Dermatillomania

Dermatillomania, also known as Excoriation Disorder or Skin-Picking Disorder, is a mental health condition characterized by the repetitive picking at one’s own skin, leading to tissue damage, distress, and difficulty functioning in daily life.

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Key features of dermatilomania include:

• Recurrent skin picking that results in lesions or wounds

• Failed attempts to stop or reduce the behaviour

• Significant emotional distress or impairment in social, occupational, or other areas of life

• Can involve hours per day spent picking, inspecting, or covering up skin

• Often focused on areas like the face, arms, hands, or scalp, though any part of the body may be targeted

• May be triggered by anxiety, boredom, perfectionism, or a need to “fix” perceived skin imperfections

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Some individuals pick skin consciously, as a way of coping with emotional discomfort, while others do it automatically, without awareness. The behaviour can be both emotionally soothing and deeply distressing, leading to cycles of guilt, shame, and secrecy.

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Cognitive-behavioural therapy, particularly Habit Reversal Training (HRT), is an evidence-based treatment for dermatilomania. HRT teaches individuals to become aware of skin-picking behaviours and replace them with healthier alternatives (e.g., using a stress ball, applying lotion, or wearing gloves). CBT may also target underlying beliefs, anxiety, or perfectionism that contribute to the behaviour. 

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Medications may be warranted, especially when symptoms are severe or co-occur wth depression or obsessive-compulsive disorder.