What is Skin Picking Disorder

Skin Picking disorder is a mental disorder of picking at one’s skin without being aware of it (unconsciously). If you have Skin Picking disorder , you may keep picking at your skin even when it causes infections or stress or it hurts your social and emotional well-being.

Skin Picking disorder can develop at any age, but it most commonly appears first during adolescence.

What are the causes?

Skin Picking disorder is more likely to be related to a type of obsessive-compulsive disorder (OCD), rather than a bigger skin problem.

• OCD involves having unwanted and distressing thoughts, ideas, or urges (obsessions), and doing repetitive physical or mental acts (compulsions) that bring a temporary sense of relief or calming.
• Compulsions of OCD may be briefly calming, but a person is likely to feel distress over the consequences of these acts.

People with Skin Picking disorder may have other mental health concerns like depression or anxiety, which also may need treatment.

The cause of this condition is not known. It often develops as a result of:

• Unresolved stress.
• A skin injury or infection that causes itchiness or a scab. Acne is one example.

What increases the risk?

You are more likely to develop this condition if:

• You have OCD.
• You have body dysmorphic disorder (BDD). This is a mental health condition that involves an obsession with how you look.
• You use or have used methamphetamine or cocaine.
• You are female.

What are the signs or symptoms?

Symptoms of this condition include:

• Unconsciously and repeatedly picking at your skin. This may be done in order to feel some relief from stress or other emotional difficulties.
• Harming your body in noticeable ways. In severe cases, sharp objects may be used.
• Inability to stop yourself from picking at your skin.

How is this diagnosed?

To diagnose Skin Picking disorder , your health care provider may perform a physical exam to rule out skin disorders, and ask questions about:

• Your mental health and well-being, including stressful events you have experienced that may have triggered your condition.
• Any strong emotions you have trouble dealing with, which lead to skin picking.
• Any history of substance abuse problems.
• Any history of skin injury or infection that may have triggered your condition.

You may be referred to a mental health care provider or a skin specialist (dermatologist) to confirm a diagnosis and determine what treatment is best for you.

How is this treated?

The first step in treatment is to make yourself aware of your disorder and the problems it causes. Treatment options may include:

• Cognitive behavioral therapy (CBT). This focuses on identifying and changing problematic thoughts and behaviors that cause your condition.
• Mindfulness-based cognitive therapy. This type of CBT emphasizes focusing your attention, meditating, and developing awareness of the present moment (mindfulness).
• Habit reversal therapy. This focuses on becoming aware of your picking and learning to use relaxation techniques or do something else instead of picking.
• Acceptance and Commitment Therapy (ACT). This focuses on accepting yourself as you are and setting goals for making changes.
• Antidepressant medicines.
• Working with a dermatologist to treat any skin problems caused by the disorder.

Follow these instructions at home:

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Become aware of what triggers you to pick at your skin, and try to avoid those triggers. Develop skills to deal with issues that trigger picking.
• If you feel an urge to pick at your skin, use strategies to stop yourself. Therapy can help you develop strategies, such as:
  • Taking a deep breath.
  • Naming the feelings you are having.
  • Keeping your hands busy.
• Consider joining a support group for people who have skin-picking disorder. This can help overcome shame that you might feel and help you cope with your condition.
• Keep all follow-up visits as told by your health care provider or therapist, including therapy and dermatology visits. This is important.

Contact a health care provider if:

• Your emotions or stress have become overwhelming.
• You develop signs of infection in an area that is affected by picking. Signs of infection may include:
  • Redness.
  • Swelling.
  • Pain.
  • Warmth.
  • Fluid or pus drainage.
  • Fever.

Get help right away if:

• You have thoughts about hurting yourself or others.

You can go to your nearest emergency department or call:

• Your local emergency services (911 in the U.S.).
• A suicide crisis helpline, such as the National Suicide Prevention Lifeline at 1-800-273-8255. This is open 24 hours a day.

Summary

• Skin picking disorder is a mental disorder of picking at one’s skin without being aware of it (unconsciously). It is often related to obsessive-compulsive disorder (OCD).
• The diagnosis of this disorder is made through both a physical exam and a mental health assessment.
• Treatment may involve managing physical skin problems, finding the appropriate mental health treatment, and taking medicine.
• Consider joining a support group for people who have skin-picking disorder. This can help overcome shame that you might feel and help you cope with your condition.