Skin Picking as a Symptom of Autoimmune Disease

Skin picking disorder (dermatillomania or excoriation disorder) and autoimmune disorders often go together. With skin picking, you have a compulsive urge to pick, scratch, rub, pull, or scrape your skin. It can continue beyond the point of causing pain and creating sores to being a significant problem.

In some people with autoimmune diseases, skin picking symptoms may become a habit and a sign of a mental health disorder

This article looks at autoimmune disorders that cause skin picking, treatments, and prevention.

picking skin

lolostock / Getty Images

Other Names

Skin picking disorder has several names, including:

  • Dermatillomania
  • Neurotic excoriations
  • Neurotic picking
  • Psychogenic excoriation

Which Autoimmune Disorders Can Cause Skin Picking?

With autoimmune diseases, the immune system attacks healthy tissues, mistaking them for pathogens like viruses or bacteria. 

The targeted tissues are different in each disease, but many of them have similar symptoms, affecting the skin in some way. Some autoimmune disorders tied to skin picking are:

Some research suggests itchiness is a persistent symptom of many autoimmune connective-tissue diseases and is under-recognized and undertreated. This could make them prone to triggering excoriation.

Other Causes

Other conditions that can cause skin picking include:

Signs and Symptoms of a Skin Picking Disorder

Symptoms of skin picking disorder include:

  • Recurrent skin picking that leads to skin lesions
  • Repeated attempts to stop the behavior
  • Significant distress or impairment due to picking
  • An urge to pick or physical tension that’s relieved by picking
  • Unusual sensations (bumps, sore spots)
  • Beliefs about how the skin should look or feel

To be diagnosed with skin picking disorder, your symptoms can’t be better explained by another psychiatric disorder and aren’t caused by another medical condition, a skin condition, or a substance (like a medication).

Effects and Complications of Skin Picking Disorder

People with skin picking disorder often pick at multiple places on their bodies that may change over time. They try to cover up the sores created from picking with makeup or clothing.

This disorder may also lead to avoiding situations like swimming, wearing shorts, or being intimate because people feel shame or don’t want others to know. Some even hide this condition from their healthcare providers.

Medically, skin picking can lead to:

  • Open wounds
  • Infections
  • Scabbing and scarring
  • Skin discoloration

Emotionally, it can result in social isolation, depression, and anxiety disorders.

Prevalence of Skin Picking Disorder

Research suggests between 2% and 5% of people pick their skin to the point that it causes damage, distress, and impairment. About 75% of people with this disorder are biologically female.

Skin Picking Disorder Treatment

Treatment for skin picking disorder tied to autoimmunity should involve multiple approaches.

Autoimmune Disorder Treatment

It’s crucial to treat the autoimmune disease. This can help alleviate the symptoms that led to skin picking in the first place.

Autoimmune disorder treatments vary by disease but may include:

  • Immunosuppressant or immunomodulant drugs
  • Anti-inflammatory drugs
  • Pain medications
  • Hormone therapy (type 1 diabetes, Hashimoto’s thyroiditis)
  • Arthritis medications (biologics and disease-modifying antirheumatic drugs)
  • Nutritional supplements
  • A healthy diet
  • Appropriate exercise and activity
  • Physical therapy, massage, and other complementary treatments

Skin Damage Treatment

The damage from skin picking can be treated as follows:

  • Antibiotics can treat infections.
  • Healing can be promoted with compresses, bandaging, topical retinoids, and topical steroids.
  • Scars may be removed with cosmetic procedures.

Mental Health Treatment

Mental health treatment is usually necessary to stop the picking behavior. Therapies that may be effective include:

Breaking the Skin Picking Habit

You can take a few steps to help break yourself of the habit of picking your skin. Whether it’s caused by dry skin, an itch, boredom, stress relief, blemishes, or something else, you'll need to figure out what makes you want to pick. That can help you change habits or seek the right kind of treatment.

It also can help to make picking harder. This strategy is called stimulus control. It may involve the following:

  • Keeping fingernails extremely short
  • Wearing long-sleeved shirts
  • Wearing gloves at times when picking is likely
  • Distracting your hands with stress balls, silly putty, or fidget toys


As awareness of skin picking in autoimmune disorders grows, healthcare providers may start looking for it routinely. This may help prevent it or catch it early on.

