Excoriation (Skin Picking) Disorder In Adults


ICD-10 code: F42.4

Excoriation (skin picking) disorder is part of a cluster of diagnoses called the obsessive-compulsive and related disorders.  Obsessive-compulsive and related disorders are a group of psychiatric conditions that include:

  • Obsessive-compulsive disorder
  • Body dysmorphic disorder
  • Hoarding disorder
  • Trichotillomania
  • Excoriation (skin picking) disorder

These disorders are characterized by the occurrence of repetitive behaviors, often called compulsions.

Individuals with obsessive-compulsive disorder might engage in compulsive behaviors such as excessive washing, checking, arranging, or counting.  Individuals with body dysmorphic disorder might engage in frequent checking of their appearance in the mirror, or excessive grooming-related behaviors.  Individuals with hoarding disorder may engage in excessive acquiring of objects, combined with a strong need to save items.  Individuals with trichotillomania engage in excessive hair pulling, and individuals with excoriation disorder engage in excessive skin picking.

In some cases, the obsessive-compulsive and related disorders are also characterized by intrusive, unwanted, or distressing thoughts, called obsessions, which come to mind again and again.  People with obsessive-compulsive disorder might have obsessive thoughts about dirt or germs, thoughts of harming others, fears of making mistakes, or distress about things being out of order.  People with body dysmorphic disorder have repetitive, negative thoughts about their own appearance.  However, people with certain other obsessive-compulsive and related disorders (such as trichotillomania or excoriation disorder) often do not experience obsessive thoughts.

What is excoriation (skin picking) disorder?

Excoriation (skin picking) disorder is a psychiatric disorder that affects approximately 1-5% of adults.  Excoriation disorder is characterized by two main symptoms:

  • Recurrent skin picking resulting in injury to the skin (skin lesions)
  • The person has repeatedly and unsuccessfully tried to decrease or stop skin picking

Individuals with excoriation disorder may pick at healthy skin, skin irregularities (such as pimples or calluses), or scabs.

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Understanding Excoriation (Skin Picking) Disorder

Excoriation disorder severity can range from mild to very severe.  Most people with excoriation disorder spend at least an hour per day thinking about or engaging in skin picking.  In severe cases, picking and picking-related thoughts can last many hours per day.  People with the disorder will sometimes avoid social events or going out in public.  Interference at work or school is also common.  In severe cases, medical complications can arise, including tissue damage, scarring, and infection. Many people with excoriation disorder also have other disorders, most commonly obsessive-compulsive disorder (OCD), trichotillomania (hair pulling disorder), and major depressive disorder.

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How is excoriation (skin picking) disorder treated?

Excoriation (skin picking) disorder is treatable.  The Trichotillomania Learning Center (TLC) has published guidelines on the treatment of excoriation.

 

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