Excoriation Disorder

Causes and Triggers of Excoriation Disorder 

The causes of excoriation disorder are emotional and neurological influences alongside the environment. The triggers could be very different from one person to another and might change over time. Understanding the underlying factors is critical for creating a comprehensive excoriation disorder treatment approach. 

Psychological and Emotional Causes 

Excoriation could be associated with anxiety, depression, trauma, ADHD or several other underlying mental health issues. For many people, this action gives them the illusion of temporarily having control, even if it’s only during that moment emotionally. These emotional factors are consistent with the excoriation disorder definition as outlined in DSM-5.

Skin-Related Triggers and Conditions 

Bug bites, acne, eczema or dry skin are all examples of irritants that can result in the urge to pick. Some users have also reported facing discomfort due to uneven patches or imperfections on the skin. These are direct contributors to skin excoriation disorder and are commonly reported during clinical assessments.

Genetic and Neurological Factors 

Newer studies have started focusing on obsessive compulsive disorder and body-focused repetitive behaviours within family history, along with serotonin and problem-forming habits, suggesting these factors of genetics and neurobiology have a larger impact on the disorder. 

Types of Excoriation Disorder 

Not all individuals’ skin picks uniformly. Specialists categorise the actions into three types based on the level of awareness and intention involved. 

Automatic Skin Picking 

This type occurs without conscious control, usually while a person is focused on another task such as reading or watching television. The picking starts with a mindless scanning and picking of skin and can escalate to skin tearing in the absence of awareness. In such cases, excoriation disorder symptoms may go unnoticed for a long time.

Focused Skin Picking 

This kind of skin picking is purposeful and sustained, often sparked by stress, anxiety, or perceived irregularities of the skin. Some individuals may use mirrors or tweezer-like tools, and sessions can stretch from minutes to hours. 

Mixed-Type Picking Behaviour 

Most people will experience a mix of both automatic and focused picking. A person may start doing it mindlessly, and at some point, they will become aware of it, especially after some emotional stress or discomfort in their physical body. These mixed behaviours often highlight the complexity involved in the excoriation disorder definition and its diagnosis.

Cadabam’s Approach to Excoriation Disorder 

We offer a compassionate, tailored, and multidisciplinary care model. Combining psychiatric care with behavioural therapies and social support, as well as structured rehabilitation plans, best serves the individual. 

Assessment 

Every journey towards recovery begins differently with a comprehensive psychiatric and behavioural evaluation for coexisting conditions and potential underlying factors to determine the most appropriate course of action. 

Rehab Modules 

Rehab incorporates:  

1. Behavioural Therapy  

2. Emotional Self-Monitoring and Regulation 

3. Habit Substitution Exercises 

4. Community participation and family involvement 

Aftercare 

Our aftercare program helps ensure long-term recovery through:  

1. Scheduled check-ins 

2. Coping toolkits 

3. Counselling for families 

1. Defined relapse prevention strategies

Start Your Recovery from Excoriation Disorder with Cadabam’s 

At Cadabam's, we know that healing is personal. For skin-picking compulsions, we provide a multidisciplinary and evidence-based strategy. With psychiatric consultations, therapy, peer support, and ongoing family involvement, we ensure that every step you take toward healing, confidence, and control is well-supported. 

If you are searching for a solution to your problem, Cadabam’s Rehabilitation Centre can help you with its team of specialised experts. We have been helping thousands of people live healthier and happier lives for 30+ years. We leverage evidence-based approaches and holistic treatment methods to help individuals effectively manage their Excoriation Disorder. Get in touch with us today. You can call us at +91 96111 94949.

Diagnosis of Excoriation Disorder 

The diagnosis is made with a clinical interview, and the excoriation disorder with cross-injury is checked with the DSM-5. Picking skin cannot be better explained by any other condition. 

DSM-5 Criteria for Diagnosis 

To diagnose excoriation (skin-picking) disorder, the following key features must be present, as outlined in the DSM-5:

1. Repeated skin picking results in lesions 

2. Repeated unsuccessful attempts to quit 

3. Clinically significant psychological distress or functioning impairment 

4. Not attributable to a substance or medical condition 

Differential Diagnosis 

Excludes: 

1. Eczema, scabies, or other dermatological diseases  

2. Skin problems due to substance use  

1. Body dysmorphic disorder (BDD) or trichotillomania

Treatment and Rehab Service Options for Excoriation Disorder 

Effective recovery combines therapy, medication, and rehabilitative care. At Cadabam’s, programs are tailored to address surface behaviours and root causes. 

Cognitive and Behavioural Therapies 

Therapies involve:  

1. Cognitive Behaviour Therapy (CBT) is used to change the cognitive processes responsible for the behaviours.  

2. Habit Reversal Training (HRT)  

3. Acceptance and Commitment Therapy (ACT)  

4. Exposure and Response Prevention (ERP)  

Medications 

Depending on severity and other concomitant conditions (comorbidity), a psychiatrist may recommend:  

1. SSRIs such as fluoxetine or escitalopram  

2. Mood stabiliser: Lamotrigine  

3. N-acetylcysteine (NAC) to aid in decreasing the urges.  

4. Antipsychotics, at lower doses, are used in resistant cases. 

Supportive Tools and Group Therapies 

Recovery may be supplemented with:  

1. Barrier aids (like gloves and bandages)  

2. Fidget tools 

3. Grounding objects  

4. Share story group therapy.  

1. Peer-led motivational recovery circles.

When to Seek Emergency Care 

Immediate assistance is critical when:  

1. There’s notable bleeding or bruising 

2. Injuries seem infected or are hot to the touch 

3. Changes in temperature or confusion are present 

Coping Tools and Self-Help Strategies 

Individual self-help methods include: 

1. Mindfulness practices centred on the body 

2. Tracking apps to monitor and log urges 

3. Designing daily routines that are structured 

4. Reducing the presence of mirrors and tweezers 

5. Skin care routines using moisturisers to maintain dermal health 

Support Systems and Peer Healing 

Support systems and peer healing create a safe space for individuals to share experiences, gain encouragement, and feel less alone in their journey with excoriation disorder.

1. Online forums and mobile communities for BFRB recovery 

2. Therapist-led support groups 

3. Hearing recovery stories fosters hope

     4. Involvement of family in long-term support