Also known as excoriation disorder and skin-picking disorder, dermatillomania is a psychological condition that manifests as repetitive, compulsive skin picking. It is an impulse-control disorder and one of several body-focused repetitive behaviors (BFRBs) currently classified in the DSM-5 under Obsessive-Compulsive and Related Disorders. Dermatillomania affects up to 1.4 percent of the total population, and approximately 75 percent of those affected are female. There is a difference between dermatillomania and normal picking at skin imperfections and irregularities—the behavior is chronic, results in severe tissue damage, and causes the individual marked distress and dysfunction.
Repetitive skin picking extends to pulling, squeezing, scraping, lancing, and even biting both healthy and damaged skin from various parts of the body. People with dermatillomania often target their face, hands, fingers, arms, and legs; they may use either their fingers or an instrument, like tweezers or pins. They can spend hours a day on their picking behavior, which can last for months or even years. Dermatillomania often results in visible skin damage and disfigurement from lesions, discoloration, open wounds, scars, and infections. It is generally a chronic condition, though symptoms may arise and disappear from time to time.
Dermatillomania is generally a chronic condition, though symptoms may arise and disappear from time to time. Individuals with this condition can spend hours thinking about picking and trying to resist the urge before giving in. Anxiety, depression, shame, fear of exposure, and embarrassment over the condition usually lead to attempts at covering up the skin with makeup, clothing, or by other means; they can also interfere with normal social interactions, resulting in uncomfortable relationships with family and friends. Dermatillomania is not diagnosed when the symptoms are caused by another medical or psychiatric condition. For instance, skin picking can also occur with dermatological conditions, autoimmune disorders, opiate withdrawal, and developmental disorders, such as autism.