[5] During these moments, there is commonly a compulsive urge to pick, squeeze, or scratch at a surface or region of the body, often at the location of a perceived skin defect.

[7] The region most commonly picked is the face,[3][6][5] but other frequent locations include the arms, legs, back, gums, neck, shoulders, scalp, abdomen, chest, and extremities such as the fingernails, cuticles, toenails, etc.

[9] Complications arising from excoriation disorder include infection at the site of picking, tissue damage, and sepsis.

[3] Excoriation disorder can cause feelings of intense helplessness, guilt, shame, and embarrassment in individuals, and this greatly increases the risk of self-harm.

[3][8] A review of behavioral studies found support in this hypothesis, in that skin-picking appears to be maintained by automatic reinforcement within the individual.

[8] In contrast to neurological theories, there are some psychologists who believe that picking behavior can be a result of repressed rage felt toward authoritarian parents.

Drugs such as cocaine and methamphetamine, which increase the pharmacological effects of dopamine, have been shown to cause uncontrollable picking in users.

Motor-inhibitory control is a function of the right-lateralized frontostriatal circuit, which includes the right inferior frontal and bilateral anterior cingulate cortices.

The impairment of motor-inhibitory control is similar to the neurological conditions of those who have problems suppressing inappropriate behaviors, such as using methamphetamine.

[12] This observation led researchers to study the effects of the SAPAP3 gene on patients with trichotillomania—a disorder marked by the same behaviors directed at one's own head and body hair.

The DISP is designed to confirm DSM-5 criteria for the diagnosis, combined with a clinical interview to determine frequency of skin picking, and the body areas impacted.

[16] However, a review of the scientific literature by Jenkins et al. on excoriation disorder as a separate category in the DSM-5 concluded that such a distinction requires more evidence.

[3] In order to better understand excoriation disorder, researchers have developed a variety of scales to categorize skin-picking behavior.

[9] A notable difference between these conditions is that skin picking seems to be dominated by females whereas trichotillomania is more evenly distributed across genders.

[6] Excoriation disorder and OCD are similar in that they both involve "repetitive engagement in behaviors with diminished control" and also both generally decrease anxiety.

[3] They argue that excoriation disorder differs from OCD in the following fundamental ways: Odlaug and Grant have recognized the following similarities between individuals with dermatillomania and patients with addictions: One study that supported the addiction theory of picking found that 79% of patients with excoriation disorder reported a pleasurable feeling when picking.

[3] Odlaug and Grant also argue that dermatillomania could have several different psychological causes, which would explain why some patients seem more likely to have symptoms of OCD, and others, of an addiction.

[5] Antipsychotic, antianxiety, antidepressant, and antiepileptic medications have all been used to treat skin picking, with varying degrees of success.

[18] SSRIs have shown to be effective in the treatment of OCD, which serves as an argument in favor of treating excoriation disorder with the same therapy.

Unfortunately, clinical studies have not provided clear support for this, because there have not been large double-blind placebo-controlled trials of SSRI therapy for excoriation disorder.

[24] Reviews of treatment of excoriation disorder have shown that the following medications may be effective in reducing picking behavior: doxepin, clomipramine, naltrexone, pimozide, and olanzapine.

[8] Small studies of fluoxetine, an SSRI, in treating excoriation disorder showed that the drug reduced certain aspects of skin picking compared with a placebo, but full remission was not observed.

[25] Topiramate, an anti-epileptic drug, has been used to treat excoriation disorder; in a small study of individuals with Prader–Willi syndrome, it was found to reduce skin picking.

[citation needed] One method is to have individuals wear a form of protective clothing that limits the ability of the patient to pick at their body, e.g., gloves or face mask.

[8] All of these techniques have been reported to have some success in small studies, but none has been tested in large enough populations to provide definitive evidence of their effectiveness.

Hindered by shame, embarrassment, and humiliation, they may take measures to hide their disorder by not leaving home, wearing long sleeves and pants even in the heat, or covering visible damage to the skin with cosmetics and/or bandages.

One U.S. telephone survey found that 16.6% of respondents "picked their skin to the point of noticeable tissue damage" and that 1.4% would qualify as meeting the requirements of excoriation disorder.

[3] Certain stressful events including marital conflicts, deaths of friends or family, and unwanted pregnancies have been linked to the onset of the condition.

The first known mention of excoriation disorder in the print can be found in 1898 by the French dermatologist Louis-Anne-Jean Brocq, describing an adolescent female patient who had uncontrolled picking of acne.

Excoriation disorder is shown as a symptom of Nina Sayers' anxiety and OCD in the movie Black Swan.