Table of ContentsView AllTable of ContentsExcoriation DisorderAutoimmune Disorders LinkSigns and SymptomsEffects and ComplicationsTreatmentPrevention
Table of ContentsView All
View All
Table of Contents
Excoriation Disorder
Autoimmune Disorders Link
Signs and Symptoms
Effects and Complications
Treatment
Prevention
Skin-picking disorder (dermatillomaniaor excoriation disorder) and autoimmune disorders often go together. With skin picking, you have a compulsive urge to pick, scratch, rub, pull, or scrape your skin. It can continue beyond the point of causing pain and creating sores to being a significant problem.
In some people with autoimmune diseases, skin-picking symptoms may become a habit and a sign of a mental health disorder.
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Skin picking disorder has several names, including:DermatillomaniaNeurotic excoriationsNeurotic pickingPsychogenic excoriation
Skin picking disorder has several names, including:
“Excoriation disorder” is the medical term for a skin-picking condition. It is also known as dermatillomania. People with this condition will pick their skin to the point where it can cause bleeding or other damage to the skin.
Research suggests that skin picking is associated with certain mental health disorders such as anxiety and depression.It can also happen with autoimmune conditions.
Why does skin picking feel good?It’s not fully understood why skin picking is gratifying to some people. The response may be tactile (the feel or texture of the skin), cognitive (inaccurate thoughts or beliefs about the need to pick), or emotional (an outlet for unpleasant feelings and psychological stress).
Why does skin picking feel good?
It’s not fully understood why skin picking is gratifying to some people. The response may be tactile (the feel or texture of the skin), cognitive (inaccurate thoughts or beliefs about the need to pick), or emotional (an outlet for unpleasant feelings and psychological stress).
Autoimmune Disorders Associated With Skin Picking
Withautoimmune disorders, the immune system attacks healthy tissues, mistaking them for pathogens like viruses or bacteria. Autoimmune diseases that cause skin problems are often associated with skin picking.
The targeted tissues are different in each disease, but many of them have similar symptoms, affecting the skin in some way. Some skin-related autoimmune disorders tied to skin picking include:
Some research suggests itchiness is a persistent symptom of many autoimmune connective-tissue diseases and is under-recognized and undertreated. This could make them prone to triggering excoriation.
Other CausesOther conditions that can cause skin picking include:Dermatologic (skin) conditionsBody dysmorphic disorderObsessive-compulsive disorder (OCD)Substance use disorder(addiction), especially during withdrawalDevelopmental disorders, such asautismPsychosis
Other Causes
Other conditions that can cause skin picking include:Dermatologic (skin) conditionsBody dysmorphic disorderObsessive-compulsive disorder (OCD)Substance use disorder(addiction), especially during withdrawalDevelopmental disorders, such asautismPsychosis
Other conditions that can cause skin picking include:
Signs and Symptoms of a Skin Picking Disorder
Symptoms of skin picking disorder include:
People with skin picking disorder often pick at multiple places on their bodies that may change over time. They try to cover up the sores created from picking with makeup or clothing.
This disorder may also lead to avoiding situations like swimming, wearing shorts, or being intimate because people feel shame or don’t want others to know. Some even hide this condition from their healthcare providers.
Medically, skin picking can lead to:
Emotionally, it can result in social isolation, depression, and anxiety disorders.
Prevalence of Skin Picking DisorderResearch suggests around 3% of people have a current or past skin-picking disorder. People with excoriation disorder are significantly more likely to be female.
Prevalence of Skin Picking Disorder
Research suggests around 3% of people have a current or past skin-picking disorder. People with excoriation disorder are significantly more likely to be female.
Treatment for skin picking disorder tied to autoimmunity should involve multiple approaches.
Autoimmune Disorder Treatment
It’s crucial to treat the autoimmune disease. This can help alleviate the symptoms that led to skin picking in the first place.
Skin Damage Treatment
The damage from skin picking can be treated as follows:
Mental Health Treatment
Mental healthtreatment is usually necessary to stop the picking behavior. Therapies that may be effective include:
Breaking the Skin Picking Habit
Skin picking disorder may come and go over time, but it’s unlikely to resolve without effort.
It also can help to make picking harder. This strategy is called stimulus control. It may involve the following:
As awareness of skin picking in autoimmune disorders grows, healthcare providers may start looking for it routinely. This may help prevent it or catch it early on.
