Skin Picking Disorder

By | June 10, 2022

Skin picking disorder is an impulse control disorder. The condition is characterized by frequent scratching, touching or squeezing of certain areas of the skin. An irresistible urge to touch the skin is typical. As a result of the skin picking disorder, significant damage to the skin tissue is possible, which in turn often causes shame in the people affected.

What is Skin Picking Disorder?

The skin picking disorder is often referred to in the German-speaking world with the term dermatillomania. In the self-help scene, however, the term skin picking is also used. Basically, skin picking disorder is understood as the compulsive self-harm of one’s own skin. This makes the disease one of the so-called dysmorphophobias. For what does cs mean, please visit

The disease was first mentioned by a British doctor in 1875. Skin Picking Disorder has not yet been intensively researched and statistical data is scarce. For this reason, the frequency of the disease can only be estimated. In addition, there are no binding criteria for assignment to skin picking disorder.

However, according to the current state of research, women are primarily affected by the disorder. The proportion of women is usually between 60 and 90 percent. However, the proportion of men is possibly underestimated because men seek psychological help less often than women. In principle, skin picking disorder can develop at any age. However, it often arises in late childhood or early adolescence.

In many cases there is a connection to the occurrence of acne. In addition to the younger sufferers, there is another age group in which the skin picking disorder occurs more frequently. These are people between the ages of 30 and 45.


The skin picking disorder represents a mental compulsion and is therefore not primarily one of the skin diseases. The repeated damage and processing of the skin occurs compulsively in most cases. Therefore, the skin picking disorder can best be assigned to obsessive-compulsive disorders and neuroses.

Nevertheless, the clinical picture affects both psychiatry and dermatology. The damage to the skin tissue occurs as a result of compulsive scratching, squeezing and pinching. Basically, however, the skin picking disorder does not belong to the so-called auto-aggressive behavior patterns.

In most cases, skin picking disorder is limited to the life span between puberty and the age of 40, with women being at particular risk of developing skin picking disorder.

Symptoms, Ailments & Signs

The symptoms of a skin picking disorder are different and vary depending on the form and severity of the disease. The cause of the disorder is a notorious compulsive behavior. The affected person works on certain skin areas, which in many cases are basically healthy. Occasionally, spots with acne or pimples are touched and damaged. This regularly takes place in front of the mirror in a ritualized form.

The spots are manipulated by scratching, squeezing, or constantly touching. While the people affected hope for an improvement in the condition of their skin, they achieve the opposite. The damage to the skin causes wounds and, as a result, scars, which in turn have to be reworked. Acne, for example, can be significantly worsened by skin picking disorder.

In addition to pimples, hairs or wound crusts are sometimes treated. Sometimes healthy skin is also manipulated, using tweezers, pointed objects such as needles or fingernails. In most cases, the people affected are subject to an irresistible impulse.

This results in considerable suffering, which can also affect everyday life. How often and in what form the skin is treated varies from person to person. However, many sufferers experience numerous episodes of compulsive skin picking on a daily basis.

Diagnosis & course of disease

The DSM-IV classification code for mental disorders lists a number of criteria to help diagnose skin picking disorder. Basically, however, there is the difficulty of distinguishing skin picking from behavior that is still healthy. Possible criteria for diagnosing skin picking disorder are, for example, the presence of a strong impulse or drive to carry out the self-damaging action on one’s own skin.

The temptation is too great to resist. So there is a certain loss of control. When performing the action, in many cases, there is a feeling of excitement and tension. The behavior itself is experienced as pacifying, relaxing, and enjoyable. After the plot is completed, reproaches, remorse and feelings of guilt are not uncommon.


Skin picking disorder can cause permanent skin damage. The constant scratching and plucking of the skin causes inflammation, bleeding and serious injuries. In the long term, this leads to permanent scarring, which in turn needs to be repaired. Acne, for example, can be significantly worsened by SPD.

