Excoriation Disorder

Compulsion to pick one's skin.

Also Known As:

Behavior, Skin Picking; Dermatillomanias; Disorder, Excoriation; Disorder, Skin Picking; Excoriation Disorders; Picking Behavior, Skin; Picking Disorder, Skin; Picking, Skin; Skin Picking Behavior; Skin Picking Disorders; Skin Picking, Pathologic; Dermatillomania; Pathologic Skin Picking; Pathologic Skin Picking Disorder; Pathological Skin Picking Disorder; Skin Picking; Skin Picking Behaviors; Skin Picking Disorder

Networked: 121 relevant articles (20 outcomes, 31 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Trichotillomania
2.	Mental Disorders (Mental Disorder)
3.	Dermatitis
4.	Pruritus (Itching)
5.	Body Dysmorphic Disorders (Body Dysmorphic Disorder)

Experts

1.	Grant, Jon E: 7 articles (01/2022 - 11/2006)
2.	Odlaug, Brian L: 5 articles (05/2016 - 09/2007)
3.	Snorrason, Ivar: 4 articles (01/2021 - 08/2013)
4.	Jafferany, Mohammad: 4 articles (11/2020 - 01/2010)
5.	Kim, Suck Won: 4 articles (05/2016 - 09/2007)
6.	Keuthen, Nancy J: 4 articles (02/2015 - 01/2002)
7.	Butler, Merlin G: 3 articles (01/2022 - 05/2011)
8.	Driscoll, Daniel J: 2 articles (10/2020 - 07/2004)
9.	Yurteri, Nihal: 2 articles (07/2020 - 03/2020)
10.	Tavares, Hermano: 2 articles (01/2019 - 01/2014)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Excoriation Disorder:

1.	Acetylcysteine (Siran)FDA LinkGeneric 01/01/2022 - "Evidence of N-acetylcysteine efficacy for skin picking disorder: A retrospective cohort study." 01/01/2022 - "N-Acetylcysteine (NAC) was previously described as a promising therapeutic option for skin picking in PWS. " 05/01/2016 - "N-acetylcysteine treatment resulted in significant reductions in skin-picking symptoms and was well tolerated. " 05/01/2016 - "N-Acetylcysteine in the Treatment of Excoriation Disorder: A Randomized Clinical Trial." 03/01/2015 - "A recent pilot study suggests N-acetylcysteine may be a viable treatment for skin picking. "
2.	Selective Serotonin Reuptake Inhibitors (Serotonin Reuptake Inhibitors)IBA 09/01/2018 - "Selective serotonin reuptake inhibitors (SSRIs) are reported to be effective in the treatment of skin-picking disorder. " 03/01/2003 - "A number of studies show that selective serotonin reuptake inhibitors (SSRIs) may be efficacious in reducing skin-picking behaviour. " 07/01/2001 - "Various studies suggest that selective serotonin reuptake inhibitors (SSRIs) may be useful in treating pathologic skin-picking. " 01/01/2003 - "Although formal drug studies have yet to be conducted, SSRIs have been effective in reducing skin picking, compulsivity and aggressive episodes in some individuals with Prader-Willi syndrome. " 03/01/2003 - "Emerging skin-picking behaviour after serotonin reuptake inhibitor-treatment in patients with obsessive-compulsive disorder: possible mechanisms and implications for clinical care."
3.	Fluoxetine (Prozac)FDA LinkGeneric 08/01/1997 - "Our objective was to determine the efficacy of fluoxetine in the treatment of pathologic skin picking in a double-blind, placebo-controlled, parallel trial. " 08/01/1997 - "This first controlled trial of the treatment of pathologic skin picking suggests that fluoxetine may be of therapeutic benefit. " 08/01/1997 - "A double-blind trial of fluoxetine in pathologic skin picking." 09/01/2018 - "Fluoxetine-Induced Skin Picking and Compulsive Behaviors in a Preschool Girl." 10/01/2005 - "Effectiveness of fluoxetine in the treatment of skin-picking."
4.	Topiramate (Topamax)FDA LinkGeneric 07/01/2004 - "Surprisingly, topiramate treatment resulted in a clinically significant improvement in the self-injury (i.e., skin-picking) that is characteristic of this syndrome. " 01/26/2017 - "Different measures to evaluate the efficacy of topiramate included subjective and objective assessment, photographs, the Skin Picking Scale modified after the Yale-Brown Obsessive-Compulsive Scale (SPS-Y-BOCS), the Skin Picking Impact Scale, the Clinical Global Impressions-Improvement (CGI-I) and CGI-Severity scales, and the Beck Anxiety Inventory and Beck Depression Inventory. " 01/26/2017 - "Topiramate improved time spent skin picking from 85 minutes to 30 minutes per day. " 01/01/2010 - "An open-label trial of topiramate in the treatment of skin picking in pervasive developmental disorder not otherwise specified." 01/26/2017 - "Topiramate appears to be a promising agent in the treatment of skin-picking symptoms. "
5.	Antipsychotic Agents (Antipsychotics)IBA 01/01/2018 - "To the best of our knowledge, there is no literature relating antipsychotics like clozapine with the occurrence of skin-picking behaviour. " 11/01/2018 - "The antipsychotic drugs are most commonly used in dermatology for the management of a delusional disorder, somatic type, manifesting as delusional infestation, and as monotherapy or as augmentation therapy of selective serotonin reuptake inhibitor (SSRI) antidepressants, and for management of trichotillomania and skin-picking or excoriation disorder. " 06/01/2018 - "The etiology, epidemiology, clinical presentation, diagnosis, and first-line treatment of specific primary psychiatric causes of dermatologic conditions, including delusional infestation, Morgellons syndrome, olfactory reference syndrome, body dysmorphic disorder, excoriation disorder, trichotillomania, and dermatitis artefacta are discussed here, followed by a discussion of the recommended treatment approach with an overview of the different first-line therapies discussed in this review, specifically cognitive behavioral therapy, atypical antipsychotics, selective serotonin reuptake inhibitors, and tricyclic antidepressants. " 01/01/2014 - "Large-scale studies investigating the use of second generation antipsychotics combined with selective serotonin reuptake inhibitors/serotonin norepinephrine reuptake inhibitors for the treatment of excoriation disorder is recommended. " 09/01/2021 - "Current literature has described an improvement in skin picking when patients are treated with fluoxetine or escitalopram; other studies have involved augmentation strategies using antipsychotics, such as olanzapine and aripiprazole; serotonin norepinephrine reuptake inhibitors; and N-acetyl-cysteine. "
6.	Cysteine (L-Cysteine)FDA Link 01/01/2016 - "Topiramate might be efficient for self-injury and impulsive/aggressive behaviors, N-acetyl cysteine is apromising treatment for skin picking and Antidepressants are indicated for OCD symptoms. " 01/01/2016 - "We identified promising treatment effects with topiramate for self-injury and impulsive/aggressive behaviors, risperidone for psychotic symptoms associated with uniparental disomy (UPD), and N-acetyl cysteine for skin picking. " 09/01/2021 - "Current literature has described an improvement in skin picking when patients are treated with fluoxetine or escitalopram; other studies have involved augmentation strategies using antipsychotics, such as olanzapine and aripiprazole; serotonin norepinephrine reuptake inhibitors; and N-acetyl-cysteine. " 03/01/2023 - "RCT-derived evidence supports the use of antidepressants in trichotillomania (sertraline and clomipramine), pathologic skin picking (fluoxetine), pathologic nail biting and dermatitis from compulsive hand washing (clomipramine or desipramine); antipsychotics in trichotillomania (olanzapine) and delusional parasitosis (pimozide); N-acetyl cysteine in trichotillomania and skin picking. "
7.	Risperidone (Risperdal Consta)FDA LinkGeneric 03/22/2017 - "Improvement in Excoriation (Skin-Picking) with use of Risperidone in a Patient with Developmental Disability." 03/22/2017 - "risperidone has been approved for irritability and aggression in Autistic spectrum disorder, and may be a valuable treatment option for skin-picking in pediatric patients with developmental disabilities." 03/22/2017 - "In this case, an 11-year-old male with intellectual disability and autistic spectrum disorder, with self-injurious skin-picking, was treated with risperidone with complete resolution of skin-picking symptoms. " 01/01/2016 - "We identified promising treatment effects with topiramate for self-injury and impulsive/aggressive behaviors, risperidone for psychotic symptoms associated with uniparental disomy (UPD), and N-acetyl cysteine for skin picking. "
8.	Glutamic Acid (Glutamate)FDA Link 01/01/2020 - "Reduced anterior cingulate glutamate of comorbid skin-picking disorder in adults with obsessive-compulsive disorder." 01/01/2015 - "The pathophysiology, animal models, and clinical trials of glutamate modulation are explored in disorders with underlying inhibitory deficits (cognitive, motor, behavioral) including obsessive-compulsive disorder, attention deficit hyperactivity disorder, Tourette syndrome, trichotillomania, excoriation disorder, and nail biting. " 01/01/2023 - "In this study, the authors sought to determine whether memantine, a glutamate modulator, is more effective than placebo in reducing hair-pulling and skin-picking behavior. " 02/01/2014 - "Recent evidence suggests that the excitatory neurotransmitter glutamate is dysregulated in obsessive-compulsive behaviors, and modulation of the glutaminergic pathway may decrease compulsive behaviors, such as recurrent hair pulling or skin-picking behaviors. " 12/01/2006 - "Beneficial effects of the glutamate-modulating agent riluzole on disordered eating and pathological skin-picking behaviors."
9.	Escitalopram FDA Link 09/01/2007 - "Twenty-nine individuals with pathological skin picking were enrolled in an 18-week, open-label trial of escitalopram. " 09/01/2007 - "This study sought to assess the effectiveness of escitalopram in treating pathological skin picking. " 09/01/2007 - "These results suggest that escitalopram can be an effective agent in reducing pathological skin picking. " 09/01/2007 - "Open-label escitalopram treatment for pathological skin picking." 01/01/2018 - "In this article, we present a case in whom skin-picking behaviour emerged during the upward dose titration of clozapine and was successfully treated with escitalopram."
10.	Serotonin (5 Hydroxytryptamine)IBA 01/01/2014 - "Large-scale studies investigating the use of second generation antipsychotics combined with selective serotonin reuptake inhibitors/serotonin norepinephrine reuptake inhibitors for the treatment of excoriation disorder is recommended. " 09/01/2021 - "Current literature has described an improvement in skin picking when patients are treated with fluoxetine or escitalopram; other studies have involved augmentation strategies using antipsychotics, such as olanzapine and aripiprazole; serotonin norepinephrine reuptake inhibitors; and N-acetyl-cysteine. "

