Skip to main content

Is Skin Picking a Form of Self-Harm?

July 23, 2026

What causes a person to continually pick at their skin? Is skin picking a form of self-harm, or is there another explanation for this concerning behavior?

At Time Wellness Arkansas, our team of experienced and compassionate professionals can help you manage the urge to pick at your skin or engage in other compulsive behaviors. For additional details or to schedule a free assessment, contact us today.

Learn more about mental health treatment in Arkansas or verify your insurance now.

What Is Skin Picking?

Skin picking is a behavioral compulsion that involves repeatedly scratching, rubbing, digging your nails into, or picking at your own skin. It is also sometimes referred to as dermatillomania, excoriation disorder, and skin-picking disorder.

Some people who struggle with this behavior intentionally pick at their own skin, while for others it is an automatic or unconscious behavior. Depending on how often a person picks at their skin, the compulsion can lead to scarring, lesions, and other types of skin damage.

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), classifies excoriation disorder as part of the Obsessive-Compulsive and Related Disorders section. 

That section also includes an entry for trichotillomania, which is characterized by overwhelming urges to pull out hair from your head, eyebrows, and other areas.

Causes

There is no single cause of skin picking, but there are a variety of factors that can push a person toward this behavior.

According to a March 2025 JAAD Reviews article, the following mental health disorders can increase a person’s risk of compulsive skin picking: 

  • Attention-deficit/hyperactivity disorder (ADHD) 
  • Posttraumatic stress disorder (PTSD) 
  • Trichotillomania
  • Major depressive disorder
  • Generalized anxiety disorder (GAD)
  • Obsessive-compulsive disorder (OCD)

Also, the Prader-Willi Syndrome Association USA has reported that as many as 80% of people with PWS are affected by compulsive skin picking.

Other risk factors for skin picking include:

  • Being female
  • Using stimulants
  • Family history of dermatillomania
  • Exposure to overwhelming stress
  • Having acne, eczema, or other skin conditions
  • Guilt, shame, or other negative self-directed emotions
  • Emotional dysregulation
  • Personality traits such as impulsivity and perfectionism

Prevalence

Millions of people are affected by compulsive skin picking:

  • The March 2025 JAAD Reviews article cited earlier in today’s post reported that skin-picking disorder affects about 3.5% of the population in the U.S.
  • The International OCD Foundation (IOCDF) estimates that about 1 in 20 people (or 5%) struggle with excoriation disorder. 
  • Both the JAAD Reviews article and the IOCDF note that skin picking is more common among girls and women than among boys and men.

Is Skin Picking a Form of Self-Harm?

The answer to the question, is skin picking a form of self-harm, can vary depending on the intent of the person who is engaging in the act.

Sometimes this behavior is classified as a type of non-suicidal self-injury, or NSSI, which is the clinical term for self-harm or self-injury. In other cases, it is categorized as a body focused repetitive behavior (BFRB) or body focused repetitive disorder (BFRD).

Skin Picking as a Form of Self-Harm

If someone picks at their skin for the purpose of hurting themselves or causing scarring, then that behavior would fall under the definition of self-harm or NSSI.

The term self-harm also encompasses a variety of other behaviors that involve the intentional infliction of pain or injury on a person’s own body, such as: 

  • Cutting or burning your skin
  • Inserting needles into your skin
  • Pulling out your hair
  • Banging or hitting your head against hard objects
  • Intentionally breaking your bones
  • Drinking bleach or other caustic liquids

There are a range of reasons why people engage in self-harm, including:

  • As a maladaptive coping strategy for stress
  • As a symptom of anxiety, depression, or another mental health concern
  • To give physical presence to emotional pain that they can’t otherwise express
  • To punish themselves for a perceived flaw or failure

Estimates of the prevalence of self-harm include:

  • A March 2010 review in The Journal of the American Board of Family Medicine found that 1%-4% of adults, 15% of teens, and as many as 80% of adolescent psychiatric patients have engaged in self-harm.
  • In July 2012, a study in the journal Pediatrics determined that 8% of students in grades three, six, and nine engaged in self-harm. The rate of self-harm was highest among girls in ninth grade, with 19% reporting prior self-harm.
  • According to the U.S. Centers for Disease Contral and Prevention (CDC), injuries from self-harm were responsible for 616,000 emergency department visits in 2022.

Skin Picking as a Type of BFRD

Body focused repetitive behaviors and disorders are more similar to the obsessions of OCD than to the various forms of self-injury. In many cases, people who have BFRBs or BFRDs may not even be aware of their behaviors, or at least not cognizant of how often they perform them.

Other examples of BFRDs include compulsively:

  • Cracking your knuckles
  • Biting your fingernails
  • Grinding your teeth
  • Chewing on your lips or cheeks 
  • Eating your hair

A December 2023 study in the journal Psychological Medicine found that BFRBs and BFRDs are quite common. 

That study, which was based on an online survey of diverse respondents, determined that:

  • More than 97% of people experienced at least one body focused repetitive behavior.
  • The lifetime rate of body focused repetitive disorders was 24%.
  • Nail-biting is was the most common BFRD, with a rate of 11.4%.
  • 8.7% of respondents had dermatophagia, or the compulsion to bite their fingernails or the skin near their fingers.
  • 8.2% of those surveyed struggled with compulsive skin picking.

How Is Skin Picking Treated?

Treatment for skin picking can vary depending on several factors, including what led to the behavior, if the behavior is a type of self-harm or a body-focused repetitive behavior, and how the person’s life has been affected by their compulsive skin picking.

Common elements of care include prescription medication and therapy. 

There are no prescription medications that specifically treat skin picking, but meds that can ease related mental health symptoms include:

  • Selective serotonin reuptake inhibitors (SSRIs)
  • Serotonin-norepinephrine reuptake inhibitors (SNRIs)
  • Atypical antidepressants
  • Tricyclic antidepressants
  • Mood stabilizers
  • Antipsychotics
  • Benzodiazepines

Effective therapies for skin picking can include:

  • Cognitive behavioral therapy (CBT): CBT is an evidence-based approach that emphasizes the interconnectedness of our thoughts, emotions, and behaviors. CBT sessions help people identify and change the maladaptive thought patterns and negative automatic reactions that may be contributing to their psychological distress.
  • Dialectical behavior therapy (DBT): DBT was originally developed to help people who had an elevated risk of suicide. This approach focuses on skill development in four key areas, mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.
  • Eye movement desensitization and reprocessing (EMDR) therapy: EMDR helps to eliminate the psychological pain that people experience when they recall specific traumatic memories. It can be an essential element of care for those whose skin picking is related to untreated trauma.

Find Help for Skin Picking and Self-Harm in Arkansas

Time Wellness Arkansas is a safe and welcoming place where adults can receive personalized outpatient care for skin picking, self-harm, body focused repetitive disorders, and other mental and behavioral health concerns.

Treatment options at our center in Fayetteville, AR, include a partial hospitalization program (PHP), intensive outpatient program (IOP), and virtual (online) services.  Regardless of which option you choose, you can expect to receive customized treatment and comprehensive support from experienced professionals who are truly invested in your success.

Call 479-336-6895 today to learn more or verify your insurance now.