Skin Picking Disorder Test (Dermatillomania)
Medically Reviewed
Medically Reviewed by Dr. Bryon McQuirt
Last Updated on:
April 3, 2025
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Skin picking disorder affects approximately 1-5% of the general population.
Excoriation disorder, also known as skin picking disorder, excoriation disorder, or dermatillomania, is a body-focused repetitive behavior characterized by recurrent, compulsive urges to pick at one’s skin despite attempts to stop.
Despite its significant impact on quality of life, including potential scarring, infection, and psychological distress, those who suffer with skin picking endure their symptoms in silence for years before seeking professional help.
Take our skin picking disorder test below or learn more about our OCD treatment programs.
Skin Picking Disorder Test
Understanding whether your skin picking behaviors constitute a clinical disorder can be challenging.
Our comprehensive skin picking disorder test is designed to help identify patterns consistent with Excoriation Disorder.
While this test cannot replace professional diagnosis, it offers valuable insight into behaviors that may warrant further evaluation by a mental health professional.
What Will This Skin Picking Disorder Test Tell Me?
This assessment will help you understand the severity and impact of your skin picking behaviors in relation to clinical criteria for Excoriation Disorder. The test evaluates multiple dimensions of skin picking, including frequency, intensity, triggers, physical consequences, and emotional distress.
Your results will indicate whether your behaviors align with patterns typically seen in clinical cases, fall into a subclinical range, or represent normal grooming behaviors.
The assessment is based on diagnostic criteria established in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition). The DSM-5 classifies Excoriation Disorder under the Obsessive-Compulsive and Related Disorders category and outlines specific criteria that must be met for clinical diagnosis, including recurrent skin picking resulting in skin lesions, repeated attempts to decrease or stop picking, and clinically significant distress or impairment in functioning.
Additionally, the assessment explores how skin picking affects various aspects of your life, from physical health to social relationships and psychological wellbeing.
This information can empower you to make informed decisions about seeking professional support and provide a framework for discussing your experiences with healthcare providers at Peachtree Wellness Solutions.
You are not alone. You deserve to get help.
Peachtree Wellness is an industry leader in mental health treatment. Our team of top medical experts specialize in dual diagnosis treatment and are committed to ensuring that each patient is treated as an individual. Call us today, we’re available 24/7.
What Causes a Skin Picking Disorder?
Research continues to evolve in this area, but several key factors have been identified as contributing to the development and maintenance of skin picking behaviors:
- Neurobiological Factors: Dysregulation in the brain’s reward circuitry and executive functioning may contribute to difficulty controlling impulses and resisting urges to pick. Brain imaging studies suggest differences in neural pathways involved in habit formation and impulse control, similar to those seen in other obsessive-compulsive spectrum disorders.
- Genetic Predisposition: Family studies indicate a potential hereditary component, with higher rates of skin picking and related disorders among first-degree relatives of affected individuals. This suggests a genetic vulnerability that may increase risk when combined with environmental triggers.
- Psychological Factors: Perfectionism, anxiety sensitivity, and body-focused awareness often underlie picking behaviors. Many individuals report that skin picking temporarily reduces negative emotions, creating a reinforcement cycle that strengthens the behavior pattern over time. The disorder may function as a maladaptive self-soothing mechanism or emotion regulation strategy.
- Comorbid Conditions: Excoriation Disorder frequently co-occurs with other mental health conditions, including anxiety disorders, depression, OCD, body dysmorphic disorder, and trichotillomania. These conditions may share underlying mechanisms and can exacerbate skin picking behaviors.
Understanding the multifaceted nature of Excoriation Disorder is essential for developing comprehensive treatment approaches.
At Peachtree Wellness Solutions, we recognize that each individual’s experience with skin picking is unique, influenced by their specific combination of biological vulnerabilities, psychological factors, and environmental circumstances.
This understanding informs our mental health treatment programs aimed at addressing not just the picking behaviors but the underlying factors that maintain them.
Skins And Symptoms of Skin Picking Disorder
Recognizing Excoriation Disorder requires attention to both physical manifestations and psychological patterns. The condition presents through a complex interplay of behaviors, sensations, and emotional responses that can significantly impact an individual’s quality of life.
While occasional skin picking is common and often benign, clinical Excoriation Disorder involves a pattern of recurrent, intense behaviors that cause noticeable impairment.
