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The Informed Parent

Is Constant Skin-picking A Problem?

by Peter W. Welty, M.D., F.A.A.P.
Published on Aug. 25, 2008

Parents sometimes come to the pediatrician with concerns that their child is picking at their skin. Clinical features of dermatillomania, or skin picking, are similar to those of trichotillomania, or hair pulling.

This behavior occurs when patients pick at their skin to the point of causing considerable and noticeable damage. Half of these patients report an onset before age ten. Unfortunately, most people with skin picking go about thirty years before they seek treatment.

Like patients with trichotillomania, those who pick at their skin might focus on any part of the body. They may experience a sense of tension, pleasure, gratification or relief as a result of their picking.

Anything can be used, such as hands, fingernails, even tweezers or razor blades. Skin-picking episodes can last minutes or hours. It can occur at multiple times during the day. Many patients require oral or topical antibiotics to treat any possible infection. In some cases even more serious treatments may be required.

The first line treatment of skin-picking involves habit reversal training. A therapist qualified in behavioral modification training can be of invaluable help. Medications are sometimes used. They are usually in the same category as those medications given to patients with obsessive-compulsive disorder. Other medications are also being researched.

See your child’s doctor if you have any further questions.

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