A systematic review and meta-analysis of psychiatric treatments for excoriation (skin-picking) disorder
Abstract
Objective While individual trials suggest benefit of interventions for excoriation (skin-picking) disorder (ExD), limited systematic evaluation of treatments, or their collective benefit, exists.Methods The present study examined the current state of treatments for ExD in a systematic review and meta-analysis and explored potential treatment moderators. Twelve trials were identified for review, including five with a control condition. Of these, nine were eligible to be included in the meta-analysis (three with a control).Results A fixed-effects meta-analysis found a large overall treatment effect size (g=1.13), comprised of large effects for behavioral treatments (g=1.19), lamotrigine (g=0.98) and selective serotonin reuptake inhibitors (g=1.09). Clinician-rated measures did not significantly differ from self-rated measures; however, larger effects were observed on self-rated measures of severity, as compared to impairment [Q(1)=4.63, P=.03]. Treatment type, trial length and trial methodological quality were not significant moderators. For controlled trials, the comparative efficacy of treatments for ExD was in the moderate range (g=0.47).Conclusion Findings suggest that treatment for ExD has benefit; however, the meta-analysis did not provide strong evidence to support any specific treatment or to suggest its unique clinical benefit over control conditions. Overall, there is a lack of study on treatments for ExD and additional randomized controlled trials with inclusion of multiple informants in assessment is needed.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Behavior therapy (BT) is an effective treatment for trichotillomania (TTM) and skin-picking disorder (SPD), with moderate to large effect sizes compared to passive and active control groups.
“Behavior therapy (BT) has been shown to be an effective treatment for TTM and SPD with moderate to large effect sizes compared to both passive and active control groups (Farhat et al., 2020; Selles et al., 2016).”
From Internet-delivered acceptance-based behavior therapy for trichotillomania and skin-picking disorder in a psychiatric setting: A feasibility trial (2022) · cites this paper as Selles et al., 2016
Cites
Diagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association (2013) · doi:10.1176/appi.books.9780890425596 · Cited by 116,369 · see citing works
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,841 · see citing works
Statistical Power Analysis for the Behavioral Sciences
Muller, K. E., & Cohen, J. (1989) · Technometrics · doi:10.2307/1270020 · Cited by 99,588 · see citing works
Statistical power analysis for the behavioral sciences
Cohen, J. (1990) · Computers Environment and Urban Systems · doi:10.1016/0198-9715(90)90050-4 · Cited by 65,406 · see citing works
Measuring inconsistency in meta-analyses
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003) · BMJ · doi:10.1136/bmj.327.7414.557 · Cited by 63,139 · see citing works
Statistical Power Analysis for the Behavioral Sciences (2nd ed.).
Lachenbruch, P. A., & Cohen, J. (1989) · Journal of the American Statistical Association · doi:10.2307/2290095 · Cited by 37,385 · see citing works
A basic introduction to fixed-effect and random-effects models for meta-analysis
Borenstein, M., Hedges, L. V., Higgins, J. P. T., & Rothstein, H. R. (2010) · Research Synthesis Methods · doi:10.1002/jrsm.12 · Cited by 6,793 · see citing works
Deeks, J. J., Altman, D. G., & Bradburn, M. J. (2001) · Systematic Reviews in Health Care · doi:10.1002/9780470693926.ch15 · Cited by 2,163 · see citing works
Smith, M. L., Glass, G. V., & Miller, T. I. (1980) · Medical Entomology and Zoology · Cited by 2,123 · see citing works
Non-suicidal self-injury among adolescents: Diagnostic correlates and relation to suicide attempts
NOCK, M., JOINERJR, T., GORDON, K., LLOYDRICHARDSON, E., & PRINSTEIN, M. (2006) · Psychiatry Research · doi:10.1016/j.psychres.2006.05.010 · Cited by 1,617 · see citing works
Cognitive Behavioral Therapy, Sertraline, or a Combination in Childhood Anxiety
Walkup, J. T., Albano, A. M., Piacentini, J., Birmaher, B., Compton, S. N., Sherrill, J. T., Ginsburg, G. S., Rynn, M. A., McCracken, J., Waslick, B., et al. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa0804633 · Cited by 1,442 · see citing works
Guy, W. L. (2025) · Springer Reference Medizin · doi:10.1007/978-3-662-65186-5_300379 · Cited by 1,441 · see citing works
Systematic Reviews in Health Care. Meta-analysis in Context.