Common signs and symptoms of Excoriation Disorder include:
- Recurrent picking at skin, causing visible tissue damage and lesions
- Repeated failed attempts to reduce or stop skin picking behaviors
- Intense urges or physical sensations that precede picking episodes
- Feelings of tension or anxiety that are temporarily relieved by picking
- Considerable time spent engaged in picking (often 1+ hours daily)
- Using tools like tweezers, pins, or needles to extract perceived skin imperfections
- Focusing on specific body areas such as the face, arms, hands, or shoulders
- Avoiding social situations, wearing concealing clothing, or applying excessive makeup to hide damage
- Experiencing a trance-like state during picking episodes, sometimes losing track of time
The impact of these symptoms extends beyond the physical realm. Many individuals with Excoriation Disorder experience significant psychological distress, including diminished self-esteem, social anxiety, and depression.
The cycle of picking, shame, and avoidance can become self-perpetuating, with each episode reinforcing the behavior pattern.
Early recognition and intervention are crucial, as the condition rarely improves without treatment and may worsen during periods of increased stress or when comorbid conditions such as anxiety or depression are present.
At Peachtree Wellness Solutions, we understand the complexity of this condition and the courage it takes to seek help.
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How Is Skin Picking Disorder Treated?
Effective treatment for Excoriation Disorder typically involves a multifaceted approach tailored to the individual’s specific needs and circumstances.
Combining different therapeutic modalities often yields the best results.
At Peachtree Wellness Solutions, we offer comprehensive, evidence-based treatment options designed to address both the picking behaviors and their underlying causes.
- Talk Therapy Approaches
- Cognitive-Behavioral Therapy (CBT): Cognitive Behavioral Therapy focuses on identifying and modifying thought patterns and behaviors that maintain skin picking. Through techniques like self-monitoring, awareness training, and stimulus control, individuals learn to recognize triggers and develop healthier responses.
- Acceptance and Commitment Therapy (ACT): Rather than focusing exclusively on reducing picking behaviors, ACT helps individuals develop a different relationship with their urges. By practicing mindfulness and acceptance of difficult thoughts and sensations, while committing to value-driven behaviors, individuals can reduce the control that picking urges have over their actions.
- Habit Reversal Training: This specialized behavioral therapy teaches individuals to recognize the early warning signs that precede picking and implement competing responses that are physically incompatible with picking. The approach also includes social support and creating awareness of picking behaviors that may occur outside conscious awareness.
- Cognitive-Behavioral Therapy (CBT): Cognitive Behavioral Therapy focuses on identifying and modifying thought patterns and behaviors that maintain skin picking. Through techniques like self-monitoring, awareness training, and stimulus control, individuals learn to recognize triggers and develop healthier responses.
- Medication Approaches
- Selective Serotonin Reuptake Inhibitors (SSRIs): These medications can help address underlying anxiety and obsessive features that often accompany skin picking. By modulating serotonin levels in the brain, SSRIs may reduce urges to pick and lessen overall distress. They are particularly helpful when Excoriation Disorder co-occurs with depression or anxiety disorders.
- N-acetylcysteine (NAC): This glutamate modulator has shown promise in reducing compulsive behaviors in several studies. NAC may help normalize glutamate transmission in the brain regions associated with compulsive behaviors, potentially reducing picking urges and improving impulse control.
- Other Medications: Depending on the individual’s symptoms and comorbid conditions, other mental health medications such as atypical antipsychotics or glutamate modulators may be considered as part of a comprehensive treatment plan.
- Selective Serotonin Reuptake Inhibitors (SSRIs): These medications can help address underlying anxiety and obsessive features that often accompany skin picking. By modulating serotonin levels in the brain, SSRIs may reduce urges to pick and lessen overall distress. They are particularly helpful when Excoriation Disorder co-occurs with depression or anxiety disorders.
- Practical Strategies
- Barrier Methods: Simple interventions like wearing gloves, bandages, or adhesive bandages on commonly picked areas can provide a physical barrier and increase awareness of picking behaviors.
- Environmental Modifications: Adjusting lighting, removing or covering mirrors, and keeping hands occupied with fidget toys or stress balls can reduce picking opportunities and triggers.
- Self-care Practices: Regular skin care routines with gentle products, keeping nails trimmed short, and establishing healthy sleep and stress management habits can reduce both the urge to pick and the availability of skin irregularities that trigger picking.
- Barrier Methods: Simple interventions like wearing gloves, bandages, or adhesive bandages on commonly picked areas can provide a physical barrier and increase awareness of picking behaviors.
Treatment outcomes are significantly improved when individuals receive proper support and comprehensive care.
At Peachtree Wellness Solutions, we work collaboratively with each client to develop a personalized treatment plan that addresses their unique challenges and goals. Many individuals find that a combination of therapy, medication when appropriate, and practical strategies offers the most effective path to recovery and long-term management of skin picking behaviors.
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