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The primary characteristic of Compulsive Skin Picking (CSP) is the repetitive picking at one's own skin to the extent of causing damage. Usually, but not always, the face is the primary location for skin picking. However CSP, also known as dermatillomania or neurotic excoriation, may involve any part of the body. Individuals with CSP may pick at normal skin variations such as freckles and moles, at actual pre-existing scabs, sores or acne blemishes, or at imagined skin defects that nobody else can observe. Individuals with CSP may use their fingernails, as well as their teeth, tweezers, pins or other mechanical devices. As a result, CSP may cause bleeding, bruises, infections, and/or permanent disfigurement of the skin.

Sometimes skin-picking is preceded by a high level of tension and a strong "itch" or "urge". Likewise, skin-picking may be followed by a feeling of relief or pleasure. A CSP episode may be a conscious response to anxiety or depression, but is frequently done as an unconscious habit. Individuals with CSP often attempt to camouflage the damage caused to their skin by using make-up or wearing clothes to cover the subsequent marks and scars. In extreme cases, individuals with CSP may avoid social situations in an effort to prevent others from seeing the scars, scabs, and bruises that result from skin picking.

As demonstrated above, CSP has obsessive-compulsive features that are quite similar to OCD, BDD and Trichotillomania. It is sometimes found in individuals with these disorders, as well as in patents with certain medical conditions. In fact, a recent study found that 23% of those with OCD, and 27% of those with BDD, also had CSP. Though not currently listed in the Diagnostic and Statistical Manual (DSM-IV) published by the American Psychiatric Association, some researchers believe it merits distinction as a separate diagnostic entity.

The primary treatment modality for CSP depends on the level of awareness the individual has regarding the problem. If the CSP is generally an unconscious habit, the primary treatment is a form of Cognitive-Behavioral Therapy called Habit Reversal Training (HRT). HRT is based on the principle that skin-picking is a conditioned response to specific situations and events, and that the individual with CSP is frequently unaware of these triggers. HRT challenges the problem in a two-fold process. First, the individual with CSP learns how to become more consciously aware of situations and events that trigger skin-picking episodes. Second, the individual learns to utilize alternative behaviors in response to these situations and events.

There are a number of other therapeutic techniques that can be used as adjuncts to HRT. Among these are Exposure and Response Prevention (ERP) and stimulus control techniques. Exposure and Response Prevention (ERP), which is the primary treatment for OCD and many OC Spectrum disorders, is most valuable if the individual with CSP is already aware of the specific situations and events that trigger skin-picking episodes. To learn more about this treatment approach, click here. Stimulus control techniques involve utilizing physical items such as gloves or rubber fingertip covers to reduce the client's ability to pick at his or her skin. Also, medications that are frequently used to treat OCD may be valuable adjuncts to CBT in the treatment of compulsive skin picking.

Please note that the above is not meant to replace a complete and thorough evaluation by a licensed Cognitive-Behavioral therapist or other qualified mental health professional. As with OCD, some individuals with CSP may benefit from medication, and may therefore require a psychiatric evaluation. Likewise, a psychiatric assessment may be necessary to differentiate between CSP and other psychological conditions. If a psychiatric evaluation is indicated, OCDLA can refer you to a qualified psychiatrist in the Los Angeles area. Furthermore, it is imperative to make the distinction between CSP and other medical conditions. For this reason, a medical examination may be necessary.

Source: OCD center of Los Angeles.


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In every neighborhood there is at least one house that all the neighbors gossip about. This is a diary from the woman who lives in that house. I am a single mother in her mid thirties. I live in North Dakota with my son, Warren.

I tend to be a bit of a slob, and am the opposite of a girly-girl. I am geek girl, who loves Star Wars, Star Trek, Harry Potter, Buffy, Angel, action movies, science fiction, action adventure, Dr. Who, and so on and so on.

I love to write and while I don't post much fiction online anymore I would love to be a writer someday. I am also overweight, bipolar and suffer from allergy induced asthma.