Excoriation (skin picking) L98.1

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Skin picking

Scab or skin picking?
Photo courtesy of Pixabay.com


Sometimes skin picking is a mental health problem.

Excoriation, also known as skin picking, is included in the DSM-5 in the chapter on Obsessive-Compulsive and Related Disorders. Excoriation is one of those unusual crossover kinds of disorders. Sort of a medical problem, but also a mental health issue. Most mental health disorders have either an F or a Z code.

What is Excoriation (skin picking?)

To meet the criteria for this disorder, the skin picking must be both recurrent and must result in visible skin lesions. People with skin picking disorder often spend a lot of time in this activity, and it made go on for years. The picking is commonly done with fingernails, but it may be done by using tools or instruments. While skin picking can take place anywhere on the body, is most often done on the face, the arms, or the hands. Some people try to hide the results of picking under clothing.

OCD mental health part involves attempts to control, reduce, or stop the picking.

Like other mental health diagnoses, the skin picking needs to impair social relationships, school or job function, interfere with other important activities, or be very upsetting to the person doing the picking. Skin picking often occurs in response to negative feelings. Excoriation can be triggered by unpleasant emotions and may be used to manage uncomfortable feelings.

Excoriation is reported much more commonly in females. Some reports estimate the rate of Excoriation at between one and two percent of the population. It is common for those with Excoriation Disorder to also have other OCD related disorders.

Excoriation is not the same thing as “Meth” or “Coke” bugs.

The kind of picking you commonly see among drug users is the result of abuse of stimulant drugs. Stimulant drugs create the sensation the bugs are crawling on the skin. If the user quits doing the drugs, the feeling of bugs crawling on the skin, he goes away. Long-term methamphetamine or cocaine users may have picked at their skin so much that there is permanent scarring.

What else could Excoriation (skin picking) be?

Before someone gets this diagnosis, medical causes and effects of drugs or other substances must be ruled out. If the picking is the result of a psychotic disorder or body dysmorphic, a stereotypic movement disorder or is intentional, the picking gets diagnosed as part of these other disorders.

There are some similarities between Skin Picking Disorder and non-suicidal self-injury, also known as “cutting.” Nonsuicidal self-injury is currently considered a symptom of borderline personality disorder, but it continues to be studied and may one day be recognized as a separate disorder.

As of now, Skin Picking Disorder is recognized as a specific disorder which may coexist with other conditions. If you or someone you know has symptoms of Excoriation (skin picking), you need to get medical attention. If those urges to skin pick are being triggered by feelings, seeing a therapist could help.

Staying connected with David Joel Miller

Four David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive?

For these and my upcoming books; please visit my Author Page – David Joel Miller

Books are now available on Amazon.

Want the latest blog posts as they publish? Subscribe to this blog.

For videos see: Counselorssoapbox YouTube Video Channel

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking, and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter.


Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.