Skin Picking Disorder & the Mind-Skin Relationship

Skin Picking Disorder & the Mind-Skin Relationship


I only get my nails done about once a year because I don’t like paying for something I’m going to ruin—by picking at the skin around my nails until it bleeds—in a few days, anyway. My cuts, scrapes and bug bites take twice as long to heal because I can’t resist the urge to pick the scabs off. If I show up to work with lipstick on, it’ll be gone by lunch because I pulled off a layer of skin on my lips (and the color, along with it).

1. What is excoriation “skin picking” disorder?

“Excoriation belongs to a collection of behaviors known as Body-Focused Repetitive Behaviors (BFRBs),” says Dr. Deibler. This collection includes “self-grooming behaviors in which individuals pull, pick, scrape or bite their own hair, skin or nails, resulting in damage to the body, including trichotillomania and onychophagia.” 

Also known as compulsive skin picking, the disorder is officially classified among the “Obsessive-Compulsive and Related Disorders” in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), says Dr. Deibler.

 2.Who is most likely to develop this type of disorder?

“Excoriation disorder is not uncommon,” Dr. Deibler tells us. “Studies suggest that pathological skin picking affects 1.4 percent to 5.4 percent of the U.S. adult population, 75 percent of whom are female.” Most often, skin picking begins during adolescence—between the ages of 11 and 15 years old. One theory suggests that skin picking tends to start around the time acne emerges. 

She also notes that it’s fairly common for anxiety and/or obsessive-compulsive disorder (OCD) to be an underlying factor in skin picking—though, it’s not the case for everyone. “Many different thoughts, feelings or sensations and other internal experiences can lead to a skin picking response.” Skin picking, anxiety and OCD are sometimes present together because the conditions share some commonalities and, as Dr. Deibler notes, likely some similar genetic underpinning as well

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