Skin Picking Disorder (Excoriation)
Skin picking disorder is treated with therapy and medications.
There are two main kinds of therapy for skin picking:
Habit reversal training. The therapist helps you identify the situations, stresses, and other factors that trigger the skin picking. Then your therapist will help you find other things to do instead of skin picking, such as squeezing a rubber ball. This will help ease stress and occupy your hands.
Stimulus control. This therapy involves making changes to your environment to help curb skin picking. For example, you might try wearing gloves or Band-Aids to help prevent feeling the skin and getting the urge to pick. Or you might cover mirrors if seeing facial blemishes or pimples brings on picking behavior.
Some psychiatric medications are occasionally used to treat skin picking disorder, but none are FDA-approved or well-established for this purpose. SSRIs (selective serotonin reuptake inhibitors) such as Prozac are the best-studied class of medicines for skin picking.
Early studies also have begun to examine the possible value of some anticonvulsant medicines, such as Lamictal (lamotrigine).
If you think you have skin picking disorder, it may be hard to find a doctor who is experienced with this kind of issue. The Trichotillomania Learning Center keeps a list of professionals who are trained in therapy for BFRBs. If there is no one on the list near you, you can also look for a therapist who treats obsessive-compulsive disorder. They are often trained in similar types of treatment.
It is also a good idea to see your primary care doctor or a dermatologist about any skin lesions, wounds, or scars caused by the repetitive picking.