Although the connection is not well-understood, there are some people with both excoriation and substance use disorders, and they require specialized treatment.

Excoriation disorder, a diagnosis marked by frequently picking at one’s skin, commonly co-occurs with other mental health conditions. People with this condition may also live with other mental health disorders, including depressionanxietytrichotillomania and obsessive-compulsive disorder.

Though excoriation increases the risks of some conditions, little is known about the connection between excoriation and substance abuse. Does having an addiction increase the risk of excoriation, or does excoriation increase the odds of having an addiction?

Effects of Drug Use on Excoriation

Some drugs produce skin-picking behaviors that can be confused for excoriation disorder symptoms. For example, someone using stimulants like cocaine or methamphetamine may begin scratching or picking at their skin. Someone injecting drugs like heroin may also develop sores or infections at the injection sites, which may resemble the symptoms of excoriation. However, for a diagnosis of excoriation to be given, skin-picking behaviors can’t be the result of drug use. If someone’s skin-picking wasn’t present before using a drug, they do not have excoriation. Substance use can exacerbate the condition in cases where excoriation symptoms were present before addiction, though.

Statistics on Excoriation and Addiction

Currently, about 20 million people in the U.S. have a substance use disorder and about 1.4 percent of the population have excoriation disorder. While there is likely some overlap between these two conditions, there is currently no information available about the rate that they co-occur. As it stands, research does not indicate that individuals with excoriation have an increased risk of addiction when compared to the average person. However, it’s possible that these findings will change as experts conduct additional studies.

Can Excoriation Lead to Drug Abuse?

Just as there is limited research regarding the number of people with excoriation and substance use disorders, there is not a clear understanding of the condition’s ability to encourage addiction or lead to a substance use disorder.

In many ways, excoriation itself resembles drug or alcohol addiction:

  • Intense or uncomfortable emotional states tend to trigger both skin picking and substance use
  • People find it challenging to end excoriation and addictions on their own
  • While engaging in skin-picking and substance use may result in short-term relief, they tend to cause long-term guilt and shame

Some people may engage in substance abuse as a form of self-medication to treat their picking. They may mistakenly believe that using drugs will stop the urge to pick. However, substance abuse often adds more problems to a person’s situation in the long run and can make excoriation symptoms even worse in some cases.

Treating Excoriation and Co-Occurring Conditions

Whenever excoriation and other mental health conditions are present together, mental health professionals must address all co-occurring issues simultaneously. Treating only one condition is like treating only one part of a problem. The best solutions look at the complete picture.

Co-occurring disorders deserve special care and attention to ensure the symptoms recede with time. If you or a loved one is dealing with excoriation and substance abuse issues, it may be time to call The Recovery Village. The professionals at The Recovery Village know many useful methods for treating co-occurring mental health disorders and addiction. Reach out to a representative today to get started.

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Editor – Megan Hull
Megan Hull is a content specialist who edits, writes and ideates content to help people find recovery. Read more
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Medically Reviewed By – Eric Patterson, LPC
Eric Patterson is a licensed professional counselor in the Pittsburgh area who is dedicated to helping children, adults, and families meet their treatment goals. Read more

American Psychiatric Association. “Diagnostic and Statistical Manual of Mental Disorders.” 2013.

Lochner C, Roos A, Stein DJ. “Excoriation (Skin-Picking) Disorder: A S[…]of Treatment Options.” U.S. National Library of Medicine. July 14, 2017. Accessed on March 17, 2019.

Philips, K.A. and Stein, D.J. “Excoriation (Skin-Picking) Disorder.” Merck Manual. June 2018. Accessed on March 17, 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.