Chronic skin picking (CSP) is a serious and poorly understood problem. People who suffer from CSP repetitively touch, rub, scratch, pick at, or dig into their skin, often in an attempt to remove small irregularities or perceived imperfections. This behavior may result in skin discoloration or scarring. In more serious cases, severe tissue damage and visible disfigurement can result.
CSP is now thought of as one of many Body-Focused Repetitive Behaviors (BFRBs) in which a person can cause harm or damage to themselves or their appearance. Other BFRBs include chronic hair pulling (trichotillomania), biting the insides of the cheeks and severe nail biting.
Skin picking or other BFRBs can occur when a person experiences feelings such as anxiety, fear, excitement or boredom. Some people report that the act of repetitively picking at their skin is pleasurable. Many hours can be spent picking the skin, and this repetitive behavior can negatively impact a person’s social, work and family relationships.
Though skin picking often occurs on its own—unconnected to other physical or mental disorders—it is important to identify whether or not skin picking is a symptom of another problem that needs treatment. For example, skin picking could be a symptom of illnesses such as dermatological disorders, autoimmune problems, body dysmorphic disorder, obsessive-compulsive disorder, substance abuse disorders (such as opiate withdrawal), developmental disorders (like autism) and psychosis. Establishing whether skin picking is an independent problem or a symptom of another disorder is an important first step in creating an appropriate treatment plan.