excoriation

What is Excoriation of the skin?

Have you ever had the urge to pick on your skin? If so, was the urge so massive that after a point, this habit became an obsession? Excoriation, or more commonly known as Skin Picking Disorder, is the condition where this obsession of picking your skin turns into a mental disorder by repeatedly picking at your skin, sometimes resulting in lesions and other such injuries.

This disease can have alternating periods of symptom remission and high-intensity urges. The breaks can be of days, weeks, or sometimes even years. 

Symptoms of Excoriation

Although there isn’t any particular sign of skin picking becoming an obsessive mental disorder, there are some questions that you can ask yourself and gauge your current situation, such as:

  • Do you have any noticeable scars from skin picking? This disorder can lead to many lesions and infections.
  • Do you fastidiously look for a scab or lesions on your body to pick at?
  • Do you spend a large amount of your time in a day at skin picking? Patients are sometimes known to spend several hours in a day picking their skin.
  • Are you often conscious of your scars? Do you try to avoid public appearances owing to the scars?
  • Are your symptoms causing stress?

What Causes Excoriation?

Although a definite cause of this disorder hasn’t yet been identified, some noticed hypothesis suggests that:

  1. Patients suffering from Obsessive-compulsive disorder(OCD) may suffer from excoriation due to their urge to pick skin to prevent perceived contamination of the skin.
  2. Patients suffering from Body Dysmorphic Disorder (BDD) may suffer from excoriation due to their desire to pick in order to fix perceived imperfections in the skin
  3. Usage of drugs such as cocaine and methamphetamine has been shown to cause irresistible picking in patients.
  4. This disorder can also be inherited genetically.
  5. Patients often use this as a stress-relieving action.

Treatment

A study has shown that only 45% of the patients suffering from excoriation seek treatment for it, and only 19% receive dermatological treatment. 

Some of the treatments available for excoriation are:

  • Pharmacological
    • SSRIs, a drug commonly used to treat OCD, have also been suggested to use as a treatment for excoriation. However, there hasn’t been an abundance of clinical reports to back up this claim
    • Glutamatergic agents, such as n-acetyl cysteine, have previously been used to treat addiction behaviors and have also been suggested to treat excoriation.
  • Behavioral
    • Habit reversal therapy 
      • Used to deal with repetitive behavior disorders
      • Usually effective in patients with no psychological problems
    • Cognitive-behavioral therapy
      • Acceptance-enhanced behavior therapy
      • Acceptance and commitment therapy (ACT)
  • For the developmentally disabled 
    • Making them wear an article of protective clothing that limits them from picking their skin
    • Differential Reinforcement of Other Behavior (DRO) is used by promising a reward to patients for abstaining from skin picking for a certain amount of time
    • Differential Reinforcement of Incompatible Behavior (DRI) is used by rewarding a patient for engaging in activities that cannot be done simultaneously as skin picking. Example- Making the patient sit on their hands to stop them from picking their skin

FAQs

Ques. What is excoriation known in medical terms?
Ans. Excoriation is known as Dermatillomania in medical terms.

Ques. Is OCD an excoriation disorder?
Ans. Excoriation is very closely related to OCD, and patients suffering from OCD may also start with picking their skin to remove perceived contamination.

Ques. Is skin-picking a sign of autism?
Ans. A behavioral symptom of autism is skin-picking

Ques. Is skin-picking a sign of anxiety?
Ans. Factors such as anxiety, stress, and boredom are known to be causes of excoriation

Ques. Is skin-picking a sign of ADHD?
Ans. As a response to hyperactivity or low impulse control, ADHD patients may develop skin-picking disorder.

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