Skin Picking and OCD. Causes of Skin Picking
OCD skin picking, called excoriation disorder in the Diagnostic and Statistical Manual for Mental Health, Fifth Edition (DSM-V), involves the repetitive picking of one's skin resulting in damage to tissue. People engage in compulsive skin picking in an attempt to relieve some type of emotional distress. Frequently, these people feel a strong, persistent urge to pick their skin, but it's an unconscious habit for many sufferers. Those suffering from the condition report a feeling of relief or even pleasure following the skin picking behavior.
Relationship Between OCD and Skin Picking
The DSM-V lists OCD and skin picking (excoriation) in a new chapter called Obsessive-Compulsive and Related Disorders. It's estimated that about 3 percent of Americans suffer from some level of compulsive skin picking or excoriation. Researchers aren't clear on skin picking causes, but many believe OCD and skin picking are related. Some even believe excoriation to represent the physical manifestation of OCD.
Skin picking shares some features with OCD in that people with the disorder pick their skin over and over in response to persistent thoughts or urges to touch and pick their skin. This often serious mental illness also shares similarities to other obsessive-compulsive spectrum disorders like trichotillomania (hair pulling disorder), body dysmorphic disorder, and some tic disorders. People with excoriation (skin picking) disorder are at greater risk than those without it to have OCD or another OC spectrum disorder.
Skin Picking Causes
As with many mental illnesses, scientists and mental health professionals suspect that the causes of OCD skin picking may involve a combination of biological and environmental factors, which could include:
- Genetic predisposition – those with first-degree relatives who are suffering or have suffered from skin picking or another body focused repetitive disorder are at greater risk of developing the condition.
- Environmental triggers – a person's family environment and childhood experience may influence who develops the disorder. Perfectionism in the family, physical violence, emotional abuse, and other trauma may trigger skin picking behavior.
Before diagnosing a person with skin picking OCD, doctors need to rule out other causes. For example, certain drugs like amphetamines (often prescribed for ADHD) can cause OCD skin picking. Kidney disease, iron deficiency anemia, scabies, and a number of other health issues can cause skin picking as well. A physician will need to test patients for these other medical causes of skin picking before diagnosing them with skin picking OCD.
If you, or someone you love, experiences significant emotional distress due to their OCD skin picking behaviors, help is available. An experienced mental health professional can evaluate the problem and develop an effective treatment plan. It's important for sufferers to seek help and stand up for their own mental health.
Last Updated: 18 November 2016
Reviewed by Harry Croft, MD