Education - Stop Picking

Understanding Excoriation (Skin Picking) Disorder

Learn about SP, its causes, and effective treatments

What is Excoriation (Skin Picking) Disorder?

Excoriation disorder, also known as skin-picking disorder or dermatillomania, is a body-focused repetitive behavior (BFRB) characterized by recurrent picking at one's own skin, resulting in skin lesions and significant distress or impairment.

It is recognized in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition) under obsessive-compulsive and related disorders. People with excoriation disorder may pick at healthy skin, minor skin irregularities, lesions such as pimples or calluses, or scabs from previous picking.

Who Does It Affect?

Prevalence: Affects an estimated 1-5% of the population

Gender: More commonly reported in females, though may be underreported in males

Age of Onset: Typically begins in adolescence or early adulthood

Impact: Affects people of all ages, backgrounds, and cultures

Common Triggers

While triggers vary by individual, common patterns include:

Stress & Anxiety

Boredom

Fatigue

Passive Activities

Mirrors

Transitions

Evidence-Based Treatments

Research supports several effective approaches:

Habit Reversal Training (HRT)

HRT is considered the gold standard for treating BFRBs. It involves:

• Awareness training to recognize urges

• Competing response training (alternative behaviors)

• Social support and motivation enhancement

Cognitive Behavioral Therapy (CBT)

CBT helps address thoughts and beliefs that maintain the behavior:

• Identifying and challenging negative thoughts

• Developing healthier coping strategies

• Building self-compassion and reducing shame

Acceptance & Commitment Therapy (ACT)

ACT focuses on accepting urges without acting on them:

• Mindfulness and urge surfing techniques

• Values clarification and committed action

• Psychological flexibility training

Medication

While no medications are FDA-approved specifically for BFRBs, some may help:

• SSRIs for co-occurring anxiety or depression

• N-acetylcysteine (NAC) showing promise in research

• Always consult with a psychiatrist or physician

Recovery is Possible!

Research shows that 70-80% of people see significant improvement with appropriate treatment. You don't have to face this alone—support and effective tools are available.

Ready to Learn More?

View Our Program Find Resources