You can prevent the condition from developing—which can also prevent complications—by recognizing early symptoms and getting medical help for them.

Once you’ve been successfully treated, you can prevent relapses by sticking to your treatment regimen, monitoring yourself for a return of symptoms or habits, and talking to your healthcare team if you notice anything concerning.


Skin picking disorder is related to several autoimmune diseases, including rheumatoid arthritis, psoriasis, lupus, MS, and type 1 diabetes. Skin picking disorder involves an urge to pick, scratch, scrape, or pull the skin and an inability to stop these behaviors. Treatment generally involves medications for the autoimmune disease, wound care, and mental health interventions.

A Word From Verywell

It’s normal to feel shame over a condition like skin picking disorder, but you don’t have to live with that feeling or the effects of the condition. Reversing the behavior starts by informing your healthcare provider. Medical attention can keep your condition from worsening and can get you on the road to feeling better.

Frequently Asked Questions

  • Why do people develop skin picking disorders?

    People develop skin picking disorders for many reasons. It may be due to a mental health disorder, a dermatologic condition, or a medical illness such as an autoimmune disease with skin-related symptoms.

  • Why does skin picking feel good?

    It’s not fully understood why skin picking is gratifying to some people. The response may be tactile (the feel or texture of the skin), cognitive (inaccurate thoughts or beliefs about the need to pick), or emotional (an outlet for unpleasant feelings and psychological stress).

  • Will skin picking disorder go away on its own?

    Skin picking disorder may come and go over time, but it’s unlikely to resolve without completing treatment.

13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Hawatmeh A, Al-Khateeb A. An unusual complication of dermatillomania. Quant Imaging Med Surg. 2017;7(1):166-168. doi:10.21037/qims.2016.12.02

  2. Narang NS, Casciola-Rosen L, Li S, Chung L, Fiorentino DF. Cutaneous ulceration in dermatomyositis: association with anti-melanoma differentiation-associated gene 5 antibodies and interstitial lung disease. Arthritis Care Res (Hoboken). 2015;67(5):667-672. doi:10.1002/acr.22498

  3. Kwon C, Sutaria N, Khanna R, et al. Epidemiology and comorbidities of excoriation disorder: A retrospective case-control study. J Clin Med. 2020;9(9):2703. doi:10.3390/jcm9092703

  4. Schröder L, Hertl M, Chatzigeorgakidis E, Phan NQ, Ständer S. Chronischer pruritus bei autoimmundermatosen : Ergebnisse einer vergleichenden Fragebogenstudie [Chronic pruritus in autoimmune dermatoses : results of a comparative survey]. Hautarzt. 2012;63(7):558-566. doi:10.1007/s00105-011-2319-2

  5. Multiple Sclerosis Trust. Altered sensations.

  6. The TLC Foundation for Body-Focused Repetitive Behaviors. How to manage psoriasis with a compulsive skin picking disorder.

  7. Wang F, Morris C, Bodet ND, Kim BS. Treatment of refractory chronic pruritus of unknown origin with tofacitinib in patients with rheumatoid arthritis. JAMA Dermatol. 2019;155(12):1426-1428. doi:10.1001/jamadermatol.2019.2804

  8. National Institutes of Health, U.S. National Library of Medicine: Endotext. Skin manifestations of diabetes mellitus.

  9. Yahya A, Gideon P. S. Characterizing pruritus in autoimmune connective tissue diseases. J Drugs Dermatol. 2019;18(10):995-998.

  10. The TLC Foundation for Body-Focused Repetitive Behaviors. Everybody picks…right? An overview of compulsive skin picking.

  11. U.S. Department of Health & Human Services, Office on Women’s Health. Autoimmune diseases.

  12. Dermatology Advisor. Neurotic excoriations (skin-picking disorder).

  13. Harvard Medical School, Harvard Health Publishing. Picking your skin? Learn four tips to break the habit.

Additional Reading

By Adrienne Dellwo
Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic.