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Childhood Trauma And Compulsive Skin Picking (Excoriation)

By about the age of ten or eleven the toxically stressful environment in which I was living, which 3 years earlier had led my school to believe I’d gone deaf due to my periods of dissociation, I developed another symptom of anxiety in the form of obsessive skin-picking (also known as dermatillomania). As both my mother and brother liked to shame and humiliate me, they soon developed a new nickname for me (they had previously often simply referred to me as ‘it’, as in ‘Oh, Christ. Looks what’s on the doorstep, it’s home’ when I returned from school. Young people who have this disorder (dermatillomania) feel deeply ashamed of it anyway so being additionally shamed by parents and siblings is nothing less, in my view, than extreme psychological cruelty and likely to make the situation worse – it certainly did in my case and now, as an adult, my body is covered in scars (mainly on the upper arms, shins, and shoulders. I remember sometimes breaking down and crying when my brother and mother referred to me as ‘scabby’ or, sometimes ‘the scab’ but my mother would tell me I was being a baby, should learn to take a joke, not be so sensitive, turn off the bloody waterworks or, simply, stop blubbing to provide some examples of her favorite ways of shaming me and invalidating my feelings (unfortunately, such behavior is all too common among abusive mothers with a sadistic streak (see my article about sadistic mothers).


According to  Okan Ibiloğlu et al., (2016), skin picking first appears in childhood and is associated with childhood trauma; they carried out a study that showed that individuals who harm themselves in this way to either a moderate or severe degree have a higher probability of having witnessed domestic violence or of having been subjected to child abuse compared to average.

Odlaug et al. (2010) define pathological skin picking as a disorder as a repetitive compulsion to pick at skin resulting in tissue damage that has many similarities to substance disorders such as a compulsion to keep doing it and a sense of pleasure derived from the act itself. The researchers also suggest that the disorder is significantly more prevalent in females than in males and, as might be expected, is also far more prevalent than average among psychiatric inpatients. In relation to the population as a whole, they estimate that 1.4-5.4% suffer from pathological skin picking disorder.

Oliveira et al (2015) refer to obsessive-compulsive skin picking as excoriation as defined by DSM 5. They split sufferers into two groups one of which was measured as having low impulsivity and the other as having high impulsivity. Those with high impulsivity also scored higher on anxiety and depression and the researchers suggest that this finding may reflect that impulsivity may be a specific clinical presentation among those with excoriation disorder.’

In a published paper named Clinical correlates of symptom severity in skin picking disorder by Grant et al. (2017), Grant and colleagues suggest that, based on their research, the severity of a person’s skin picking disorder positively correlates with attentional impulsiveness, motor impulsivity, general impulsivity, and higher levels of anxiety and depression.

Another study, carried out by Leibovici et al (2017) found that those with skin picking disorder were significantly more likely to suffer from depression alcohol misuse, substance misuse and  to perceive their lives as stressful

Ozten (2015) et al carried out a study to determine the relationship between traumatic life events, PTSD symptoms, dissociation, and compulsive skin picking. It was found that those suffering from skin picking disorder did not have a higher rate of experiencing dissociation than normal controls but did report significantly more traumatic events during childhood.

For general information about skin picking disorders from the NHS, click here.

To visit, a very useful external link, click here.

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Leibovici V, Murad S, Cooper-Kazaz R, Tetro T, Keuthen NJ, Hadayer N, Czarnowicki T, Odlaug BL. Excoriation (skin picking) disorder in Israeli University students: prevalence and associated mental health correlates. Gen Hosp Psychiatry. 2014 Nov-Dec;36(6):686-9. doi: 10.1016/j.genhosppsych.2014.07.008. Epub 2014 Jul 26. PMID: 25150776.

Okan Ibiloğlu , Atli A, Kaya MC, Demir S, Bulut M, Sir A. A Case of Skin Picking Disorder of a Patient with a History of Childhood Abuse. Noro Psikiyatr Ars. 2016 Jun;53(2):181-183. doi: 10.5152/npa.2015.10110. Epub 2016 Jun 1. PMID: 28360794; PMCID: PMC5353026.

Odlaug BL, Grant JE. Pathologic skin picking. Am J Drug Alcohol Abuse. 2010 Sep;36(5):296-303. doi: 10.3109/00952991003747543. PMID: 20575652.

Oliveira EC, Leppink EW, Derbyshire KL, Grant JE. Excoriation disorder: impulsivity and its clinical associations. J Anxiety Disord. 2015 Mar;30:19-22. doi: 10.1016/j.janxdis.2014.12.010. Epub 2015 Jan 3. PMID: 25591046.

Özten E, Sayar GH, Eryılmaz G, Kağan G, Işık S, Karamustafalıoğlu O. The relationship of psychological trauma with trichotillomania and skin picking. Neuropsychiatr Dis Treat. 2015 May 15;11:1203-10. doi: 10.2147/NDT.S79554. PMID: 26028973; PMCID: PMC4440428.