What Are the Treatments for Skin Picking?

Everyone itches or rubs their skin or picks at a hangnail or other imperfection once in awhile. However, for some people, skin picking moves from an occasional nervous habit to an uncontrollable urge. According to the Trichotillomania Learning Center, it can become so pervasive that it affects a person's work, social and family life. Fortunately, skin picking, known as neurotic excoriation, can be treated with a combination of medication and psychological therapies.

Definition

• According to the Obsessive Compulsive Foundation, skin picking is a form of obsessive compulsive disorder (OCD). It causes an urge to rub or pick at perceived irregularities in the skin. In the most severe cases the Trichotillomania Learning Center says that person may dig so deeply that she causes skin discoloration, lesions and permanent scarring. She will generally admit that the sores are self-inflicted, although they will embarrass her and she will most likely wear clothes to hide them. Even with these negative consequences, she will not be able to control the urge to pick.

Triggers

• The Obsessive Compulsive Foundation says that skin pickers will indulge in the behavior at any time, but stress tends to make it worse. Some say that skin picking puts them into a nearly trancelike state that focuses or calms them during the behavior. However, they tend to be regretful and embarrassed when they snap out of it.

Incidence

• More women than men tend to be skin pickers, and the Obsessive Compulsive Foundation says that the behavior usually starts between the ages of 30 and 40, although it can also occur during the 20s. Symptoms tend to last for a long time, with an average duration of five to 12 years.

Psychological Treatment

• Skin picking is primarily a psychiatric disorder, so it must be treated by a psychiatrist, psychologist or counselor. Psychiatrists can prescribe medication, and the Obsessive Compulsive Foundation says they often give selective serotonin reuptake inhibitors, a type of antidepressant, to help control the picking behavior. Medication is typically combined with treatment by a psychologist or counselor who does cognitive therapy. This type of therapy teaches skin pickers to interrupt the behavior with a mental cue and to redirect to a more appropriate behavior. They also learn healthy stress management techniques reduce the urge to pick.

Physical Treatment

• Because skin picking causes sores, many patients need treatment for their lesions and other skin damage. Otherwise, they may get an infection or end up with permanent scars. Treatment for the physical effects is usually done by a dermatologist who can help control the damage.