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

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 that 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

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

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.

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Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

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Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

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