The noticeable skin changes and the urge to scratch them again and again often represent a psychological burden for those affected. Usually, feelings of shame and guilt are added to the compulsion to control. In the long term, people are cut off from social life – be it through their own shame or through rejection from other people, who usually find pecking at the skin unpleasant and repulsive.

As a result, the skin picking disorder usually gets worse – a vicious circle is created that can only be broken with therapeutic help. Cognitive behavioral therapy occasionally has undesirable side effects. Actively dealing with your own fears and problems can put a strain on those around you.

Mental health may deteriorate briefly before improving. If medication is prescribed to accompany psychotherapy, this can also be associated with symptoms.

When should you go to the doctor?

Since skin picking disorder is a serious illness that can make life much more difficult for those affected, a doctor should always be consulted. If the disease is not treated, it can lead to significant complications and irreversible damage to the skin that can no longer be treated. The earlier the skin picking disorder is recognized and treated, the better the further prognosis of the disease. A doctor should be consulted if the person concerned wants to touch their skin permanently. Most of the time, the skin is pinched and scraped off and, of course, damaged as a result.

If these symptoms persist, a doctor should be consulted. In the case of this disease, it is primarily the outsiders who have to point out the skin picking disorder to those affected and persuade them to seek treatment. In serious cases, treatment in a closed clinic may be necessary. In the case of skin picking disorder, a dermatologist or family doctor can be consulted, with treatment taking place with a psychologist. Whether the disease can be completely cured cannot be universally predicted. However, the life expectancy of the affected person remains unchanged.

Treatment & Therapy

Psychological help is recommended to treat skin picking disorder. Cognitive behavioral therapy, for example, is able to help the affected patient to control their own actions. Once the skin picking disorder has been contained, the existing skin problem, such as acne vulgaris, is usually treated.


Researchers are not aware of any concrete measures to prevent skin picking disorder. Individuals with a neurotic personality and a tendency toward obsessive-compulsive disorder are advised to monitor their behavior and seek professional help if there are signs of the disorder.


Follow-up care for dermatillomania or skin picking disorder depends on the severity of the condition. In the case of mild symptoms, the behavioral therapy is followed by regular discussions with a therapist. In order to avoid relapses, the behavioral therapy sometimes has to be repeated several times. At the same time, skin damage that has already been caused must be treated and monitored if there is a risk of inflammation or bleeding.

In the case of a pronounced skin picking disorder in particular, value is placed on a physical examination as part of the aftercare. Follow-up care for dermatillomania is carried out by the general practitioner, dermatologist and therapist. Since the condition is usually based on serious psychological problems, therapy is almost always necessary. If scars have already formed as a result of the skin picking disorder, this represents an additional psychological burden for the patient.

As part of the psychological aftercare, the causes of dermatillomania are determined. On the other hand, the therapist gives advice on how to deal with the affected areas. In some cases, the scars can be surgically removed or covered with makeup. The therapist gives the patient orientation as part of the follow-up care and, if necessary, refers him to a specialist therapist.

You can do that yourself

To combat skin picking disorder as a mental illness, there are some useful everyday tips. Among other things, it should help to keep the hands busy elsewhere so that the patients do not constantly give in to the itching. Substitute activities such as handicrafts or exercise therapy reduce the risk of inflicting serious skin damage on oneself.

In a self-help group, those affected learn to recognize the actual causes of the problem. In addition, together with like-minded people, they can strengthen their self- confidence and no longer feel like outsiders. In order to return to social life, psychological support is also useful. This is where cognitive behavioral therapy comes in handy. Reflecting on one’s own wishes plays a part in the development, and the patients should also train their discipline and self-control. This is achieved, among other things, by the fact that those affected do not close themselves off, but talk to their friends.

Other tools in everyday life include, for example, peeling or shortening the fingernails. This reduces the risk of those affected repeatedly pressing and scratching their skin blemishes. A combination of alternative employment and targeted self-therapy for emotional difficulties often leads to success, especially when patients find self-help groups and counselors through their doctor.

Skin Picking Disorder