FAQs About Teen Excoriation Disorder

What is excoriation disorder?

Teen Excoriation Disorder

And how can your teen find help for this obsessive-compulsive behavior?

Also known as skin-picking, between 1.4 and 5.4 percent of Americans have this anxiety disorder, according to Medscape. If you’ve noticed your teen excessively picking their skin, take a look at the top questions parents have about excoriation disorder answered.

What is the difference between minor scratching and excoriation disorder?

Everyone scratches their skin at some time. Your child has an itchy arm from dryness or a bug bite and they scratch it to stop the irritation. While this type of skin scratching supplies relief, excoriation disorder involves a different type of skin picking.

Teens with this disorder obsessively and repeatedly pick at their skin. They may pick at completely healthy skin, a pimple, or scabs. Even though pimple and scab picking is a sign of excoriation disorder, an occasional scratch at a blemish or bump doesn’t necessarily equal an anxiety issue. Some teens scratch or pick at zits, scabs, and other marks from time to time – minus the compulsion or obsessive behavior.

Why does excoriation disorder happen?

There’s no universal or standard answer to this question. Some teens use skin-picking as a stress reliever or outlet for their anxiety or strong emotions.

This behavior acts as a soothing mechanism in times of increased stress, sadness, or anger. Even though a person with this disorder may feel immediate psychological or emotional relief, the behavior can eventually lead to increased anxiety, embarrassment, or significant guilt.

Can someone stop picking on their own?

Some people with excoriation disorder may have the ability to stop picking.

But this “recovery” doesn’t always last. It’s possible to stop picking for days, weeks, or longer. Some teens may not return to the behavior, while others will relapse. The possibility of relapse makes it necessary to get professional help.

Why get help for excoriation disorder?

Some teens (and adults) don’t feel this issue is a major problem.

This doesn’t mean the disorder doesn’t or won’t interfere with daily life or cause increased anxiety. Not only can skin-picking lead to pronounced feelings of shame, guilt, embarrassment, and worry, the behavior also has physical risks. The picking or scratching action can cut the skin, cause dermatologic irritations, or result in infections or serious scarring.

Excoriation disorder can also take up time and isolate some teens. Time spent picking is often time spent alone. This can add to the sadness or stress your teen feels and interfere with their social life.

How can a teen overcome excoriation disorder?

The good news is that it is possible to treat skin-picking disorder. Again, recovery may not last forever.

A professional-level treatment plan can give your child the best chance for a full recovery. There are a few different treatment and therapy options available. The specific course of action your child will take depends on their individual needs and comfort level.

The first step is to accept this diagnosis and explore the triggers. Triggers may include boredom, stress, anxiety, the feel of picking, or a specific aspect of your teen’s life (such as their social circle or school). Some teens may respond well to stimulus control. This strategy requires a change that makes it harder for your child to pick or a distraction, such as a fidget toy or stress ball.

Along with these strategies, some teens also require therapy. Cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and habit reversal training (HRT) are options to explore. To learn more about which type of therapy your teen should try, talk to a licensed mental health professional.

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About the Author

Headshot: Daniel Villiers, Ph.D.
Dr. Dan brings over 10 years of experience working with children, adolescents, young adults and families in a range of clinical and educational settings.