Excoriation disorder

Excoriation disorder, more commonly known as dermatillomania, is a mental disorder on the obsessive–compulsive spectrum that is characterized by the repeated urge or impulse to pick at one's own skin, to the extent that either psychological or physical damage is caused. Episodes of skin picking are often preceded or accompanied by tension, anxiety, or stress. In some cases, following picking, the affected person may feel depressed. During these moments, there is commonly a compulsive urge to pick, squeeze, or scratch at a surface or region of the body, often at the location of a perceived skin defect. When picking, one may feel a sense of relief or satisfaction. The region most commonly picked is the face, but other frequent locations include the arms, legs, back, gums, neck, shoulders, scalp, abdomen, chest, and extremities such as the fingernails, cuticles, toenails, etc. Most patients with excoriation disorder report having a primary area of the body that they focus their picking on, but they will often move to other areas of the body to allow their primary picking area to heal. Individuals with excoriation disorder vary in their picking behaviour; some do it briefly multiple times a day, while others can do one picking session that can last for hours. The most common way to pick is to use the fingers although a significant minority of people use tools such as tweezers or needles. Skin picking often occurs as a result of some other triggering cause. Some common triggers are feeling or examining irregularities on the skin, and feeling anxiety or other negative feelings. This anxiety most commonly stems from a type of OCD, which can range in severity and often goes undiagnosed. Complications arising from excoriation disorder include infection at the site of picking, tissue damage, and sepsis. Damage from picking can be so severe as to require skin grafting, and severe picking can cause epidermal abscesses. Severe cases of excoriation disorder can cause life-threatening injuries.