Dermotillomania-Excoriation Disorder

Excoriation disorder (also referred to as chronic skin-picking or dermatillomania) is a mental illness related to obsessive-compulsive disorder. It is characterized by repeated picking at one’s own skin which results in skin lesions and causes significant disruption in one’s life.


Wik1: W060
Diagnoses: Dermotillimania (Excoriation Disorder)
USPatnts: Est. 4%
SexRatio: M;F+
AveOnset: Can be permanent
Brain Area: anterior cingulate cortices-not inhibiting uncontrollable picking; inadequate SAPAP3 gene may also be a factor
Symptoms: picking sores into skin on the body; follows tension with relief following the act; mostly on the face by fingers or tools
Progression & Effects: causes scarring and disfigurement followed by shame and guilt; 11.5% attempt suicide; 79% pleasure with picking skin
Causes: childhood sexual abuse, rage against authoritarian parents, dealing with stress; affected by other itching conditions
Productive Medications: SSRI (antidepressants which increase serotonin and norepinephrine in the brain)antianxiety, antipsychotics; inositol
Productive Therapies: habit reversal training (for example, close a fist for one minute instead of picking when the urge arose)
Patient Organizations:

Youtube Video: Skin Picking Disorder (Dermatillomania)

Amazon or Library Book: Skin Picking-The Freedom to Finally Stop

Click the book to link or order from Amazon.


The world-wide medical research
reports chosen for each diagnosis 

Clicking each title opens the
PubMed article’s summary-abstract.

  • Prevalence of and Risk Factors for Skin Picking Disorder Symptoms Among Adults in an Arab Middle Eastern Population: A Cross-Sectional Study
    by Hazim Abdulkarim Khatib on December 9, 2022

    CONCLUSION: SPD symptoms are relatively common among the adult population in Jeddah, but those with threshold symptoms indicative of SPD are relatively few. Such behavior is particularly common in vulnerable groups such as those with depressive symptoms and the unmarried. More attention to this condition by clinicians will improve the quality of life of those affected, and reduce the emotional and physical health consequences of this often unrecognized condition.

  • Characteristics of 262 adults with skin picking disorder
    by Jon E Grant on July 17, 2022

    INTRODUCTION: Skin picking disorder (also known as excoriation disorder or dermatillomania) is a common mental health disorder currently classified as an obsessive-compulsive and related condition. Despite being first described in the 1800s, very little is known about its phenomenology and clinical presentation. Most information about this disorder to date is based on online surveys rather than in-person assessments.

  • Pediatric skin picking disorder: A review of management
    by Michael N Nemeh on February 23, 2022

    Skin picking disorder (SPD) commonly presents in childhood; often, families will first turn to dermatologists for evaluation. It is imperative that dermatologists accurately diagnose and treat the disorder as children are vulnerable to face significant negative psychosocial impacts. This article reviews the limited literature on the management of SPD in pediatric patients to better prepare dermatologists for educating families and recommending treatment options. We discuss studies evaluating...

  • Skin Picking Successfully Treated With Atomoxetine in Comorbid Skin Picking and Attention-Deficit/Hyperactivity Disorder: A Case Report
    by Nihal Yurteri on June 17, 2020

    "Skin picking disorder" (SPD: also known as neurotic excoriation, psychogenic excoriation, or dermatillomania) is classified in the "obsessive-compulsive and related disorders" category in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and characterized by unintentional, repetitive skin picking behaviors. Atomoxetine is a selective noradrenaline reuptake inhibitor used in the treatment of attention-deficit/hyperactivity disorder (ADHD). In this case report, we present...