What is Dermatillomania?
Dermatillomania, (also known as excoriation disorder or skin-picking disorder) falls under the category of Obsessive-Compulsive Disorder and is characterised by a compulsion to pick or scratch your own skin. Some people create new wounds while others may focus on already damaged areas of skin such as spots, cuts or scars. This can be done with fingernails, teeth or with the help of tweezers, pins, razors or scissors. People with dermatillomania experience growing tension and anxiety until they are able to satisfy the intense urge to pick.
There are two different types of picking:
- Automatic: This kind of picking often happens without a person thinking about it. They tend to run their hands or fingertips over the skin to find any areas that feel different, which might become an area for focused picking.
- Focused: This kind of picking is “focused” on a specific area, and can be intense causing more serious damage to the skin.
What causes Dermatillomania?
Dermatillomania, or skin-picking, is often a symptom rather than a standalone condition. The underlying causes can vary widely and may include:
- Learned behaviours passed down from family members or others close to us.
- Low self-esteem that leads to self-soothing or control-seeking behaviours.
- Past trauma or significant stress, often resulting in compulsive coping responses.
Here are some strategies that may help relieve anxiety and reduce the urge to pick:
- Practice grounding techniques like deep breathing or the 5-4-3-2-1 method, identifying things you can see, hear, feel, smell, and taste. (You will find more grounding techniques at the bottom of this page).
- Squeeze a stress ball, alternating between hands – 5 squeezes in the left hand, then 5 in the right, and repeat as needed.
- Keep your hands busy with activities like crafting, working on a jigsaw puzzle, or using a Rubik’s cube to redirect focus.
- Wear gloves to add a physical barrier and remind you to avoid skin contact.
- Create a skin care routine, using moisturisers or body lotion to care for and appreciate your skin in a gentle, positive way.
These techniques can offer healthy alternatives and help shift the focus from the urge to pick.
Overcoming Dermatillomania
No one is born with dermatillomania, meaning it doesn’t have to be a lifelong condition—it can be fully overcome with the right strategies and support.
A crucial first step is to address and reframe your perception of the events or feelings that initially triggered the urge to pick. Understanding what originally prompted this behavior is key. Using tools like our Timeline Resource can help you identify these root causes so you can begin to challenge and positively reshape any negative beliefs (schemas) that developed. Here are some tips to guide you:
- Identify the root of your belief by creating a personal timeline of significant events or feelings related to skin-picking.
- Challenge old beliefs by questioning if what you once believed still applies, or if it was ever fully accurate.
- Build confidence with small, intentional practices—our Mirror Therapy Resource can be a helpful way to practice self-affirmation.
- Break down difficult situations into manageable steps, setting small goals that you can celebrate as you progress.
- Use grounding techniques in stressful situations to keep you centered and focused.
- Learn to appreciate yourself, recognizing your own worth and potential to live a full, joyful life.
These steps encourage self-compassion and empowerment as you work toward lasting change.
