GentleskinWhat is dermatillomania?
Dermatillomania is repeated picking at your own skin that you can't stop, even though it damages the skin. Doctors call it excoriation disorder or skin picking disorder. It belongs to a group called body-focused repetitive behaviors, or BFRBs, which also includes hair pulling (trichotillomania) and nail biting.
Most people pick at a scab now and then. The difference is how often it happens, how hard it is to stop, and how much it costs the person in time, marks on the skin, and hiding them.
Where and how people pick
The face is the most common place, but people also pick at the scalp, lips, cuticles, arms, legs, back and chest. Some go after spots, scabs or bumps, and some pick at skin that looks fine but feels uneven to them. Some people pick without noticing, while they read or watch something. Others do it on purpose at a mirror, sometimes for an hour or more. Many people do both.
How it's diagnosed
The DSM-5, the manual psychiatrists use, added excoriation disorder in 2013 and lists it next to OCD. A diagnosis needs all of these: the picking causes skin lesions, the person has tried to cut down or stop more than once, it causes distress or gets in the way of daily life, and a medical condition, a drug or another disorder doesn't explain it better.
How common it is
Studies put it at roughly 1 to 5 adults in 100. Most people in treatment studies are women, and it often starts in the teenage years. Many people never mention it to a doctor.
Why people do it
Picking usually relieves something for a moment, like stress, boredom or tension, or the itch of a bump that feels wrong. That short relief is what keeps the habit going. Afterwards people often feel guilt or embarrassment, which adds to the stress before the next time. It has nothing to do with willpower.
Risks
Picking can cause open wounds, infections and scars. See a doctor about a wound that looks infected or doesn't heal.
Treatment
The treatment with the most evidence is cognitive behavioral therapy built around habit reversal training. You learn to notice when you pick and to do something else with your hands instead. There's more on this in how to stop picking your skin. The TLC Foundation for BFRBs has a directory of therapists who treat it at bfrb.org.
Gentleskin is an iPhone app for tracking skin picking. See it on the App Store.
General information, not medical advice.