Dermatillomania (Compulsive Skin Picking)

Compulsive skin picking, also known as neurotic excoriation or dermatillomania, is characterized by excessive scratching, gouging, or squeezing of the skin. Individuals that compulsively pick at their skin do so repetitively and ritualistically, and report that this satisfies an almost uncontrollable urge. Most patients use their fingernails to excoriate the skin, but instruments such as tweezers, toothpicks, or pins are commonly used as well. The face is the most commonly excoriated area, but any accessible area of the body may become targeted as well. Skin picking frequently occurs as a response to an itch, skin sensation, or what is perceived as a flaw in the skin.

Onychophagia, more commonly referred to as nail biting, is similar to compulsive skin picking. This is characterized by the uncontrollable urge to bite fingernails and cuticles. Both compulsive skin picking and fingernail biting seem to deliver a pleasurable or relaxed sensation, is tension reducing, and often becomes an automatic response to stressful situations. This may partially explain why so many sufferers find it extremely difficult to decrease the behavior, even when they are aware of its consequences. Those who compulsively pick their skin frequently have red sores and scabs, called acne excoria, and the compulsive nail biter may damage their fingernails and cuticles to the point that they are sore, bleed, or even become infected.

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