Excoriation disorder

Excoriation disorder, also known as skin-picking disorder or dermatillomania, is a psychiatric disorder characterized by the recurrent compulsion to pick at one's own skin, often to the extent of causing damage. This condition is classified within the spectrum of Obsessive-Compulsive and Related Disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

Symptoms and Diagnosis

Individuals with excoriation disorder repeatedly pick at their skin, leading to skin lesions, scarring, and significant distress or impairment in social, occupational, or other important areas of functioning. The picking is not attributable to physiological effects of a substance (e.g., cocaine) or another medical condition (e.g., scabies). Diagnosis is primarily clinical, based on the individual's history and the presence of characteristic behaviors.

Etiology

The exact cause of excoriation disorder is unknown, but it is believed to involve a combination of genetic, environmental, and psychological factors. There is often a history of Obsessive-Compulsive Disorder (OCD) or other related disorders in the family. Stress, anxiety, and depression can also trigger or exacerbate the skin-picking behaviors.

Treatment

Treatment for excoriation disorder may include a combination of psychotherapy, medication, and self-care strategies. Cognitive-behavioral therapy (CBT) is considered the most effective psychotherapeutic approach, focusing on identifying and modifying the underlying thoughts and behaviors contributing to the skin picking. Medications, such as selective serotonin reuptake inhibitors (SSRIs), may also be beneficial for some individuals. In addition, habit reversal training, a component of CBT that teaches individuals to recognize the urge to pick and to substitute a less harmful behavior, is often effective.

Prognosis

The prognosis for individuals with excoriation disorder varies. While some may achieve significant improvement with treatment, others may continue to struggle with the disorder over the long term. Ongoing therapy and support are often necessary to manage the condition.

Epidemiology

Excoriation disorder affects both males and females, although it is more commonly reported in females. The onset can occur at any age but typically begins in adolescence. The prevalence of excoriation disorder is estimated to be around 1.4% of the general population, although this may be an underestimation due to underreporting.

See Also

• Obsessive-Compulsive Disorder (OCD)
• Body Dysmorphic Disorder
• Trichotillomania (Hair-Pulling Disorder)
• Anxiety Disorders