Kleijnen, J., & Antes, G. (2002) · International Journal of Epidemiology · doi:10.1093/ije/31.3.697 · Cited by 1,373 · see citing works
Espinosa, J. C. (2004) · Cited by 939 · see citing works
Klonsky, E. D. (2011) · Psychological Medicine · doi:10.1017/s0033291710002497 · Cited by 753 · see citing works
Behavior Therapy for Children With Tourette Disorder
Piacentini, J. C., Woods, D. W., Scahill, L. D., Wilhelm, S., Peterson, A. L., Chang, S. W., Ginsburg, G. S., Deckersbach, T., Dziura, J., Levi-Pearl, S., et al. (2010) · JAMA · doi:10.1001/jama.2010.607 · Cited by 722 · see citing works
Calabrese, J. R., Suppes, T., Bowden, C. L., Sachs, G. S., Swann, A. C., McElroy, S. L., Kusumakar, V., Ascher, J. A., Earl, N. L., Greene, P. L., et al. (2000) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v61n1106 · Cited by 498 · see citing works
Eddy, K. T., Dutra, L., Bradley, R., & Westen, D. (2004) · Clinical Psychology Review · doi:10.1016/j.cpr.2004.08.004 · Cited by 475 · see citing works
Which SSRI? A Meta-Analysis of Pharmacotherapy Trials in Pediatric Obsessive-Compulsive Disorder
GELLER, D. A., Biederman, J., Stewart, S. E., Mullin, B. C., Martin, A., Spencer, T. J., & Faraone, S. V. (2003) · American Journal of Psychiatry · doi:10.1176/appi.ajp.160.11.1919 · Cited by 433 · see citing works
Grant, J. E., Odlaug, B. L., & Won Kim, S. (2009) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2009.60 · Cited by 424 · see citing works
Woods, D. W., Wetterneck, C. T., & Flessner, C. A. (2006) · Behaviour Research and Therapy · doi:10.1016/j.brat.2005.05.006 · Cited by 381 · see citing works
A placebo-controlled trial of cognitive-behavioral therapy and clomipramine in trichotillomania
Ninan, P. T., Rothbaum, B. O., Marsteller, F. A., Knight, B. T., & Eccard, M. B. (2000) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v61n0111 · Cited by 303 · see citing works
The effectiveness of treatment for pediatric obsessive-compulsive disorder: A meta-analysis
Abramowitz, J. S., Whiteside, S. P. H., & Deacon, B. J. (2005) · Behavior Therapy · doi:10.1016/s0005-7894(05)80054-1 · Cited by 274 · see citing works
Self-Injurious Skin Picking: Clinical Characteristics and Comorbidity
Wilhelm, S., Keuthen, N. J., Deckersbach, T., Engelhard, I. M., Forker, A. E., Baer, L., O'Sullivan, R. L., & Jenike, M. A. (1999) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v60n0707 · Cited by 252 · see citing works
Skin picking behaviors: An examination of the prevalence and severity in a community sample.
Hayes, S. L., Storch, E., & Berlanga, L. (2009) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2009.01.008 · Cited by 213 · see citing works
Flessner, C. A., & Woods, D. W. (2006) · Behavior Modification · doi:10.1177/0145445506294083 · Cited by 202 · see citing works
The prevalence of pathologic skin picking in US adults.
