Excoriation is a disorder characterized by recurrent skin picking, resulting in skin lesions. Some children with the disorder say that picking at their skin makes them feel good, but not all children affected by the disorder do it intentionally, or consciously; some may not even remember doing it. Onset is most often around puberty.
The face is the most common target of skin picking, but other targets may be limbs, back, gums, lips, shoulders, scalp, stomach, chest, fingernails and toenails. A child may pick at one part of the body repeatedly, or “rotate” to allow the previously picked part to heal
- Marks or scabs on the face or body
- Attempts to hide or cover up both the act and resulting marks or scabs
- Blemishes, scabs, infection and tissue damage
- Guilt, shame, embarrassment
- Significant distress or impairment in functioning
Treatment for excoriation usually involves psychotherapy and may include medication. Cognitive behavior therapy (CBT) can help a child become more aware of her skin picking and begin to recognize the emotions and mental states that are likely to trigger it. Over time, with professional help, the habit can be reversed. Medication is usually not the first choice in treating excoriation, although antidepressants like selective serotonin reuptake inhibitors (SSRIs) may be prescribed while a child participates in CBT.