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Mental Disorders

Similarities and Differences Between Skin-Picking (Excoriation Disorder) and Other Obsessive-Compulsive Disorders

Matthew D. Jacofsky, Psy.D., Melanie T. Santos, Psy.D., Sony Khemlani-Patel, Ph.D. & Fugen Neziroglu, Ph.D. of the Bio Behavioral Institute, edited by C. E. Zupanick, Psy.D.

As with obsessive-compulsive disorder (OCD), people with skin-picking disorder experience some type of distress because of the disorder. They may feel embarrassed by the condition of their skin. They may also feel ashamed because they seem unable to stop themselves from engaging in this harmful behavior.

This perceived lack of control is very similar to the compulsions in obsessive-compulsive disorder (OCD). Like OCD, the desire to skin-pick is frequently described as a compelling urge that is often preceded by a strong emotion. However, unlike OCD compulsions, people with skin-picking disorder report a pleasurable gratification from picking.

Another difference between OCD and skin-picking is the behavior may not be preceded by an obsession or intrusive thought. In fact, the behavior is often performed without any conscious awareness of it. The same is true of hair-pulling disorder (trichotillomania). This distinction has led some professionals to suggest that perhaps hair-pulling and skin-picking are more similar to each other, than to OCD.

Like hair-pulling, skin-picking may require medical attention. This is because skin-picking can cause lesions that become infected. The unsightly lesions and scars can cause embarrassment. Therefore, people may attempt to hide or camouflage these areas. Other people intentionally chose to pick at sites, such as the scalp or the back, where the skin-picking is not easily visible to others.