Summary
Skin picking disorder is related to several autoimmune diseases, including rheumatoid arthritis, psoriasis, lupus, MS, and type 1 diabetes. Skin picking disorder involves an urge to pick, scratch, scrape, or pull the skin and an inability to stop these behaviors. Treatment generally involves medications for the autoimmune disease, wound care, and mental health interventions.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Hawatmeh A, Al-Khateeb A.An unusual complication of dermatillomania.Quant Imaging Med Surg. 2017;7(1):166-168. doi:10.21037/qims.2016.12.02Grant JE, Chamberlain SR.Prevalence of skin picking (excoriation) disorder.J Psychiatr Res. 2020;130:57-60. doi:10.1016/j.jpsychires.2020.06.033The TLC Foundation for Body-Focused Repetitive Behaviors.Everybody picks…right? An overview of compulsive skin picking.Narang NS, Casciola-Rosen L, Li S, Chung L, Fiorentino DF.Cutaneous ulceration in dermatomyositis: Association with anti-melanoma differentiation-associated gene 5 antibodies and interstitial lung disease.Arthritis Care Res (Hoboken). 2015;67(5):667-672. doi:10.1002/acr.22498Kwon C, Sutaria N, Khanna R, et al.Epidemiology and comorbidities of excoriation disorder: A retrospective case-control study.J Clin Med. 2020;9(9):2703. doi:10.3390/jcm9092703Multiple Sclerosis Trust.Altered sensations.The TLC Foundation for Body-Focused Repetitive Behaviors.How to manage psoriasis with a compulsive skin picking disorder.Wang F, Morris C, Bodet ND, Kim BS.Treatment of refractory chronic pruritus of unknown origin with tofacitinib in patients with rheumatoid arthritis.JAMA Dermatol. 2019;155(12):1426-1428. doi:10.1001/jamadermatol.2019.2804National Institutes of Health, U.S. National Library of Medicine: Endotext.Skin manifestations of diabetes mellitus.Yahya A, Gideon P. S.Characterizing pruritus in autoimmune connective tissue diseases.J Drugs Dermatol. 2019;18(10):995-998.Grant JE, Chamberlain SR.Prevalence of skin picking (excoriation) disorder.J Psychiatr Res. 2020;130:57-60. doi:10.1016/j.jpsychires.2020.06.033U.S. Department of Health & Human Services, Office on Women’s Health.Autoimmune diseases.Dermatology Advisor.Neurotic excoriations (skin-picking disorder).Harvard Medical School, Harvard Health Publishing.Picking your skin? Learn four tips to break the habit.Additional ReadingThe TLC Foundation for Body-Focused Repetitive Behaviors.What is excoriation (skin picking) disorder?
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Hawatmeh A, Al-Khateeb A.An unusual complication of dermatillomania.Quant Imaging Med Surg. 2017;7(1):166-168. doi:10.21037/qims.2016.12.02Grant JE, Chamberlain SR.Prevalence of skin picking (excoriation) disorder.J Psychiatr Res. 2020;130:57-60. doi:10.1016/j.jpsychires.2020.06.033The TLC Foundation for Body-Focused Repetitive Behaviors.Everybody picks…right? An overview of compulsive skin picking.Narang NS, Casciola-Rosen L, Li S, Chung L, Fiorentino DF.Cutaneous ulceration in dermatomyositis: Association with anti-melanoma differentiation-associated gene 5 antibodies and interstitial lung disease.Arthritis Care Res (Hoboken). 2015;67(5):667-672. doi:10.1002/acr.22498Kwon C, Sutaria N, Khanna R, et al.Epidemiology and comorbidities of excoriation disorder: A retrospective case-control study.J Clin Med. 2020;9(9):2703. doi:10.3390/jcm9092703Multiple Sclerosis Trust.Altered sensations.The TLC Foundation for Body-Focused Repetitive Behaviors.How to manage psoriasis with a compulsive skin picking disorder.Wang F, Morris C, Bodet ND, Kim BS.Treatment of refractory chronic pruritus of unknown origin with tofacitinib in patients with rheumatoid arthritis.JAMA Dermatol. 2019;155(12):1426-1428. doi:10.1001/jamadermatol.2019.2804National Institutes of Health, U.S. National Library of Medicine: Endotext.Skin manifestations of diabetes mellitus.Yahya A, Gideon P. S.Characterizing pruritus in autoimmune connective tissue diseases.J Drugs Dermatol. 2019;18(10):995-998.Grant JE, Chamberlain SR.Prevalence of skin picking (excoriation) disorder.J Psychiatr Res. 2020;130:57-60. doi:10.1016/j.jpsychires.2020.06.033U.S. Department of Health & Human Services, Office on Women’s Health.Autoimmune diseases.Dermatology Advisor.Neurotic excoriations (skin-picking disorder).Harvard Medical School, Harvard Health Publishing.Picking your skin? Learn four tips to break the habit.Additional ReadingThe TLC Foundation for Body-Focused Repetitive Behaviors.What is excoriation (skin picking) disorder?