Therapies and Procedures

1.	Therapeutics 04/01/2023 - "However, because patients with skin picking disorder may decline referral to a mental health professional, dermatologists should be aware of techniques based on CBT, such as habit reversal therapy (HRT), and be prepared to implement them in clinical practice to decrease the burden of disease in affected patients." 04/01/2023 - "Habit Reversal Therapy for Skin Picking Disorder." 01/27/2021 - "Non-pharmacological treatments such as behavioral therapy, habit reversal exercises and support groups have also proved to be helpful and are well tolerated amongst patients suffering from dermatillomania." 09/01/2020 - "Although behavioral therapies can effectively treat skin picking disorder (SPD), there is no standardized treatment for improving SPD and its comorbidities and there is no group intervention option. " 11/01/2017 - "Clinicians should be aware of the characteristics of dermatillomania to ensure that appropriate therapy can be promptly initiated to prevent morbidity."
2.	Drug Therapy (Chemotherapy) 12/01/2017 - "Objective • This review article intended to review the current literature on the alternative therapies to provide a brief update on their benefits for the treatment of excoriation disorder for use in conjunction with psychotherapy and pharmacotherapy in the management of a challenging group of patients. " 02/01/2009 - "The recognition and treatment of pathological skin picking: a potential neurobiological underpinning of the efficacy of pharmacotherapy in impulse control disorders."
3.	Hypnosis (Mesmerism) 12/01/2017 - "Alternative therapies for excoriation disorder and other body-focused repetitive behaviors include yoga, aerobic exercise, acupuncture, biofeedback, hypnosis, and inositol and N-acetylcysteine, among others. " 12/01/2017 - "Conclusions • The review indicates that yoga, aerobic exercise, acupuncture, biofeedback, hypnosis, and inositol and N-acetylcysteine all show promise in the treatment of excoriation disorder and other body-focused repetitive behaviors, such as trichotillomania. "
4.	Psychology Biofeedback (Biofeedback) 12/01/2017 - "Results for biofeedback were as follows: Several case reports have suggested the value of biofeedback in reducing tics, which bear some psychophysiological similarities to body-focused repetitive behaviors, such as trichotillomania and excoriation disorder. " 12/01/2017 - "Alternative therapies for excoriation disorder and other body-focused repetitive behaviors include yoga, aerobic exercise, acupuncture, biofeedback, hypnosis, and inositol and N-acetylcysteine, among others. " 12/01/2017 - "Conclusions • The review indicates that yoga, aerobic exercise, acupuncture, biofeedback, hypnosis, and inositol and N-acetylcysteine all show promise in the treatment of excoriation disorder and other body-focused repetitive behaviors, such as trichotillomania. "
5.	Transcranial Magnetic Stimulation 03/01/2020 - "Repetitive Transcranial Magnetic Stimulation in the Treatment of Skin Picking Disorder: An Exploratory Trial."