Quick Guide to Excoriation Disorder

Excoriation disorder (or skin-picking) is a mental health condition that can cause children to pick at their skin constantly. Children with excoriation disorder pick at their skin so much that they cause harm and pain to the spots they pick at. They can’t stop picking even if they want to.  

Some kids pick at their skin because it makes them feel good, and it can be triggered by stress or anxiety. Many children do not even know they are doing it. Skin picking can cause bleeding, scabs, infection and scars. It can also cause shame and embarrassment if other people see the damage. Excoriation disorder usually starts in the early teen years. 

Children who have obsessive-compulsive disorder (OCD) are more likely to develop excoriation disorder. 

Marks or scabs on the child’s body from picking their skin are the main symptom. Some children pick at the same spot over and over. Others move from one spot to another. Usually, kids with excoriation use their own fingernails to pick, but some might use tweezers or other tools.  

Children with excoriation disorder may pick at any part of their body. The face is the most common area. Other common spots that kids might pick include arms, legs, back, gums, lips, shoulders, scalp, stomach, chest, fingernails, toenails and cuticles. 

Three things have to happen for a child to be diagnosed with excoriation disorder: 

• They must pick at their skin so much and for so long that the picking causes wounds. 
• They must have tried and failed to stop on their own.  
• The picking must make them very upset or cause problems in their day-to-day activities. 

Usually, skin picking can be stopped with the help of a therapist. Cognitive behavioral therapy (CBT) can help the child become aware of what feelings and situations make them pick. CBT teaches kids other ways to deal with the feelings that cause them to pick. 

Medication is not usually used to treat excoriation. However, some kids benefit from taking antidepressants while also getting CBT.