Keuthen, N., Koran, L., Aboujaoude, E., Large, M., & Serpe, R. (2010) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2009.04.003 · Cited by 198 · see citing works
A Double-Blind Trial of Fluoxetine in Pathologic Skin Picking
Simeon, D., Stein, D. J., Gross, S., Islam, N., Schmeidler, J., & Hollander, E. (1997) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v58n0802 · Cited by 186 · see citing works
Development of a quality assessment instrument for trials of treatments for depression and neurosis
Moncrieff, J., Churchill, R., Drummond, D. C., & McGuire, H. (2001) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.108 · Cited by 185 · see citing works
Clinical characteristics and medical complications of pathologic skin picking
Odlaug, B. L., & Grant, J. E. (2008) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2007.07.009 · Cited by 176 · see citing works
<i>N</i>-Acetylcysteine in the Treatment of Excoriation Disorder: A Randomized Clinical Trial
Grant, J. E., Chamberlain, S. R., Redden, S. A., Leppink, E. W., Odlaug, B. L., & Kim, S. W. (2016) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2016.0060 · Cited by 172 · see citing works
Bloch, M., Panza, K. E., Grant, J., Pittenger, C., & Leckman, J. (2013) · Journal of the American Academy of Child and Adolescent Psychiatry · doi:10.1016/j.jaac.2012.12.020 · Cited by 171 · see citing works
Habit Reversal as a Treatment for Chronic Skin Picking
Teng, E. J., Woods, D. W., & Twohig, M. P. (2006) · Behavior Modification · doi:10.1177/0145445504265707 · Cited by 155 · see citing works
Twohig, M. P., Hayes, S. C., & Masuda, A. (2006) · Behaviour Research and Therapy · doi:10.1016/j.brat.2005.10.002 · Cited by 143 · see citing works
McGuire, J. F., Ung, D., Selles, R. R., Rahman, O., Lewin, A. B., Murphy, T. K., & Storch, E. A. (2014) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2014.07.015 · Cited by 142 · see citing works
Keuthen, N. J., Wilhelm, S., Deckersbach, T., Engelhard, I. M., Forker, A. E., Baer, L., & Jenike, M. A. (2001) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(01)00215-x · Cited by 135 · see citing works
Magnitude of placebo response and drug–placebo differences across psychiatric disorders
Khan, A., Kolts, R. L., Rapaport, M. H., Krishnan, K., Brodhead, A. E., & Brown, W. A. (2004) · Psychological Medicine · doi:10.1017/s0033291704003873 · Cited by 123 · see citing works
Lamotrigine Treatment of Pathologic Skin Picking
Grant, J. E., Odlaug, B. L., & Kim, S. W. (2007) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v68n0909 · Cited by 112 · see citing works
Acceptance-Enhanced Behavior Therapy (AEBT) for Trichotillomania and Chronic Skin Picking
Flessner, C. A., Busch, A. M., Heideman, P. W., & Woods, D. W. (2008) · Behavior Modification · doi:10.1177/0145445507313800 · Cited by 112 · see citing works
The Skin Picking Impact Scale (SPIS): scale development and psychometric analyses.
Keuthen, N., Deckersbach, T., Wilhelm, S., Engelhard, I., Forker, A. E., O'Sullivan, R. L., Jenike, M., & Lee, B.-E. (2001) · Psychosomatics · doi:10.1176/appi.psy.42.5.397 · Cited by 111 · see citing works
Fluoxetine in Pathologic Skin-Picking: Open-Label and Double-Blind Results
Bloch, M. R., Elliott, M., THOMPSON, H. B., & Koran, L. M. (2001) · Psychosomatics · doi:10.1176/appi.psy.42.4.314 · Cited by 111 · see citing works
Schuck, K., Keijsers, G. P. J., & Rinck, M. (2010) · Behaviour Research and Therapy · doi:10.1016/j.brat.2010.09.005 · Cited by 101 · see citing works
Pathological skin picking in individuals with body dysmorphic disorder
Grant, J. E., Menard, W. E., & Phillips, K. A. (2006) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2006.08.009 · Cited by 99 · see citing works
An Open Clinical Trial of Fluvoxamine Treatment of Psychogenic Excoriation
Arnold, L. M., Mutasim, D. F., Dwight, M. M., Lamerson, C. L., Morris, E. M., & McElroy, S. L. (1999) · Journal of Clinical Psychopharmacology · doi:10.1097/00004714-199902000-00005 · Cited by 97 · see citing works
Grant, J., Odlaug, B., Chamberlain, S., & Kim, S.-W. (2010) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e3181e617a1 · Cited by 86 · see citing works
Overview of the Clinical Efficacy of Lamotrigine
Richens, A., & Yuen, A. W. C. (1991) · Epilepsia · doi:10.1111/j.1528-1157.1991.tb05880.x · Cited by 83 · see citing works
Open-label escitalopram treatment for pathological skin picking
