Excoriation Disorder (Skin Picking Disorder)

Many individuals pick at their skin from time to time, but it can occasionally lead to a disease known as excoriation (skin picking disorder).

What is excoriation disorder?

It’s typical to pick at scabs or bumps from time to time. Picking, on the other hand, might become a habit for certain people. Picking can aggravate existing sores and possibly lead to the formation of new ones. This might result in even more scabbing and scarring.

Skin-picking disorder, also known as excoriation, is a condition that results from excessive picking. Picking at one’s skin is a habit or an impulse for people with this disease. They frequently describe the urge to pick as a difficult one to restrain.

Some people might pick for a few minutes multiple times a day. Others may choose for many hours at a time during the day.

Skin-picking condition isn’t all that prevalent, although it’s well-known. It’s a mental health issue that’s linked to obsessive-compulsive disorder (OCD). Although not everyone with OCD develops skin-picking disorder, many persons with this disease also have OCD.

Continue reading to discover more about excoriation, including why it occurs and how to treat it.

Related: Tongue Biting Disorder

Difference between dermatillomania and obsessive-compulsive disorder

OCD refers to a category of mental disorders as well as a specific condition. There are some key differences between dermatillomania and obsessive-compulsive disorders despite falling under the category of obsessive-compulsive disorders.

• Obsessions. People with OCD experience obsessions, which are thoughts or urges that are impossible to control and unwelcome. The obsessions described above don’t occur with dermatillomania.
• Rewarding feeling. Dermatillomaniacs often experience relief when picking at their own skin. There is no such thing as OCD.
• Damage. There is very little self-damage or self-injury associated with OCD. There is a great deal of self-injury associated with dermatillomania.

What are the effects of this condition on my body?

People with dermatillomania pick at their skin compulsively. Many people pick without noticing they are doing it, because it is an automatic movement. Then there are those who know that they are doing it, but they are unable to stop doing it.

Picking can occur on rough skin or skin that already has blemishes or irregularities. There are many types of picking, including picking at pimples, dry skin patches, and scabbed-over cuts and scratches (which may have resulted from picking or from another cause).

When wounds are picked, new ones are created or old wounds are reopened, causing bleeding and scarring. If the condition is severe enough, it might require surgery to repair the damaged skin, such as skin grafting. It may also be necessary to treat infected wounds with antibiotics.

A severe overreaction of the immune system can result when infections spread through these wounds. Severe overreactions, such as sepsis, can be life-threatening.

Mental health effects

People with this condition often hide their visible injuries behind clothing, makeup, or other means in order to hide the embarrassing condition. This causes anxiety, depression, or social isolation because of its effect on the mind. People can also suffer from this condition at work or in their social lives.

Skin picking disorder symptoms

Understanding the signs and symptoms of skin-picking disorder can help you determine if certain actions are due to “normal” picking or something more serious.

For example, picking regularly is almost never an issue. Scabs itch a lot as they recover, which causes a lot of individuals to scratch their skin. Many people pick at pimples and blackheads, despite recommendations to the contrary.

People with excoriation disorder, on the other hand, may pick at scabs, bumps, pimples, or even other skin lesions until they bleed or become inflamed. Picking at the skin surrounding their fingernails and toenails is also a possibility.

People with the condition will sometimes let the chosen areas heal before picking them again. It’s a difficult cycle to break because of habit and instinct.

Other skin-picking disorder indications and symptoms include:

• Attempting to remove “imperfections”: Some individuals scrape their skin or try to rub off “imperfections” they believe they perceive. This can also result in more lesions, wounds and sores.
• Picking at the skin for long periods of time: Some persons with this disease pick at their skin many times a day. Others may select for a long period of time. In any case, their actions may cause substantial disturbance in their personal and professional life.
• Scarring and infections as a result of regular picking: Infections, lesions and scars can result from the condition, which can continue for a long time. Antibiotics may be required to treat infections.
• Frequent picking can cause skin covered with sores and scars, thus many avoid going to public gatherings because of their skin. Because of their skin’s look, some persons with this disease may avoid going to the beach, the gym or other places that need short clothes.

Related: Cheek Biting Disorder

How this condition develops

Skin-picking disorder is characterized by a pattern of self-grooming. A body-focused repeated behavior is another name for it (BFRB). Hair pulling and nail picking are two more BFRBs.

