Excoriation (Skin-picking) Disorder

Excoriation disorder is characterized by recurrent skin picking leading to lesions, scarring, or significant distress, often associated with anxiety or obsessive-compulsive symptoms. Etiology involves genetic predisposition, dysregulation of reward pathways, and environmental triggers such as stress. Clinically, patients present with visible skin damage, repeated attempts to stop, and psychosocial impairment. Diagnosis requires ruling out dermatologic conditions and other psychiatric disorders. Management includes cognitive-behavioral therapy, habit reversal training, and pharmacologic interventions such as SSRIs. Prognosis improves with early intervention and adherence to behavioral and pharmacologic strategies.