin
• Underlying emotional and nervous disorders
• Scar tissues due to excoriation without any underlying acne
• Emotional and Psychological distress

When To Seek Medical Care?

It is important to seek help when your acne condition does not improve over a period of time. Also, if you feel distressed and are suspecting depression or anxiety issues, you need to understand that mental health is as important as physical health and should seriously consider counseling or therapy.

Excoriated Acne Treatment

As excoriated acne is more about the behavioural aspect, so the treatment must have both the esthetic procedures for acne control along with behavioural therapy to stop the urge to pick. Physicians may prescribe anti-depressants and anxiety controlling medicines along with dermatologic procedures to remove acne from the skin.
Points to factor-in before proceeding with treatment – Treatment for Acne Excoriee varies depending on the severity of the acne condition. The following are the treatments that will help you in treating your condition –

• Counselling to treat your underlying psychological and emotional issues, and ensuring that you religiously consume the medications prescribed
• Using antibiotic, antibacterial, antiseptic, anti-inflammatory creams, lotions, and gels as prescribed. Benzoyl Peroxide is the most popular treatment that is given to treat mild acne. Further, to regulate the hair follicles and ensure that they are unclogged, topical retinoids are also used.
• Sometimes, certain dermatologists advise taking medications such as antibiotics, hormones (oral contraceptives), and retinoids.
• In some cases, if the severity of acne is high, then is used, but this should be consumed only after being counselled by an expert dermatologist, as it may have certain side effects.

Must Read: What Are The Best Treatments For Adult Acne?

Dermatologist Procedures To Treat Excoriated Acne

• Chemical peels: It is the first-line treatment for majority of acne. Here a plant extract-based controlled exfoliation is proceeded at the skin clinic. Chemicals like TCA, salicylic acid or phenol are recommended usually to resurface the upper deformed skin layers and bring the newer skin cells from beneath. This helps in eliminating the appearance of acne and acne scars.

• Pixel laser resurfacing: It is an advanced fractionated, ablative or non-ablative laser resurfacing technique to remove the upper layer of the skin using multiple small beams of light. Thus inducing collagen production that helps in bringing new skin cells from beneath and replacing the deformed upper layers of the skin.
• Dermal fillers: This is a quick treatment where scars are injected with natural components like hyaluronic acid to flatten and hide them effectively.
• Intralesional injections: It is used on those scars which protrude out from the skin. These help in flattening and reducing the size of the scars. Thus eventually fading them effectively.
• Dermabrasion: It is a surgical and invasive treatment to help in flattening bumpy lumps of acne scars also fading dark spots on the skin. Roller device is used to surgically plane the scars from the skin. Local anaesthesia is required for this procedure.

How Can Acne Excoriée Be Prevented?

Acne Excoriée is mostly related to psychological factors which happen to work together with acne to give you scars and scabs on the skin. Some ways to prevent excoriated acne include –

• Applying topical treatments, like benzoyl peroxide after consulting with your dermatologist
• Keeping stress at bay by including meditation in your routine
• Maintaining a habit of occasionally exfoliating your skin
• Maintaining a clean skin, by using cleansers to unclog the skin pores

Additionally, you need to take care of your mental health by following treatments as given by the doctor. The psychological conditions that prompt acne excoriee include dysmorphic disorder, anxiety disorder, and obsessive-compulsive disorder. Proceed with proper counseling sessions to prevent further aggravation of the situation.

Must Read: Best Skin Care Routine For Acne Prone Skin

There are multiple reasons that cause acne, out of which some are unavoidable. However, it is the habit of picking on acne lesions that worsens the condition. The urge to scratch the affected area leaves the skin scarred, flares up the acne even more, and causes more breakouts. One of the most crucial reasons that make you pick on your acne is associated with your psychological state. And, this is often ignored by many of us. Hence, it is important to take care of your mental wellness as much as your physical health. Seek help from an expert to understand the causes and treatments for your condition.