Excoriation disorder
| Excoriation disorder | |
|---|---|
| Synonyms | dermatillomania, skinning disorder, neurotic excoriation, acne excoriee, pathologic skin picking (PSP), compulsive skin picking (CSP), psychogenic excoriation |
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| Image of a person with excoriation disorder with sores as a result of skin picking on arms, shoulders and chest | |
| Classification and external resources | |
| Specialty | Dermatology, psychiatry |
| ICD-10 | L98.1 |
| ICD-9-CM | 312.3 |
| DiseasesDB | 29765 |
| eMedicine | article/1122042 |
| MeSH | D007174 |
Excoriation disorder is a mental disorder characterized by the repeated urge to pick at one's own skin, often to the extent that damage is caused.
Research has suggested that the urge to pick is similar to a body-focused repetitive behavior but others have argued that for some the condition is more akin to a substance abuse disorder. The two main strategies for treating this condition are pharmacological and behavioral intervention.
Since the DSM-5 (2013), excoriation disorder is classified as "L98.1 Excoriation (skin-picking) disorder" in ICD-10; and is no longer classified in "Impulse control disorder" (f63)".
Excoriation disorder is defined as "repetitive and compulsive picking of skin which results in tissue damage".
Its most official name had been "dermatillomania" for some time. As of the release of the fifth Diagnostic and Statistical Manual of Mental Disorders in May 2013, excoriation disorder is classified as its own separate condition under "Obsessive Compulsive and Related Disorders" and is termed "excoriation (skin-picking) disorder".
The inability to control the urge to pick is similar to the urge to compulsively pull one's own hair, i.e., trichotillomania. Researchers have noted the following similarities between trichotillomania and excoriation disorder: the symptoms are ritualistic but there are no preceding obsessions; there are similar triggers for the compulsive actions; both conditions appear to play a role in modifying the arousal level of the subject; and the age of onset for both conditions is similar. There is also a high level of comorbidity between those that have trichotillomania and those that have excoriation disorder. A notable difference between these conditions is that skin picking seems to be dominated by females whereas trichotillomania is more evenly distributed across genders.
Research has also suggested that excoriation disorder may be thought of as a type of obsessive compulsive disorder (OCD). Excoriation disorder and OCD are similar in that they both involve "repetitive engagement in behaviors with diminished control" and also both generally decrease anxiety.
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