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Compulsive Skin Picking

Compulsive Skin Picking (CSP), also called pathological skin picking, neurotic excoriation, or dermatillomania, is defined as the habitual picking of skin lesions or the excessive scratching, picking, or squeezing of otherwise healthy skin is a poorly understood disorder.

Some researchers now believe that compulsive hair pulling, skin picking, and nail biting form a subgroup of what is becoming known as the Obsessive- Compulsive Disorder Spectrum. OCD has been previously been regarded as only a single disorder but may in fact represent a range of related disorders, including classic OCD, Body Dysmorphic Disorder, Anorexia Nervosa, Bulimia, Trichotillomania, Onychophagia, Compulsive Skin Picking, Compulsive Nail Biting, and Tourette's Syndrome.

The characteristics of skin picking include:

Recurrent skin picking - face, lips, scalp, hands or arms.

Tension increase immediately before picking.

Pleasure, gratification, tension decrease or relief when skin picking.

The picking causes significant difficulties in life, or stress.

Sensations such as itching, tingling, burning, or an uncontrollable urge to pick their skin.

Associated Features:

Stereotypic Behaviors - body rocking, thumb sucking, knuckle cracking, cheek chewing, and head banging.

Differential Diagnosis 

Some disorders have similar symptoms. The clinician, therefore, in his diagnostic attempt has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis.

Substance Abuse
Body Dysmorphic Disorder
Obsessive Compulsive Disorder
Dermatillogical Skin Disorder.


Most people develop this problem in their teens or 20's. An episode may be a conscious response to anxiety or depression, but is frequently done as an unconscious habit.


The primary treatment modality for CSP depends on the level of awareness the individual has regarding the problem. If the CSP is generally an unconscious habit, the primary treatment is a form of Cognitive-Behavioral Therapy and drug therapy.

Counseling and Psychotherapy [ See Therapy Section ]:

Cognitive Behavioral Therapy and Habit Reversal Training (HRT) may be used, as it appears that skin-picking is a conditioned response to specific situations and events, and that the individual with CSP is frequently unaware of these triggers. HRT challenges the problem in a two ways. Firstly, the individual learns how to become more consciously aware of situations and events that trigger skin-picking episodes and secondly, the individual learns to utilize alternative behaviors in response to these situations and events.

Pharmacotherapy [ See Psychopharmacology Section ] :

Prozac, Zoloft.

DSM Code

300.3 Obsessive-Compulsive Disorder


Disorder Sheets

National Self-Harm Network
PO Box 7264
Tel: +448006226000
Email: Click Here
Website: Click Here

Recommended Book

None Identified


Compulsive Skin Picking

Misc Information


Impulse Disorder's