Skin Picking Disorder (Excoriation): Causes, Symptoms, Treatment & Prevention Tips

You may not realize it till someone points out, that you are constantly picking your skin. If you do, then you may be suffering from a mental ailment called dermatillomania or excoriation disorder. Skin picking is a form of obsessive compulsive disorder and it can disrupt your life and skin significantly, if not stopped immediately. You may pick a healthy skin or acne/ pimple lesions, calluses around nails, etc. And in the process hurt yourself with bleeding and wounds sometimes.

What Is Skin Picking Disorder?

Dermatillomania or skin picking disorder is a psychological condition that prompts a repetitive urge to pick, scratch, dig or touch one’s own skin. Individuals may pick or scratch healthy skin, lesions, scabs or minor skin irregularities (pimples, calluses, dry skin etc.), often to an extent where severe damage and bleeding is caused.
This obsessive compulsive disorder is often chronic that can last for weeks, months and years if left untreated. Some periods of this disease can intensify and reduce depending on the mental condition of the individual. Sometimes the skin picking can last for hours at a stretch (again depending on their picking behavior).
Excoriation disorder is an impulse controlled disorder, and linked to body dysmorphic disorder, suggesting that the person is excessively preoccupied by their own appearance.
Compulsive skin picking or excoriation is a body focused repetitive behavior (BFRB) that usually starts during adolescence either during or after the onset of puberty. But it can also occur amongst younger children (under 10 years of age) or adults (between 35 and 45). More women are found to be affected by this disorder.

Also Read: How To Treat Skin Pigmentation Disorder?

Affected Body Parts Due To Skin Excoriation Disorder

The different body parts affected by compulsive skin picking depend entirely on the individual’s behaviour. The most affected body parts include –

1. Picking the skin around your finger nails (cuticles)
2. Lips
3. Scalp
4. Palm and sole
5. Arms and legs
6. Face
7. Picking any skin disorder or blemish (insect bite, acne, chicken pox, lesions, scabs dry skin, eczema, dandruff, psoriasis)

Interestingly, the people who seek therapy for excoriation or skin peeling are mostly women. You can only be diagnosed after unsuccessful attempts to lessen or even stop the picking. Excoriation is a dangerous disease that can alter your life and create stress and anxiety.

Causes Of Skin Picking Compulsion Or Urge

There are no specific causes that have been identified with excoriation disorder. However, with observation and evidence, there is genetic predisposition associated with this mental illness. If you are someone who suffers from obsessive compulsive disorder along with your close family members, then dermatillomania may run in your family. It is a subconscious action wherein a person can’t stop themselves from carrying out a particular action.
Skin picking syndrome can be triggered by:

• Depression
• Stress or anxiety
• Boredom
• Negative emotions such as sadness, guilt or shame
• Picking on acne, scabs, psoriasis or eczema
• Conscious about blemishes and trying to get rid of it

Also Read: How To Repair Damaged Skin?

Symptoms Of Skin Picking Disorder

Skin picking disorder isn’t just about picking your own skin. There are more factors involved. Look at some of the symptoms below to understand this excoriation disorder –

1. It occurs to people who also suffer from Trichotillomania (hair-pulling), major depressive disorder and obsessive compulsive disorder
2. Nail biting may coincide with excoriation along with lip biting
3. Excoriated skin results in open wounds, skin lesions and cuts
4. Skin picking is not explained by any psychiatric disorder, abuse of medical substance or dermatological concern
5. The symptoms cause clinical distress
6. There is no other psychiatric disorder that can explain this condition
7. The symptoms are repeated constantly without any self-awareness.

Treatment For Excoriation Or Skin Picking Disorder

Skin picking is a disease that must be controlled and stopped immediately. It not only damages your skin but your mind and self-image as well. It’s all about healing the mind and the brain from this dysfunctional disorder. Skin picking treatment must be performed by a doctor who has many years of experience and is an expert in this field. There must be a holistic treatment undertaken which focusses on both behavioural therapy and medications –
1. Medication – Using antidepressants such as selective serotonin reuptake inhibitors (SSRIs) helps reduce obsessive thoughts and compulsive actions/ behaviors
2. CBT- Cognitive-behavioral therapy helps patients become more self-aware about their thoughts and action. The therapy can also help reduce repetitive behavior and understand the consequences of their action. It includes a technique called habit reversal training. This helps in making you more and more aware of your skin picking urge and also understand what is prompting you. It also helps in replacing excoriation with less harmful and fulfilling behaviours.

