Which specialist consultations are beneficial to patients with excoriation (skin-picking) disorder?

Updated: Jul 10, 2018
  • Author: Roxanne Graham, MD; Chief Editor: Dirk M Elston, MD  more...
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A meta analysis of 9 studies examined the efficacy of various psychiatric treatments available for excoriation disorder including cognitive-behavioral therapy (CBT), acceptance and commitment therapy (ACT), and habit reversal training (HRT). The overall findings suggest that behavioral treatments were associated with large reductions in severity of excoriation disorder from baseline to post treatment. [26]  CBT involves psychoeducation, relapse prevention, and cognitive restructuring. HRT, which is used to treat a variety of repetitive behavior problems, involves competing response training. ACT entails acceptance and mindfulness strategies as well as commitment and behavior change strategies. [1]

A psychiatrist and a psychologist should be consulted. Neurotic excoriations can be associated with psychopathology. Social stressors may be well hidden because of shame or a delusional belief system. Suppression, inappropriate channeling, and repression of aggression can be consequences of unmet emotional needs. Conflicts can result from past or current situations. Resolving these issues alone can be difficult.

Excoriation disorder can be associated with anxiety disorders, low self-confidence, generalized apprehension, meticulousness, depressive mood, and hypersensitivity to perceived self-negativism. Thus, the intervention of a psychiatrist or other trained mental health care professionals can be useful. Patients can benefit from psychotherapy and other forms of counseling. [27]

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