Excoriation Disorder

GinaMarie Guarino, LMHC

Excoriation Disorder

A person with excoriation disorder suffers from the compulsive need to pick at their skin. It is a disorder that creates a compulsion to pick at various areas of the body to relieve stress.

A person with excoriation disorder will pick at their skin when they are feeling upset, anxious or overwhelmed. The chronic picking will leave sores, lesions and scars on the targeted areas of the body.

Excoriation disorder has the potential for serious consequences. The most common side effect of the disorder is scarring. The constant need to pick at skin leaves deep scars throughout the body. It often causes irreparable damage. The skin picking compulsion can lead to infection, as there are constant open wounds on various places of the body.

Symptoms of Excoriation Disorder

Excoriation disorder has a deeply negative impact on an affected person. They often feel embarrassed and ashamed about their habit.

People with excoriation disorder will try to hide their habit. They will do so by being subtle with their picking. They will also hide their sores and scabs.

Knowing the signs and symptoms of excoriation disorder can be a helpful first step in learning how to take control over the condition. It is important to note that in order to be diagnosed with excoriation disorder, the skin picking must not be due to another issue. This means that the picking is not the result of another factor, like:

  • Allergies
  • Cutting to cope with emotional pain
  • Other medical and mental health conditions.
  • Side effects of medication
  • Substance abuse.

The following are signs and symptoms of excoriation disorder:

  • Compulsively picking at one’s own skin, scabs, or cuticles
  • Picking at skin in response to stress or anxiety
  • Having noticeable open scars, wounds, and sores on body
  • Having the skin picking significantly affect one’s ability to perform academically or at work
  • Social withdrawal or isolation from family and friends
  • Embarrassment and shame for habit and resulting sores and scars
  • Attempts to hide or conceal the act and habit of skin picking
  • Attempts to hide or conceal sores and scabs on body
  • Having the skin picking significantly affect relationships
  • Failed attempts to stop the skin picking habit
  • Visible sores, scars, scabs and wounds on face, arms, legs, hands, neck and chest

Causes of Excoriation Disorder

Excoriation disorder develops as a result of biological and environmental influences. This means developing the disorder has a lot to do with one’s genetic history, and the way they grew up.

These causal factors often induce a level of stress that is uncomfortable for the affected person. The habit of skin picking will ultimately result as a reaction to stress.

The following are risk factors that may contribute to the development of excoriation disorder:

  • Poor coping skills for stress and anxiety
  • Insecurities about personal appearance
  • Low self-esteem
  • A family history of obsessive-compulsive disorder or related disorders
  • A previous habit of playing with hair or biting nails
  • A family member modeling similar compulsive behaviors

A person with excoriation disorder may also suffer from a co-occurring disorder. This is a mental health disorder that occurs simultaneously with excoriation disorder.

Common co-occurring disorders with excoriation disorder include:

Treatment for Excoriation Disorder

Excoriation disorder is nearly impossible to recover from without treatment. People with the disorder pick at their skin so frequently that eventually they do not even realize they are doing it. This makes quitting the habit very difficult. Many people will repeatedly attempt to stop picking at their skin, and often fail. They fail because they do not also work on developing healthy coping skills for stress. They are also not using a cessation method (like quitting cold turkey) that is effective.

There are forms of effective treatment for excoriation disorder. They require therapy with a mental health counselor. With commitment to therapy it is possible to get better.

Common forms of therapy for excoriation disorder include:

  • Awareness Training. Awareness training teaches an affected person how to pay attention to their body. With awareness training, the affected person becomes aware of their behaviors in the moment. This helps them to understand what their body does in response to stress.
  • Cognitive behavioral therapy (CBT). CBT helps the affected person gain insight as to why the resort to skin picking. It also helps to learn stress management skills and methods to change thinking patterns to reduce anxiety.
  • Habit Reversal training. Habit reversal training is a method used to find healthier ways to relieve stress. Instead of picking skin, a therapist may recommend using a fidget toy of stress ball when stressed.

Habit reversal training also helps to identify triggers and stressors that cause the skin picking habit.

Mental health professionals may also recommend medication options. Medication helps to reduce the symptoms of the condition.

With therapy, medication can be helpful in reducing the skin picking behavior. It is important to note that medication alone will not be enough to recover from excoriation disorder. An affected person must also be active in their therapy.

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