Excoriation: What Counselors Need to Know About Skin Picking Disorder

Excoriation is a disorder in which individuals repetitively scratch or pick their skin, resulting in visible tissue damage. The skin lesions that occur from excoriation can lead to physical disfigurement, functional impairment, and emotional distress. Although skin picking is a common behavior that can negatively impact various domains of a person’s life, many clinicians are unaware that there are instances in which this condition can be classified a pathological disorder. This article focuses on the prevalence, course, etiology, assessment, diagnosis, and treatment of excoriation. A case scenario is included to demonstrate how a client may present in session, followed by suggested approach to treatment. Implications for clinicians are also discussed.