What is dermatillomania? Plus, 4 treatments to help you cope
Clinically reviewed by Dr. Chris Mosunic, PhD, RD, CDCES, MBA
Explore what dermatillomania is, including its symptoms and treatment options. Plus, how mindfulness can support those living with dermatillomania.
If you’ve ever picked, poked, or scratched at a scab or a blemish, you may know just how addicting it can be. But for some, the urge to constantly pick at their skin can be constant and feel uncontrollable. This persistent urge is a condition called dermatillomania, also known as excoriation or skin-picking disorder, and is a mental health condition that falls under the category of obsessive-compulsive disorder.
Not only can dermatillomania lead to painful physical wounds and scars, but it can also cause severe mental anguish. People with dermatillomania often feel isolated, embarrassed, and even guilty that they can’t stop picking their skin, no matter how badly they want to.
If this describes you, know that you’re not alone and that there’s help available and resources to guide you as you work to overcome your compulsions.
What is dermatillomania?
Dermatillomania is a body-focused repetitive behavior (BFRB) that affects an estimated 2% of the population — though some believe that figure is underreported. People with dermatillomania feel compelled to pick at their skin, especially if there’s a blemish or a scab.
While picking can happen on any area of the body, common sites include the face, arms, and hands. Although dermatillomania is a mental health disorder, the consequences of engaging in this compulsion physically manifest as skin lesions, infections, and scars.
Common triggers of dermatillomania
Stress: High stress can worsen the urge to pick at the skin.
Anxiety: Anxiety can increase nervous behaviors, including skin picking.
Boredom: When you’re bored, you may turn to picking at your skin to fill the time.
Perfectionism: A desire to remove perceived imperfections can lead to obsessive skin picking.
Other mental health conditions: Conditions such as obsessive-compulsive disorder (OCD) and depression can also contribute to skin picking behaviors.
What are the symptoms of dermatillomania?
People with dermatillomania may display a range of physical and psychological symptoms, from low self-esteem from feeling bound to their disorder to anxiety and other forms of shame.
Physical symptoms
The physical symptoms of dermatillomania can vary in severity and may lead to long-term skin damage if they aren’t addressed and managed.
Skin lesions: Open sores or wounds
Scabs: Repeated picking prevents healing
Scars: Permanent marks left after the skin has healed
Infections: Open wounds can become infected, leading to further complications
Skin discoloration: Areas of the skin may become darker or lighter after constant picking
Emotional and psychological symptoms
The emotional and psychological symptoms of dermatillomania are both important to explore and address, as they can trickle into other areas of a person’s life.
Guilt: Feeling bad not being able to stop picking
Avoidance: Missing social situations or activities that may expose the skin to hide the damage
Shame: Feeling embarrassed or ashamed about your skin's appearance and hiding it with clothing
Low self-esteem: Visible effects of skin picking can affect self-image and confidence
Mental health issues: Dermatillomania can cause or worsen anxiety and depression
Living with dermatillomania: 4 treatment options to help you cope
1. Seek out cognitive-behavioral therapy (CBT)
Cognitive-behavioral therapy is a type of psychotherapy that can help you identify and change negative thought patterns and behaviors. CBT can be effective in treating dermatillomania, because it can address the underlying issues of skin picking.
A therapist can help you identify what triggers your skin picking, like anxiety or boredom, and work with you to develop healthy ways to cope, including techniques like habit reversal training and breathwork.
💙 Calm your nerves whenever they overwhelm you with our Calming Anxiety breathwork exercises.
2. Explore different medications
Medications can be part of a comprehensive treatment plan for dermatillomania, especially when anxiety and depression are present. They can help stabilize mood and reduce the intensity of urges to pick at the skin. Medications are often used in combination with therapy for the best results.
Selective serotonin reuptake inhibitors (SSRIs): Antidepressants may help reduce compulsive behaviors.
Anti-anxiety medications: These can reduce acute anxiety symptoms that may trigger skin picking.
3. Make space in your life for support groups
Joining an in-person or virtual support group for people with dermatillomania can help you feel less alone. Talking to others who understand what you’re going through can inspire you to stick with treatment plans, and you can learn new tips and strategies. Look for groups through local mental health organizations, online forums, and social media platforms.
💙 Learn to nurture relationships in your life with guidance from the Daily Jay’s session on Mindful Friendships.
4. Try making small changes everyday
Sometimes making a few small changes in your everyday routine can help you reduce the urge to pick.
Remove mirrors: Reduce visual triggers to help minimize the urge to pick.
Wear gloves: Create a physical barrier to picking.
Get active: Exercise to help reduce stress and improve your overall wellbeing.
Develop a skincare routine: Take care of your skin to reduce damage and promote healing.
Use relaxation techniques: Practice deep breathing, progressive muscle relaxation, or yoga to help you feel calm.
Enjoy hobbies: Find activities that occupy your hands and mind, such as knitting, drawing, or playing a musical instrument.