Keuthen, N. J., Jameson, M., Loh, R., Deckersbach, T., Wilhelm, S., & Dougherty, D. D. (2007) · International Clinical Psychopharmacology · doi:10.1097/yic.0b013e32809913b6 · Cited by 70 · see citing works
An open‐label pilot study of N‐acetylcysteine for skin‐picking in Prader–Willi syndrome
Miller, J. L., & Angulo, M. (2014) · American Journal of Medical Genetics. Part A · doi:10.1002/ajmg.a.36306 · Cited by 70 · see citing works
Sertraline in the Treatment of Neurotic Excoriations and Related Disorders
Kalivas, J. (1996) · Archives of Dermatology · doi:10.1001/archderm.1996.03890290131022 · Cited by 66 · see citing works
The Current Understanding of Lamotrigine as a Mood Stabilizer
Hahn, C.-G., Gyulai, L., Baldassano, C. F., & Lenox, R. H. (2004) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v65n0610 · Cited by 63 · see citing works
StopPicking.com: Internet-based treatment for self-injurious skin picking
Flessner, C. A., Mouton-Odum, S., Stocker, A. J., & Keuthen, N. J. (2007) · Dermatology Online Journal · doi:10.5070/d31dx97474 · Cited by 48 · see citing works
Arbabi, M., Farnia, V., Balighi, K., Mohammadi, M. R., Nejatisafa, A., Yazdchi, K., Golestan, B., & Darvish, F. (2008) · DOAJ (DOAJ: Directory of Open Access Journals) · Cited by 36 · see citing works
Psychotherapy and Neurotic Excoriations
Fruensgaard, K. (1991) · International Journal of Dermatology · doi:10.1111/j.1365-4362.1991.tb04634.x · Cited by 31 · see citing works
Leibovici, V., Koran, L. M., Murad, S., Siam, I., Odlaug, B. L., Mandelkorn, U., Feldman-Weisz, V., & Keuthen, N. J. (2014) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2014.12.008 · Cited by 28 · see citing works
A near fatal case of pathological skin picking
Thompson, G. (2013) · American Journal of Case Reports · doi:10.12659/ajcr.889357 · Cited by 20 · see citing works
Efficacy of olanzapine in the treatment of psychogenic excoriation
Blanch, J., Grimalt, F., Massana, G., & Navarro, V. (2004) · British Journal of Dermatology · doi:10.1111/j.1365-2133.2004.06151.x · Cited by 13 · see citing works
Özden, M. G., Aydın, F., Şentürk, N., Bek, Y., Cantürk, T., & Turanlı, A. Y. (2010) · Photodermatology Photoimmunology & Photomedicine · doi:10.1111/j.1600-0781.2010.00512.x · Cited by 8 · see citing works
McGuire, J., Kugler, B. B., Park, J. M., Horng, B., Lewin, A., Murphy, T., & Storch, E. (2012) · Child Psychiatry and Human Development · doi:10.1007/s10578-012-0300-7
Flagged first, then by citations
Cited by
Sorted by citations
Excoriation (skin-picking) disorder: a systematic review of treatment options
Lochner, C., Roos, A., & Stein, D. J. (2017) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s121138 · Cited by 122 · see citing works
“17,18 Cognitive-behavioral interventions In the context of ED, CBT generally involves psychoeducation, cognitive restructuring, and an emphasis on relapse prevention through enhancement of self-efficacy, as well as agreement on clearly defined measures to prevent or address relapse.”
Psychocutaneous disease: Clinical perspectives.
Kuhn, H., Mennella, C., Magid, M., Stamu‐O'Brien, C., & Kroumpouzos, G. (2017) · Journal of American Academy of Dermatology · doi:10.1016/j.jaad.2016.11.013 · Cited by 16 · see citing works
Skin-Picking Disorder: A Guide to Diagnosis and Management
Jafferany, M., & Patel, A. (2019) · CNS Drugs · doi:10.1007/s40263-019-00621-7 · Cited by 57 · see citing works
Abnormal perceptual sensitivity in body-focused repetitive behaviors
Houghton, D. C., Alexander, J. R., Bauer, C. C., & Woods, D. W. (2017) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2017.12.005 · Cited by 54 · see citing works
“Indeed, BFRBs have similar symptom presentations, phenomenology, age of onset, and courses; co-occur at a high rate [2, 3]; and respond to similar treatments [[4], [5], [6]].”
Characteristics of 262 adults with skin picking disorder
Grant, J. E., & Chamberlain, S. R. (2022) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2022.152338 · Cited by 51 · see citing works
Self-induced dermatoses: A great imitator.
Gupta, M., & Gupta, A. (2019) · Clinical Dermatology · doi:10.1016/j.clindermatol.2019.01.006 · Cited by 37 · see citing works
Reddy, Y. C. J., Sudhir, P. M., Manjula, M., Arumugham, S. S., & Narayanaswamy, J. (2020) · Indian Journal of Psychiatry · doi:10.4103/psychiatry.indianjpsychiatry_773_19 · Cited by 51 · see citing works
“Similar strategies are suggested for excoriation disorder also.[114] Skin-picking disorder, being a recently recognized diagnostic entity, has been less studied less extensively.”