Also Read: How To Get Flawless Skin?

Treatment Of Skin Picking Scar By A Dermatologist

If the skin is damaged from excessive picking, then it’s bound to leave scars. Please consult with a dermatologist about the treatments and use them under his/her supervision. As a dermatologist treats the skin membrane and its dysfunctions to prevent any further urge of skin picking. Beginning from acne or pimples, scars, scabs, bumps, moles, warts, lesions, wounds, etc. must be treated by some specialist procedures by an expert dermatologist. Dermatillomania treatment for scars and other skin lesions include –

1. Laser – The best solution to any type of scar removal is Laser. Laser uses heat and light energy to gently remove the upper layers of skin and bring skin repair without causing severe side-effects. Laser treatment can improve the skin texture and induce more collagen to help uplift any deep pitted scars. It does not take many sessions to see positive results
2. Cryotherapy – Cryotherapy is used along with other treatments to avoid the growth of Keloid like scars. It freezes the scar using liquid nitrogen and then reduces the appearance by fading them
3. Micro needling/ Derma roller – Hundreds of tiny needles are rolled over the scars to help induce the production of collagen. This will only help superficial scars and may be combined with other treatments to give effective results.
4. Fillers – Every time you pick your skin, deep pitted scars are formed. Filler injections help even out the skin surface and fill any indentions left by skin picking. You may need to go for filler injections twice or even thrice a year to maintain the skin’s even texture
5. Skin lightening creams – Hyperpigmentation scars are treated using skin lightening creams such as Triluma cream, isotretinoin combined with Hydroquinone (2-4%)
6. Chemical peel – Chemicals peels are the first and foremost treatment for any acne or skin lesion. These offer controlled exfoliation of the damaged dead skin layer using plant extract based acids.
7. Surgical Excision – When everything else fails, surgical excision is used to remove deep rolling/ice pick scars. The surgery is performed carefully and comes with many side-effects and long period of downtime.

Also Read: How To Find A Good Dermatologist Near You?

Skin Care Tips To Prevent Skin Picking Urge

If you are someone who constantly picks their skin or you’ve been diagnosed with excoriation, then you may want to incorporate these tips on how to avoid or lessen the chances of hurting your skin subconsciously –

1. Trim your nails – Cutting or filling your nails completely is an excellent start to curing your skin picking habit. Just don’t cut too deep as that might hurt your skin around the nail bed
2. Clean pillow cases – Scratching will lead to open wounds and anything that comes in contact with an open wound must be very clean. This is why pillow cases must be clean. Also, make sure your makeup brushes and mobile phones are thoroughly clean as to avoid bacterial infection
3. Dettol – A strong disinfectant must be used while cleaning freshly picked skin and wounds. This is highly important because bacteria can crop up easily in such cases which makes Dettol the best solution to keep those pesky bacteria away
4. Hand sanitizer, antiseptic wipes and band aids – Skin picking is dangerous and if your nails and fingers are dirty severe infection can crop in. Keep your hands clean with hand sanitizer and antiseptic wipes. Use a band aid on bleeding wounds. Band aids will also stop you from scratching the same place which will allow your skin to heal
5. Snacks – Now, snacking may seem like an odd solution but it keeps your fingers and mind busy. Skin picking usually occurs when the hand is pre-occupied and your fingers are idle. Remember to indulge in healthy snacks. This will stop your skin picking disorder and keep you healthy
6. Stress ball or fidget spinner – Many people believe keeping your fingers and hands busy and reducing stress in the meanwhile can prevent skin picking disorder and urge to touch. A stress ball gives you a chance to squeeze and distress also preventing your hands from reaching out to the skin, similarly the fidget spinner also keeps your mind and hands occupied
7. Friendly note – Lastly, keep a small post it note nearby reminding you not to pick on your gorgeous skin! This is not only help you remember but keep you motivated and inspired.

Don’t become your skin’s enemy, instead seek therapy and accept the help you must get. Skin picking may sound trivial, but it can have a lasting impact on your skin health and nourishment. Be strong and stop picking your skin!