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:


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  • 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...

  • Atomoxetine Induced Skin Picking: A Case Report
    by Nurdan Kasar on February 28, 2020

    "Skin picking disorder," also known as "dermatillomania" or "psychogenic excoriation," is classified in the "Obsessive Compulsive and Related Disorders" category in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and characterized by repetitive skin picking behaviors resulting in skin lesions. Atomoxetine (ATX) is a selective norepinephrine (noradrenaline) reuptake inhibitor commonly used in the management of attention-deficit/hyperactivity disorder. Atomoxetine is...

  • Skin Picking Disorder in a Woman with Polyarteritis Nodosa. Case Report
    by Mariana Aranda on November 30, 2019

    INTRODUCTION: Excoriation (skin picking) disorder is included in the DSM-5 in the obsessive compulsive and related disorders category. It is defined as the recurrent urge to touch, scratch, scrape, scrub, rub, squeeze, bite or dig in the skin, leading to skin lesions. It is a rare disorder (1.4-5.4% of the population) and occurs mainly in women.