BackgroundDouble-Blind Placebo-Controlled Study of Memantine in Trichotillomania and Skin-Picking Disorder.
Grant, J., Chesivoir, E. K., Valle, S., Ehsan, D., & Chamberlain, S. (2023) · American Journal of Psychiatry · doi:10.1176/appi.ajp.20220737 · Cited by 35 · see citing works
Farhat, L. C., Reid, M., Bloch, M. H., & Olfson, E. (2023) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2023.03.034 · Cited by 42 · see citing works
Asplund, M., Rück, C., Lenhard, F., Gunnarsson, T., Bellander, M., Delby, H., & Ivanov, V. Z. (2021) · Journal of Clinical Psychology · doi:10.1002/jclp.23147 · Cited by 42 · see citing works
“Behavioral treatments are efficacious and appear superior to most pharmacological treatments (Ninan et al., 2000; Schumer et al., 2016; Selles et al., 2016; Slikboer et al., 2017; van Minnen et al., 2003).”
BackgroundResultLee, M. T., Mpavaenda, D. N., & Fineberg, N. A. (2019) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2019.00079 · Cited by 40 · see citing works
Gallinat, C., Moessner, M., Haenssle, H. A., Winkler, J. K., Backenstrass, M., & Bauer, S. (2019) · Journal of Medical Internet Research · doi:10.2196/15011 · Cited by 38 · see citing works
“So far, two meta-analyses suggest an overall beneficial effect of behavioral treatments on skin picking severity, but these studies must also be seen as preliminary due to the small number of included original studies and their limited validity [20,21].”
Kim, D., Ryba, N., Kalabalik, J., & Westrich, L. (2018) · Drugs in R&D · doi:10.1007/s40268-018-0246-8 · Cited by 37 · see citing works
“Disease progression or improvement can be monitored through use of a modified version of an existing rating scale for OCD (Y-BOCS modified for neurotic excoriation) or via self-rating by use of one of several scales, such as the Skin Picking Scale [12].”
MethodEpidemiology and Comorbidities of Excoriation Disorder: A Retrospective Case-Control Study
Kwon, C. D., Sutaria, N. H., Khanna, R., Almazan, E., Williams, K. A., Kim, N., Elmariah, S. B., & Kwatra, S. G. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9092703 · Cited by 32 · see citing works
Use of antipsychotic drugs in dermatology.
Gupta, M., Vujcic, B., Pur, D., & Gupta, A. (2018) · Clinical Dermatology · doi:10.1016/j.clindermatol.2018.08.006 · Cited by 26 · see citing works
Krooks, J., Weatherall, A., & Holland, P. (2018) · Journal of dermatological treatment (Print) · doi:10.1080/09546634.2017.1395389 · Cited by 21 · see citing works
“Multiple randomized control trials have reported that CBT has the most significant treatment effect; thus, CBT is indicated as first-line therapy (89,103,104).”
BackgroundAsplund, M., Lenhard, F., Andersson, E., & Ivanov, V. Z. (2022) · Internet Interventions · doi:10.1016/j.invent.2022.100573 · Cited by 25 · see citing works
Hiranandani, S., Ipek, S. I., Wilhelm, S., & Greenberg, J. L. (2023) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2022.100765 · Cited by 21 · see citing works
Help-seeking attitudes and experiences in individuals affected by skin picking
Gallinat, C., Moessner, M., Haenssle, H. A., Winkler, J. K., Backenstraß, M., & Bauer, S. (2019) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2019.100483 · Cited by 21 · see citing works
Two brief valid measures of therapeutic alliance in counseling for tobacco dependence
Warlick, C. A., Richter, K. P., Catley, D., Gajewski, B. J., Martin, L. E., & Mussulman, L. M. (2017) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2017.12.010 · Cited by 19 · see citing works
Whittington, J. E., & Holland, A. J. (2020) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2020.01.029 · Cited by 18 · see citing works
Xavier, A. C. M., de Souza, C. M. B., Flores, L. H. F., Bermúdez, M. B., Silva, R. M. F., de Oliveira, A. C., & Dreher, C. B. (2020) · Brazilian Journal of Psychiatry · doi:10.1590/1516-4446-2019-0636 · Cited by 17 · see citing works