Skin-picking disorder is categorized as an OCD kind. For many people, the compulsive need to pick is much too strong to overcome on their own. A person’s ability to regulate their conduct decreases as they pick at their skin more.

What causes a person to develop this condition is unknown.

One of two events or situations frequently triggers the disorder:

• A scab forms when an infection, injury or wound begins to heal. Scratching and picking are common responses to itching. The fresh wound or lesion begins to heal and a new scab forms. This starts the choosing process.
• During times of stress, the activity is a stress-relieving habit. Skin plucking, with its repeated activity and control, may provide respite from other uncontrollable situations.

Both children and adults suffer from skin-picking problems. It can start at any age, although it is most common during adolescence or at the start of puberty. It is more common in women than in males.

Related: Lip Biting Disorder

Co-occurring diseases are very common

Skin-picking problem is frequently accompanied by other illnesses. These diseases or disorders might be signs of a larger problem, or they could share a number of risk factors in common.

The following are examples of co-occurring illnesses:

• Obsessive-compulsive disorder (OCD) is a mental disorder that leads a person to engage in repetitive activities that significantly reduce their quality of life.
• Body dysmorphic disorder (BDD) is a body-image problem in which people have obsessive negative thoughts about their appearance. Picking at the skin to eliminate “imperfections” might result as a result of this.
• Major Depressive Disorder can cause a variety of habits, including skin plucking.
• Trichotillomania (hair-pulling) is a condition that affects about 38% of persons who have skin-picking disorder.
• Other BFRBs: Hair-pulling seems to be the most common co-occurring BFRB, although others can occur. This involves nail-biting, chewing on the inside of your cheeks, and biting your lips till they bleed.

Read: Nail Biting Disorder

Excoriation diagnoses

The skin-picking disorder is impossible to diagnose on one’s own. Even if you believe skin-picking disorder is the origin of your symptoms, your doctor will need to check out certain underlying conditions before establishing a diagnosis.

Following a physical examination, your doctor will inquire about your habits and the sensations you have while engaging in them. They can also tell if the sores or scabs you’re picking are caused by a skin disorder or illness like eczema or psoriasis.

Your doctor may send you to a mental health expert if they believe you have a skin-picking problem. If your family doctor or internist suspects you’re picking your skin as a consequence of stress, anxiety or OCD, they can refer you.

Read: Motor Disorders

Excoriation disorder treatment

Skin-picking disorder treatment options are divided into two categories: medication and therapy.

Therapy

Skin picking triggers can be identified with the aid of a mental health expert or counselor. Then, together, you can figure out how to halt the behavior when these triggers occur.

When you wish to pick your skin, this might involve learning to utilize healthier practices. Squeezing a stress ball, solving a Rubik’s cube, drawing, and other activities that occupy your hands are all examples of ways to quit picking.

A mental health professional can also assist you in learning to reject triggers in your surroundings or on your body that cause you to pick. Avoid picking by wearing gloves or using adhesive bandages to cover scabs or wounds.

Read: How to Stop Trichotillomania

Medications

Antidepressants may assist to reduce self-picking. SSRIs (selective serotonin reuptake inhibitors) are the most often given medications for this problem.

Other medicines, such as psychiatric and anticonvulsant medications, may be recommended for “off-label” usage. This implies that, while the drug is designed to treat a separate ailment, it is often used to treat BFRB skin picking disease.

Outlook

Your doctor will cooperate with you to establish a treatment plan after a diagnosis has been determined. It may take some trial and error to find a treatment plan that works for you.

Although therapy can help you manage your symptoms and stop picking, there may be times when you pick again. Even after long periods of remission from the practice, this can occur.

That isn’t to say you won’t be able to “overcome” the disorder. It simply means that you and your doctor may need to reevaluate and revise your treatment plan to meet your requirements.

Read: Chronic Motor Tic Disorder

How do you deal with it

There are a few things you may do to effectively guide your treatment strategy as you go toward management:

Look for a support group in your area. This group of individuals will understand your situation and will be able to help you discover a treatment plan that will work for you. They can also help you to understand how the condition is progressing and what to expect in the future.

Seek advice from a mental health professional or therapist. The education outreach office at your hospital may provide a list of experts and organizations you may contact.

Above all, be encouraging to yourself. Set objectives for yourself and reward yourself when you achieve them. However, keep in mind that results may come slowly at first. Praise yourself for minor victories and give yourself some mercy if you don’t make a deadline.