Skin-picking disorder: Risk factors, comorbidities, and treatments

<h3>Introduction</h3> Skin-picking disorder (SPD), also known as excoriation disorder or dermatillomania, is characterized by compulsive skin picking, resulting in tissue damage. SPD affects 3.5% of the US population and is more common in females. Patients find their picking difficult to stop and tend to suffer from social impairments and emotional distress. Herein, we explore risk factors, comorbidities, and treatment options associated with SPD. <h3>Methods</h3> One thousand thirty-three unique articles were retrieved from PubMed. We conducted title, abstract, and full-text screenings to identify articles describing psychiatric comorbidities of SPD and current treatments. <h3>Findings</h3> Fifty-five articles met inclusion criteria, offering epidemiological data regarding SPD and common psychiatric conditions, including attention-deficit/hyperactivity disorder, posttraumatic stress disorder, trichotillomania, and depressive and anxiety disorders. Clinical data on behavioral therapies (cognitive behavioral therapy, habit-reversal training, and acceptance and commitment therapy), as well as pharmacotherapy, were also included. <h3>Conclusion</h3> While no official treatment guidelines exist for SPD, this review sought to characterize pertinent risk factors and promising emerging therapies. Cognitive behavioral therapy, habit-reversal training, and glutamate-modulating agents (eg, N-acetylcysteine and memantine) were observed to be the most efficacious. Larger studies are required to validate these treatments and understand their long-term outcomes.