Excoriation Disorder (Skin Picking)

Trudi Griffin - LPC
Jul 26th, 2019
DSM-5

Excoriation disorder (dermatillomania) is a compulsive disorder where the people afflicted repetitively and compulsively pick at their skin, often to the point of discoloration and scarring. Excoriation disorder is very similar to other compulsive disorders. It is classified as a Body-Focused Repetitive Behavior (BFRB) like trichotillomania (compulsive hair pulling), compulsive nail biting, and the compulsive chewing of the inside of the cheeks. Besides the physical symptoms of excoriation (discoloration, scarring, and sometimes severe tissue damage), people with excoriation disorder also experience multiple mental symptoms including negative emotions such as depression, anxiety, shame, and helplessness.

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Another Name for the Same Disorder

Excoriation is another name for dermatillomania. They both describe the same compulsive skin picking disorder. Though the condition is most often referred to as dermatillomania, even in medical circles, its proper diagnostic name is Excoriation Disorder according to the DSM-5 (DSM-V). Although the diagnosis is categorized within the cluster of obsessive-compulsive and related disorders, excoriation disorder is classified as its own disorder because it has marked and separate characteristics from Obsessive Compulsive Disorder (OCD).

 excoriation disorder in DSM-5

a screenshot of the relevant section is the DSM-5 table of contents

Origin of the Name Excoriation

The word excoriation originally meant “the act of stripping possessions wrongfully or by force.” The term is now obsolete. However, it is easy to see how the original meaning of the word, especially “the act of stripping,” applies to the modern definition of excoriation. That modern definition of excoriation is: “to tear or wear off the skin; abrade.” When not used to describe a skin picking disorder, the meaning of excoriate is very similar to chafe. It means the act of the skin being rubbed or worn off, either by yourself or by an external object. The medical origin of the term excoriation likely originates in the late 1890s. The first known mention of the disorder was in 1898 by a French dermatologist. His female adolescent patient was suffering from the uncontrollable urge to pick at her acne. Today, the term excoriation is almost exclusively used to describe dermatillomania.

Excoriation Disorder

Excoriation disorder is sometimes known as dermatillomania or compulsive skin picking disorder. It can be a very serious compulsive disorder that has several negative effects.

Trudi Griffin - LPC

 

Education, experience, and compassion for people informs Trudi's research and writing about mental health. She holds a Master of Science degree in Clinical Mental Health Counseling: Addictions and Mental Health from Marquette University, with Bachelor’s degrees in Communications and Psychology from the University of Wisconsin Green Bay. Before committing to full-time research and writing, she practiced as a Licensed Professional Counselor providing therapy to people of all ages who struggled with addictions, mental health problems, and trauma recovery in community health settings and private practice.

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