The essential feature of excoriation (skin-picking) disorder is recurrent picking at one’s own skin. The most commonly picked areas are the face, arms, and hands, but many individuals pick from multiple sites.
In addition to skin picking, skin rubbing, squeezing, lancing, and biting are also common. Most individuals pick with their fingernails, although many use tweezers, pins, or other objects.
Diagnostic criteria includes:
- Repeated attempts to decrease or stop skin picking.
- The skin picking causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
- The skin picking is not attributable to the physiological effects of a substance (e.g., cocaine) or another medical condition (e.g., scabies).
- The skin picking is not better explained by symptoms of another mental disorder (e.g., delusions or tactile hallucinations in a psychotic disorder, attempts to improve a perceived defect or flaw in appearance in body dysmorphic disorder, stereotypic movement disorder, or non-suicidal self-harm).
Individuals with excoriation disorder often spend significant amounts of time on their picking behavior, sometimes several hours per day. Skin picking may endure for months or years.
This is a new disorder added to the updated DSM-5 (2013).