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Hawatmeh A, Al-Khateeb A.An unusual complication of dermatillomania.Quant Imaging Med Surg. 2017;7(1):166-168. doi:10.21037/qims.2016.12.02Grant JE, Chamberlain SR.Prevalence of skin picking (excoriation) disorder.J Psychiatr Res. 2020;130:57-60. doi:10.1016/j.jpsychires.2020.06.033The TLC Foundation for Body-Focused Repetitive Behaviors.Everybody picks…right? An overview of compulsive skin picking.Narang NS, Casciola-Rosen L, Li S, Chung L, Fiorentino DF.Cutaneous ulceration in dermatomyositis: Association with anti-melanoma differentiation-associated gene 5 antibodies and interstitial lung disease.Arthritis Care Res (Hoboken). 2015;67(5):667-672. doi:10.1002/acr.22498Kwon C, Sutaria N, Khanna R, et al.Epidemiology and comorbidities of excoriation disorder: A retrospective case-control study.J Clin Med. 2020;9(9):2703. doi:10.3390/jcm9092703Multiple Sclerosis Trust.Altered sensations.The TLC Foundation for Body-Focused Repetitive Behaviors.How to manage psoriasis with a compulsive skin picking disorder.Wang F, Morris C, Bodet ND, Kim BS.Treatment of refractory chronic pruritus of unknown origin with tofacitinib in patients with rheumatoid arthritis.JAMA Dermatol. 2019;155(12):1426-1428. doi:10.1001/jamadermatol.2019.2804National Institutes of Health, U.S. National Library of Medicine: Endotext.Skin manifestations of diabetes mellitus.Yahya A, Gideon P. S.Characterizing pruritus in autoimmune connective tissue diseases.J Drugs Dermatol. 2019;18(10):995-998.Grant JE, Chamberlain SR.Prevalence of skin picking (excoriation) disorder.J Psychiatr Res. 2020;130:57-60. doi:10.1016/j.jpsychires.2020.06.033U.S. Department of Health & Human Services, Office on Women’s Health.Autoimmune diseases.Dermatology Advisor.Neurotic excoriations (skin-picking disorder).Harvard Medical School, Harvard Health Publishing.Picking your skin? Learn four tips to break the habit.
Hawatmeh A, Al-Khateeb A.An unusual complication of dermatillomania.Quant Imaging Med Surg. 2017;7(1):166-168. doi:10.21037/qims.2016.12.02
Grant JE, Chamberlain SR.Prevalence of skin picking (excoriation) disorder.J Psychiatr Res. 2020;130:57-60. doi:10.1016/j.jpsychires.2020.06.033
The TLC Foundation for Body-Focused Repetitive Behaviors.Everybody picks…right? An overview of compulsive skin picking.
Narang NS, Casciola-Rosen L, Li S, Chung L, Fiorentino DF.Cutaneous ulceration in dermatomyositis: Association with anti-melanoma differentiation-associated gene 5 antibodies and interstitial lung disease.Arthritis Care Res (Hoboken). 2015;67(5):667-672. doi:10.1002/acr.22498
Kwon C, Sutaria N, Khanna R, et al.Epidemiology and comorbidities of excoriation disorder: A retrospective case-control study.J Clin Med. 2020;9(9):2703. doi:10.3390/jcm9092703
Multiple Sclerosis Trust.Altered sensations.
The TLC Foundation for Body-Focused Repetitive Behaviors.How to manage psoriasis with a compulsive skin picking disorder.
Wang F, Morris C, Bodet ND, Kim BS.Treatment of refractory chronic pruritus of unknown origin with tofacitinib in patients with rheumatoid arthritis.JAMA Dermatol. 2019;155(12):1426-1428. doi:10.1001/jamadermatol.2019.2804
National Institutes of Health, U.S. National Library of Medicine: Endotext.Skin manifestations of diabetes mellitus.
Yahya A, Gideon P. S.Characterizing pruritus in autoimmune connective tissue diseases.J Drugs Dermatol. 2019;18(10):995-998.
U.S. Department of Health & Human Services, Office on Women’s Health.Autoimmune diseases.
Dermatology Advisor.Neurotic excoriations (skin-picking disorder).
Harvard Medical School, Harvard Health Publishing.Picking your skin? Learn four tips to break the habit.
The TLC Foundation for Body-Focused Repetitive Behaviors.What is excoriation (skin picking) disorder?
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