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If you find yourself picking at wounds and injuries on your skin, you may be suffering from dermatillomania. Help is available.

What is Dermatillomania?

Dermatillomania is compulsive, repetitive picking at one’s own skin, resulting in damage and wounds. The condition usually occurs in adolescence or young adulthood, but can also occur later in life. Stress can often exacerbate dermitillomania symptoms. Behaviours can lead to feelings of shame that may prevent people from seeking help. However, dermatillomania is treatable.

Causes of dermatillomania

There are several reasons why people can develop dermatillomania. Research shows that both genetic and environmental factors contribute to the problem. Dermatillomania has a similar cause to trichotillomania, which involves hair pulling.

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Dermatillomania diagnosis

There are some screening questions to get an idea of whether you need to seek help for dermatillomania symptoms:

Do you pick, scratch, poke, pick or otherwise damage your skin?

Do you do it often?

Have you tried not to do it without success?

Have these behaviours negatively impacted your life?

If you answered yes to these questions, you may want to seek help.

Studies of adults have shown that between 1-5% of the population has the diagnosis. According to research, dermatillomania occurs more often in women than men. There are currently no studies on how common it is in children and adolescents, but the problem is also present in this population. It is also common to have other psychological conditions such as anxiety, depression, body dysmorphia, obsessive-compulsive disorder, eating disorders and bipolar disorder at the same time as dermatillomania.

Dermatillomania and self-harm

Many people who have self-harming behaviours can also pick and scratch their body. However, if the purpose is to hurt themselves, this is different from dermatillomania. It is still important to seek help so that you can get treatment for your symptoms.


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Symptoms of dermatillomania

Dermatillomania involves compulsive picking at different parts of the body, such as the face, hands, nails, feet or arms. Picking can be done consciously, but it is also common to pick without thinking about it. This can lead to cuts and abrasions that are, in turn, picked at again. Some of the symptoms of dermatillomania are:

  • Picking, scratching, poking, prodding, or damaging the skin
  • Trying to reduce or stop without success
  • Anxiety and stress that may be relieved by picking
  • Picking unconsciously or consciously
  • Focusing on a specific scab or part of the body to pick. Many people also examine, play with or swallow skin after it has been picked. Since people often pick in the same place, this can result in skin problems.
  • Skin picking behaviour having an impact on daily activities and function. It can also lead to feelings of shame and guilt, as well as social withdrawal.

If you recognize the symptoms of dermatillomania, you may want to seek help. For milder symptoms, we have psychologists at Lavendla who can help you. If you have more severe concerns, it is good to seek help via specialist psychiatry. Below you can read more about what treatment for dermatillomania entails.

Treatment for dermatillomania

The most effective treatment for dermatillomania is habit reversal training (HRT). HRT seeks to find alternative behaviors to skin picking. In short, the treatment involves first making the client aware of when they are picking skin (awareness training). Then the client is taught an action (competing response) that is physically incompatible with skin picking (for example, clenching their fists). For best results, family members are also given information on how to help the client if they pick. In the case of dermatillomania, it is also important to continue to follow up with a health care provider to ensure results are maintained over time.

HRT treatment consists of five parts:

  1. Awareness training
  2. Competing response training
  3. Motivation building
  4. Relaxation training
  5. Applying the new skills

Dermatillomania has different degrees of severity, from mild to moderate to severe. For milder concerns with skin picking, treatment with a licensed psychologist or CBT therapist can be beneficial. If you have more severe concerns, seeking specialized care with a psychiatrist is the best way to get the support you need. You can get a referral through your family doctor or walk-in clinic. If you have physical health concerns as a result of skin picking, such as infections or other injuries, you can seek help from your local emergency department, urgent care or walk-in clinic. In terms of medical treatment with drugs, there is not yet enough research to make a recommendation.


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Seeking help can change your life

Dermatillomania is not something that you should have to go through alone. Talking to a licensed psychologist or psychotherapist can not only help you understand your condition better but also offer effective ways to manage it. You are not alone and it is okay to ask for help. On our website, we have qualified therapists and psychologists who are happy to help you.

