Even if you’ve never heard the term excoriation disorder, also known as dermatillomania, you probably have known someone who tends to pick at their skin more than the average person. Excoriation (skin picking) disorder is a compulsive body-focused repetitive behavior; people who engage in this behavior may not even realize they are doing it and may have a difficult time abstaining from it. Excoriation statistics and skin picking disorder facts demonstrate the prevalence of this condition, the way it manifests itself and what treatment options are currently available.
Table of Contents
Prevalence of Dermatillomania
Excoriation disorder prevalence may be more common than one would assume:
- An estimated 2–5% of the population has excoriation disorder
- Excoriation is most common among kids between the ages of 13–15 years old but can also affect younger children and adults ages 30–45
- Dermatillomania can be present in males and females, but it is more common in females
Common Body Areas Affected by Skin Picking
Skin picking can occur on any area of the body, but there are some common spots that many people with this condition tend to pick at frequently:
- Hands: The presence of hangnails and skin abrasions makes skin picking on the hands an easily accessed point of focus for people with dermatillomania
- Arms: Skin picking on the arms accounts for 20% of those with the condition
- Face: An estimated 32% of people with dermatillomania pick at the skin of their face
- Legs: Approximately 17% of people with excoriation disorder focus most of their picking on their legs
- Scalp: For 22% of those with skin picking disorder, the focus is on the scalp
Skin Picking Risk Factors and Causes
Everyone picks at their skin occasionally for one reason or another. But what causes excoriation, the more severe, compulsive form of skin picking? While there is no perfect answer to this question, initial research has indicated that excoriation is related to obsessive-compulsive disorder (OCD) and commonly runs in families.
While the behavior may seem harmless enough, there are risks associated with unmanaged dermatillomania, including:
- Shame and Embarrassment: People who experience excoriation disorder may feel embarrassed or ashamed of their skin’s appearance
- Avoidance of Social Situations: Embarrassment about the condition of the skin may result in social avoidance and increase feelings of isolation
- Avoidance of Medical Care: Those with dermatillomania are less likely to seek medical care when needed, as a result of the fear of having their condition discovered by a physician
- Skin Infection and Scarring: Skin picking over a prolonged period irritates and inflames the skin and surrounding tissue, which can result in infection if left untreated
Excoriation Disorder and Related Conditions
While excoriation disorder often exists on its own, it may also co-occur with OCD or hair pulling, trichotillomania. The co-occurrence of excoriation and trichotillomania is 38%. Dermatillomania is sometimes a symptom that occurs in disorders that cause negative emotional distress. For example, skin picking and body dysmorphic disorder reflect the relationship between perceived imperfections and the urge to pick at the skin to rid oneself of these perfections.
Anxiety-induced excoriation is rooted in self-soothing. People who struggle with anxiety may pick at the skin to relieve their symptoms without realizing it. Humans are hardwired to self-soothe, and some of the behaviors people engage in to comfort themselves are more subtle than others. Endorphins are released in a variety of ways: pain and increased stress levels are two of the negative forms of release. Excoriation can result in the release of endorphins, which elicits feelings of euphoria and pain relief.
Excoriation Treatment and Prognosis
Excoriation disorder can be managed and successfully treated. Excoriation disorder treatments include cognitive behavioral therapy and medications, such as SSRIs. The use of behavioral interventions, such as wearing gloves or using harmless fidget objects to distract one’s hands, are practical strategies for managing this condition.
If you or a loved one is dealing with co-occurring excoriation disorder and substance use disorder, reach out to The Recovery Village for support and treatment options.
Bfrb.org. “What is Excoriation (Skin Picking) Disorder?” Accessed May 3, 2019. Mentalhealthamerica.net. “Excoriation Disorder (Skin Picking or Dermatillomania).” Accessed May 3, 2019. Iocdf.org. “Skin Picking Disorder Fact Sheet.” Accessed May 3, 2019. Skinpick.com. “Body Areas Affected.” Accessed May 3, 2019. Stargell, Nicole et. al. “Excoriation Disorder: Assessment, Diagnosis and Treatment.” The Professional Counselor. Accessed May 3, 2019. Stoppler, Melissa C. MD. “Endorphins: Natural Pain and Stress Fighters.” MedicineNet. Accessed May 3, 2019. Holland, Kimberly. “What Is Excoriation (Skin Picking) Disorder?” Healthline. Accessed May 3, 2019.
Bfrb.org. “What is Excoriation (Skin Picking) Disorder?” Accessed May 3, 2019.
Mentalhealthamerica.net. “Excoriation Disorder (Skin Picking or Dermatillomania).” Accessed May 3, 2019.
Iocdf.org. “Skin Picking Disorder Fact Sheet.” Accessed May 3, 2019.
Skinpick.com. “Body Areas Affected.” Accessed May 3, 2019.
Stargell, Nicole et. al. “Excoriation Disorder: Assessment, Diagnosis and Treatment.” The Professional Counselor. Accessed May 3, 2019.
Stoppler, Melissa C. MD. “Endorphins: Natural Pain and Stress Fighters.” MedicineNet. Accessed May 3, 2019.
Holland, Kimberly. “What Is Excoriation (Skin Picking) Disorder?” Healthline. Accessed May 3, 2019.
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