Talk to family and friends: Share your experiences and ask for support and understanding.
Get professional help: See therapists or counselors who specialize in body-focused repetitive behavior.
💙 Explore more tools to help you better understand your mental health with our Overcome Stress and Anxiety series with psychologist Dr. Julie Smith.
How to use mindfulness to treat dermatillomania
Mindfulness involves being present in the moment and observing your thoughts and feelings without judgment. It can help you become more aware of your urges to pick your skin, so you can develop healthier responses.
Here are a few mindfulness techniques to try:
Mindful breathing: Focus on your breath to help calm your mind and reduce stress.
Body scanning: Increase awareness of physical sensations to identify and manage urges.
Grounding exercises: Staying present and connected to the moment can help reduce the likelihood of picking.
💙 Become more aware of what's happening in your body with our Body Scan series, a collection of meditations ranging from three to 30 minutes.
Dermatillomania FAQs
What are the long-term effects of dermatillomania on skin health?
The long-term effects of dermatillomania on skin health can be severe.
Continuous skin picking can lead to permanent scarring, as deep wounds may leave behind noticeable marks such as hyperpigmentation (darker areas) or hypopigmentation (lighter areas). This can result in uneven skin tone that may affect your self-esteem and confidence. In some cases, keloids, which are raised, fibrous tissue growths that extend beyond the wound edges, may form.
Open wounds from picking can become infected and can sometimes require medical treatment. In addition, persistent damage can cause chronic pain or increased sensitivity in the affected areas, making everyday activities like washing uncomfortable or painful.
Getting support and treatment early can help you manage the condition and minimize any long-term effects.
Can dermatillomania be completely cured?
Dermatillomania is a chronic condition, meaning it typically doesn’t have a complete cure. However, you can learn to manage it. A combination of therapies, medications, and self-help strategies can help reduce the frequency and severity of skin picking.
Cognitive-behavioral therapy (CBT) and habit reversal training (HRT) can be particularly useful in helping you control your urges and develop healthier behaviors.
For some people, medications like selective serotonin reuptake inhibitors (SSRIs) can help manage underlying anxiety and depression, which can reduce the compulsion to pick. Mindfulness and stress management practices can help you spot your triggers and improve your responses.
Support from mental health professionals, support groups, and loved ones can provide the encouragement and resources needed for long-term management.
Are there any support groups specifically for dermatillomania sufferers?
Several support groups exist specifically for people with dermatillomania. These can offer a sense of community, understanding, shared experiences, and practical advice, all of which can be valuable in helping you deal with this condition.
The TLC Foundation for Body-Focused Repetitive Behaviors provides resources, support groups, and information tailored to those with body-focused repetitive behaviors, including dermatillomania.
Mental Health America offers resources and support group information for various mental health conditions, including dermatillomania.
Online forums and social media platforms host groups where people can share their experiences, offer support, and discuss coping strategies.
Local mental health organizations and hospitals often offer in-person support groups.
What are some common misconceptions about dermatillomania?
Addressing misconceptions about dermatillomania can help reduce stigma and promote understanding and support for those affected.
A common misconception is that dermatillomania is simply a bad habit that can be easily stopped if you try hard enough. In reality, it’s a recognized mental health disorder, and because it’s compulsive, the urge to pick isn’t easily controlled by willpower. That means it usually requires professional treatment and a comprehensive management plan.
Some people mistakenly believe that dermatillomania is a form of self-harm, but it’s typically not motivated by a desire to self-injure. Instead, it’s simply an uncontrollable urge.
There’s also a misconception that only people with poor hygiene or skin conditions have this disorder. But dermatillomania can affect anyone, regardless of their skin condition or cleanliness.
Lastly, some people might think dermatillomania isn’t a serious issue. However, it can have significant physical and psychological impacts, such as severe skin damage, infections, and emotional distress, which can affect quality of life.
How can family and friends support someone with dermatillomania?
Family and friends can support someone with dermatillomania in lots of helpful ways. By being empathetic, informed, and supportive, you can make a positive impact for a loved one living with dermatillomania.
Be understanding and nonjudgmental: Recognize that dermatillomania is a mental health condition, not just a bad habit. Educate yourself about the disorder so you can better understand what your loved one’s experiencing and provide informed support.
Gently encourage professional help: Offer to help them find therapy, medical treatment, or resources. You could even accompany them to appointments if they’d like.
Reduce triggers: Limit access to mirrors or suggest activities that keep their hands busy.
Offer emotional support: Let them know you’re there for them, and listen to their feelings and experiences without judgment. This can provide much-needed comfort.
Encourage healthy stress management techniques: Invite them to join you in mindfulness practices, exercise, or hobbies to show your support.
Respect their privacy and boundaries: Remember that some people may not want to talk about their condition all the time or might need space to cope.
Celebrate small victories: Acknowledge their progress in managing their condition to keep them motivated and to reinforce positive behaviors.
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