Common misconceptions about therapy

Many people think that therapy is only for “serious” problems or that seeking help is a weakness. In both cases, these are misconceptions. Rather, therapy is a step towards improvement and a greater quality of life. We make the difficult easier by connecting you with licensed psychologists and therapists online.

Your next step

If you or someone you know is struggling with compulsive behaviours, it’s a good idea to talk to a professional therapist or psychologist. We assure you that all therapists and psychologists on our platform are qualified and that your conversation is always confidential. Don’t be afraid to take the first step.

Living with dermatillomania can be a daily struggle but there is help available. With the right support and tools, you can significantly improve your quality of life. If you are ready to take the plunge, we are here to support you. Book your first session today and start your journey towards a better future.


12 frequently asked questions about dermatillomania

What is dermatillomania?

Dermatillomania is compulsive, repetitive picking at one’s own skin, resulting in injuries and wounds.

How is dermatillomania diagnosed?

A diagnosis of dermatillomania is usually made by a licensed psychologist or psychiatrist through various tests and assessments. This may include questionnaires and clinical interviews.

Is dermatillomania hereditary?

Research shows that dermatillomania may have a genetic component but it is not the only factor. Environment also plays a role, as well as stress and anxiety.

What are the symptoms of dermatillomania?

In dermatillomania, people may compulsively pick at different parts of the body, such as the face, hands, nails, feet and arms. The picking may be conscious, i.e. there is a ‘craving’ to do it. It is also common to pick without thinking about it.

How is dermatillomania treated?

Treatment can include cognitive behavioural therapy with specific habit reversal training (HRT), which has been shown to be particularly effective.

Is there a cure for dermatillomania?

With the right treatment, symptoms can be managed and quality of life significantly improved.

Can children get dermatillomania?

Yes, children and teenagers can also be affected. It is important to seek professional help as soon as possible for the best possible treatment outcome.

How common is dermatillomania?

About 1-5% of the population have some form of dermatillomania.

Does dermatillomania affect my ability to work?

Yes, severe dermatillomania can affect functional capacity. However, it is possible to return to normal function with proper treatment.

Is dermatillomania more common in women or men?

Research has shown that dermatillomania is more common among women.

Can you have other problems at the same time as dermatillomania?

It is also common to have other psychological conditions such as anxiety, depression, obsessive-compulsive disorder, eating disorders and bipolar disorder. It is important to have an assessment by a licensed professional.

Where can I go if I need help?

At Lavendla, we have experienced psychologists and therapists working with CBT who can help you feel better if you have mild symptoms. If you have more severe symptoms, you can contact your family doctor to get a referral to a specialist psychiatrist. If you have thoughts of self-harm or suicide, call 911, call or text the National Suicide Hotline at 988, or go to the nearest emergency room.

What does treatment for dermatillomania involve?

Seeking help is a big step towards better health. It’s a positive thing to decide to take control of how you feel. Here is an overview of the steps of CBT treatment.

Step 1: An initial assessment session

The first meeting with your psychologist or therapist is an assessment to review your mental and physical health. Your therapist may questions about your life situation, feelings, thoughts and behaviours. You may also complete assessment forms.

Step 2: Goal setting

This is where you and your therapist set concrete goals for the therapy, both short and long term.
It can identify which areas of your life are most affected by your wellbeing and how you would like to change them.

Step 3: Treatment with different techniques and tools

This is the start of the actual treatment phase, which involves exercises aimed at giving you tools to overcome and work through the problem you are suffering from. Habitual reversal training (HRT) is often helpful to find alternative behaviours for dermatillomania.

Step 4: Monitoring and evaluation

Treatment is monitored regularly to see how well the therapy is working. If necessary, the treatment plan can be adjusted.

Step 5: Ending and looking ahead

As the therapy comes to an end, it is time to reflect on the progress made. You will also receive a maintenance plan for how to use the tools and strategies you have learned in the future. It is also important to monitor your results over time.

If you or someone close to you is looking for professional help, don’t hesitate to book a session with one of our licensed psychologists or therapists. Together, we can make the difficult easier.


Written by Sophia Coulter

Sophia is a registered nurse with experience in inpatient, emergency and community mental health care. She has a passion for providing emergency support for those experiencing mental health crises.