Excoriation disorder, also known as skin picking disorder or dermatillomania, is a mental health condition characterized by the repetitive and compulsive picking of one’s own skin, leading to tissue damage. The signs of excoriation disorder can be quite distinct and often cause significant physical and emotional distress.
The primary and most obvious sign is **recurrent skin picking that results in visible skin lesions, wounds, or scars**. These skin areas are often picked to the point of bleeding or infection. The damage is usually chronic and can be found on various parts of the body, but common target areas include the face, scalp, arms, fingers (especially around the nails and cuticles), back, and sometimes areas hidden under clothing. People with excoriation disorder tend to focus on specific spots repeatedly, which worsens the skin damage over time.
Another key sign is the **inability to stop or reduce the skin picking behavior despite repeated attempts**. Individuals often feel a strong urge or compulsion to pick their skin and may spend excessive amounts of time engaged in this behavior. This can happen consciously or sometimes without full awareness, such as picking while watching TV or during other activities.
Emotional and psychological signs are also prominent. Many people with excoriation disorder experience **intense feelings of anxiety, tension, or distress before picking**, and picking provides a temporary sense of relief or gratification. After picking, feelings of guilt, shame, embarrassment, or frustration are common, especially because the behavior often leads to visible marks that can be socially stigmatizing. This emotional cycle can contribute to social withdrawal or avoidance of situations where the skin damage might be noticed.
Other signs include:
– **Frequent checking or focusing on the skin**, often in front of mirrors, to find imperfections or areas to pick.
– **Picking at scars, pimples, calluses, or perceived skin irregularities**, sometimes obsessively.
– **Physical signs such as bruising, scabbing, or infections** resulting from repeated skin trauma.
– **Avoidance of social activities or wearing clothing that covers affected areas** to hide the damage.
– **Associated behaviors like nail biting or picking at cuticles**, which can be part of the same compulsive pattern.
Excoriation disorder is often linked with other mental health conditions, particularly obsessive-compulsive disorder (OCD) and attention deficit hyperactivity disorder (ADHD). The compulsive nature of skin picking resembles OCD behaviors, where the picking acts as a compulsion to relieve anxiety or distress. People with excoriation disorder may also have difficulty concentrating or controlling impulses, especially if ADHD is present.
Because excoriation disorder is a body-focused repetitive behavior, it shares features with other disorders like trichotillomania (hair pulling). The disorder is not simply a bad habit or a dermatological problem; it is a recognized mental health condition that can cause significant disruption in daily life and well-being.
In summary, the signs of excoriation disorder include persistent, uncontrollable skin picking causing physical damage; emotional distress related to the behavior; repeated unsuccessful attempts to stop; and social or functional impairment due to the visible effects and psychological burden of the disorder. Recognizing these signs is crucial for seeking appropriate treatment and support.
