What Is Skin Picking Disorder? A Psychiatrist Explains

More Than a Bad Habit: Understanding Excoriation Disorder

If you’ve ever found yourself picking at a scab, blemish, or dry patch of skin, you’re not alone. But for some people, skin picking becomes much more than occasional grooming—it turns into a compulsive, distressing behavior that causes damage, shame, and emotional distress.

This condition is called Excoriation Disorder, or Skin Picking Disorder. And no, it’s not just about having "bad habits" or "low willpower." It’s a real, diagnosable mental health condition that deserves compassion—and treatment.

At T. Psychiatry Associates, we see patients across New Jersey and New York who struggle with body-focused repetitive behaviors (BFRBs) like skin picking.

Here’s what you need to know.

What Exactly Is Skin Picking Disorder?

Skin Picking Disorder (officially called Excoriation Disorder in the DSM-5) is a body-focused repetitive behavior where someone repeatedly picks at their skin—often until it bleeds or leaves scars. It can affect any part of the body but commonly involves the face, arms, hands, or scalp.

People with this condition often:

• Pick at real or perceived imperfections

• Spend hours a day engaged in picking

• Try to stop but can’t

• Feel embarrassed, anxious, or depressed about the behavior

• Avoid social situations due to visible skin damage

Skin picking can be intentional or unconscious, and it’s often triggered by stress, boredom, or even feelings of perfectionism. For some, it brings temporary relief or a sense of control. For others, it’s simply automatic.

How Is It Different From Everyday Picking?

Most people occasionally pick at their skin. The difference with Excoriation Disorder is intensity, frequency, and impact on daily life.

To meet diagnostic criteria, the behavior must:

• Cause significant distress or impairment

• Occur repeatedly over time

• Be difficult to control, despite efforts to stop

This disorder is often closely linked to anxiety, depression, or OCD. It also shares similarities with trichotillomania (hair-pulling disorder), and many people experience both.

Treatment: Yes, There Is Hope

The good news? Skin Picking Disorder is treatable.

Here are some of the most effective options:

Cognitive Behavioral Therapy (CBT)

CBT—especially a version called Habit Reversal Training (HRT)—can help identify triggers and teach alternative coping skills to interrupt the picking cycle.

Medication

In some cases, medications like SSRIs (e.g., fluoxetine, sertraline) can reduce obsessive urges and anxiety that drive the behavior. Medication isn’t a cure-all but can be an important part of a broader treatment plan.

Behavioral Substitutions

Fidget tools, textured surfaces, or sensory objects can provide alternative stimulation when the urge to pick arises.

You’re Not Alone—and You’re Not Broken

Skin Picking Disorder is more common than people realize, affecting about 1 in 50 people, yet it remains underdiagnosed due to shame or lack of awareness.

If you’ve been silently struggling, please know: you are not alone, and you are not your behavior. This is a mental health condition, and it’s okay to ask for help.

Ready to Take the First Step?

At T. Psychiatry Associates, we provide compassionate, evidence-based care for patients dealing with BFRBs, anxiety, OCD, and more—across NJ and NY via telepsychiatry or in person.

Let’s work together to break the cycle.

Book a consultation today—judgment-free, personalized care is just a conversation away.