Skin picking in children is a repetitive behavior characterized by picking the skin. It is most common in teenagers and children below ten years. While for most people, it is a rare instance, for others, it might become a habit that can turn into a skin picking disorder. Frequent skin picking can cause skin lesions (1) (2).
Uncontrollable skin picking is also called dermatillomania, excoriation, or body-focused repetitive behavior (BFRB) and is related to obsessive-compulsive disorder (OCD) (2).
Read on to know the causes, symptoms, effects, and treatments for skin picking in children.
Signs Of Skin Picking Disorder
As per the criteria set by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the following signs and symptoms could confirm a diagnosis of skin picking disorder in children (3).
- Recurrent skin picking resulting in lesions
- Repeated attempts at changing the behavior
- Skin picking that causes significant stress or impairment to one’s daily life
- Skin picking that is not associated with the effects of a medication or medical condition such as scabies
- Symptoms are not linked to a psychiatric condition
Causes Of Skin Picking In Children
The exact cause of skin picking disorder in children is not known. However, research suggests that skin picking is more prevalent in individuals with OCD, and their immediate family may be genetically predisposed to this condition (1).
Major depression and anxiety disorders are the other most common psychiatric disorders that coexist with skin picking. Besides, anemia, uremia, or liver diseases may also cause compulsive skin picking.
In some cases, certain stressful events or situations may trigger skin-picking episodes in children. In contrast, a few children might indulge in skin picking as they associate it with feelings of relief or pleasure (4).
Manifestations Of Skin Picking Disorder
How and where people pick their skin may differ from person to person. The face, head, cuticles, back, arms, legs, hands, and feet are the most common areas people pick their skin. Some children might pick their skin with their nails and fingers, while others might use scissors and tweezers or resort to biting (5).
Effects Of Skin Picking Disorder
The effects of compulsive skin picking in children can range from mild to extreme. Some children might pick the skin from scabs or a rash, which can worsen the wound and cause bleeding, bruising, and secondary infections. In severe cases, the itching may lead to wounds or sores that warrant hospitalization or even surgical correction (5). Teens usually pick their acne lesions/pimples, which worsens the severity and can lead to scarring.
Compulsive skin picking can also lead to alteration to one’s appearance and cause a feeling of shame. Teens with permanently disfigured skin may resort to wearing clothes that cover their wounds or using makeup to hide their scars. In some extreme cases, they may isolate themselves and avoid social situations (4).
Treatments For Skin Picking Disorder In Children
The treatment for skin picking disorder depends on the child’s motivation and readiness to address the problem. One or more of the following treatments could be followed (2).
- Placing barriers
- Using a band-aid can help prevent the child from picking the skin to an extent. You could also use a paint-on liquid bandage, which can help distract the child when they feel the urge to pick their skin.
- Although this approach may not help eliminate the habit, it can prevent the child from acting impulsively.
- Cognitive behavior therapy (CBT)
- It is the most successful treatment for skin picking.
- It mainly focuses on teaching the child more effective ways to deal with stress and anxiety.
- It helps children find similar but less damaging behaviors to focus on.
- NAC (N-acetyl-cystine)
- It is an over-the-counter ointment that can be effective on some children.
- It is a safe option as it is devoid of side effects.
- If the skin picking habit is triggered by anxiety and depression, selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant, can effectively help manage the condition.
- Acceptance and commitment therapy (ACT)
- This therapy is a combination of CBT and mindfulness techniques.
- It focuses on accepting emotions instead of suppressing them or resorting to coping mechanisms such as skin picking.
- It helps in training the child to accept that they may experience negative emotions, and when they do, they need not succumb to self-destructive habits.
Frequently Asked Questions
1. Can skin picking disorder in children be cured?
To cure skin picking disorder in children, you must identify the triggers. Then, help them find ways to avoid or control the triggers. You may also seek a therapist’s assistance, who may help your child manage their feelings. Usually, medications are not prescribed to cure this disorder (6).
2. What helps skin-picking wounds heal faster in children?
To help skin-picking wounds heal faster, clean the wound with mild soap and water. Apply the prescribed ointments or petroleum jelly on the areas frequently. Cover the areas with a bandage and change the band-aid if it gets dirty. Trim your child’s nails frequently to avoid any sharp cuts on their skin.
3. When should I see a doctor about skin picking?
If you notice that your child picks on their skin compulsively and cannot control it, seek a doctor’s help. You should also consult a doctor if you notice any infection near the skin-picking wounds.
If you notice your child picking their skin, start by telling them not to do it. If the habit persists, you could use barriers such as band-aids that will help them stop picking. Do not try to force stop your child from picking as it might take things the other way. The management of signs will be easier if your child understands the issue and wants to manage the disorder. If you have any questions or concerns regarding the same, consult a medical professional or a pediatric skin specialist for proper guidance.
- Constant skin picking that causes lesions, stress, or disruption may indicate that the child has skin picking disorder.
- The condition is often seen in children with depression, anxiety, or OCD. It may also indicate anemia, uremia, or liver diseases.
- The habit may lead to bleeding, bruising, sores, or permanent disfiguration of skin.
- The disorder may be treated using barriers such as band-aids, cognitive behavior therapy, antidepressants, etc.
- Excoriation Disorder (Skin Picking Or Dermatillomania).
- What Is Excoriation, or Skin-Picking?
- Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health [Internet].
- Compulsive skin picking.
- What is Skin Picking Disorder?
- A Quick Guide to Exorciation Disorder;