Excoriation

Definition:

Excoriation refers to a skin condition characterized by the act of scratching or picking at one’s own skin, resulting in visible wounds, tissue damage, or sores. It is often associated with various psychiatric or psychological conditions.

Symptoms:

1. Visible skin wounds or abrasions:

Excoriation typically presents with noticeable skin injuries, which may vary in severity, size, and location. These wounds are caused by excessive scratching or picking and can range from superficial scratches to deep sores.

2. Compulsive behavior:

An individual with excoriation often exhibits a compulsive urge to scratch or pick at their skin. This behavior can be difficult to control and may lead to distress or impaired functioning in daily life.

3. Frequent skin infections:

Due to the skin’s compromised integrity from excoriation, individuals may experience an increased risk of developing frequent infections. Bacterial or fungal infections can occur as a secondary consequence of the open wounds.

Causes:

1. Dermatological conditions:

Excoriation can be related to underlying skin conditions such as eczema, psoriasis, or prurigo nodularis, which can cause itchiness or discomfort, leading to excessive scratching or picking.

2. Psychiatric or psychological disorders:

Mental health conditions like obsessive-compulsive disorder (OCD), anxiety disorders, body dysmorphic disorder (BDD), or impulse control disorders, may be associated with excoriation. The repetitive skin-picking behavior can act as a coping mechanism or a result of heightened stress or anxiety.

3. Sensory processing issues:

Some individuals with excoriation may have difficulties with sensory processing, leading them to scratch or pick at their skin as a response to certain stimuli. This can provide temporary relief or sensory stimulation.

Treatment:

1. Cognitive-behavioral therapy (CBT):

Cognitive-behavioral therapy, particularly habit reversal training, has shown effectiveness in treating excoriation. It aims to identify triggers, develop alternative coping strategies, and modify behavior patterns.

2. Medications:

In some cases, medications such as selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, or opiate receptor antagonists may be prescribed to manage underlying psychiatric conditions contributing to the excoriation.

3. Support groups:

Joining support groups or seeking peer support can provide individuals with excoriation a sense of belonging, understanding, and opportunities to share coping strategies.

4. Skin care and wound management:

Proper wound care, maintaining good hygiene, and using soothing topical treatments can help prevent infections and promote healing of excoriated skin. Dermatologists or wound care specialists can provide guidance in this regard.