Dermatillomania: Strategies for Developing Protective Biomaterials/Cloth
Ravipati, P., Conti, B., Chiesa, E., & Andrieux, K. (2021) · Pharmaceutics · doi:10.3390/pharmaceutics13030341 · Cited by 15 · see citing works
Rahman, S. M., Jafferany, M., & Barkauskaite, R. (2023) · Clinical and Experimental Dermatology · doi:10.1093/ced/llad247 · Cited by 14 · see citing works
Prevalence and clinical characteristics of skin picking among adults with skin disease symptoms
Dixon, L. J., & Snorrason, Í. (2019) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2019.100454 · Cited by 14 · see citing works
O’Connor, K. P., Lavoie, M. E., Desaulniers, B., & Audet, J. (2017) · Journal of Clinical Psychology · doi:10.1002/jclp.22501 · Cited by 14 · see citing works
Turk, T., Liu, C., Fujiwara, E., Straube, S., Hagtvedt, R., Dennett, L., Abba-Aji, A., & Dytoc, M. (2023) · Journal of Cutaneous Medicine and Surgery · doi:10.1177/12034754231155888 · Cited by 14 · see citing works
Obsessive–compulsive and related disorders
Mattina, G. F., Slyepchenko, A., & Steiner, M. S. (2020) · Handbook of clinical neurology · doi:10.1016/b978-0-444-64123-6.00025-4 · Cited by 12 · see citing works
Rautio, D., Andrén, P., Bjureberg, L., Silverberg-Mörse, M., Mataix‐Cols, D., & de la Cruz, L. F. (2023) · Behavior Therapy · doi:10.1016/j.beth.2023.07.010 · Cited by 11 · see citing works
State of the Evidence for Use of Psychotropic Medications in School-Age Youth
Shahidullah, J. D., Roberts, H. J., Parkhurst, J. T., Ballard, R., Mautone, J. A., & Carlson, J. S. (2023) · Children · doi:10.3390/children10091454 · Cited by 11 · see citing works
“Small placebo-controlled trials have demonstrated the efficacy of fluoxetine, citalopram, and lamotrigine in adults with the skin-picking disorder [96].”
BackgroundRoi, C., & Bazzano, A. N. (2017) · Pediatric Reports · doi:10.4081/pr.2017.6946 · Cited by 10 · see citing works
Insights into recurrent body-focused repetitive behaviors: evidenced by New York Times commenters
Stewart, C. R., & Lipner, S. (2020) · Archives of Dermatological Research · doi:10.1007/s00403-020-02045-6 · Cited by 9 · see citing works
Repetitive Transcranial Magnetic Stimulation in the Treatment of Skin Picking Disorder
Aydın, E. P., Kenar, J. G., Altunay, İ. K., Kaymak, D., Özer, Ö. A., & Karamustafalıoğlu, O. (2019) · Journal of Ect · doi:10.1097/yct.0000000000000616 · Cited by 10 · see citing works
“Ameta-analysis study (comprising lamotrigine, SSRIs, and behavioral therapy studies) suggested that behavioral psychotherapieswere superior to pharmacotherapies and first-line treatments; neither approach could demonstrate strong evidence about the effectiveness of treatment.(33) In pharmacotherapies, it was recommend…”
BackgroundGallinat, C., Moessner, M., Haenssle, H. A., Winkler, J. K., Backenstraß, M., & Bauer, S. (2018) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2018.100315 · Cited by 9 · see citing works
The genetics of trichotillomania and excoriation disorder: A systematic review
Reid, M., Lin, A., Farhat, L. C., Fernandez, T. V., & Olfson, E. (2024) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2024.152506 · Cited by 11 · see citing works
Group Therapy for Excoriation Disorder: Psychodrama versus Support Therapy
Gulassa, D. C. R., Amaral, R., Oliveira, E., & Tavares, H. (2019) · Annals of Clinical Psychiatry · doi:10.1177/104012371903100209 · Cited by 8 · see citing works
“23 Existing literature tends to focus on the individual’s repetitive behavior that produces lesions on his or her skin, without being concerned with the psychopathological factors that are subjacent to this state.”
Eskeland, S. O., Moen, E. M., Meland, K. J., Andersen, A., & Hummelen, B. (2021) · Tidsskrift for Den norske legeforening · doi:10.4045/tidsskr.21.0128 · Cited by 5 · see citing works
A case of clozapine‐induced skin picking behaviour
Reddy, B., Das, S., & Guruprasad, S. (2018) · General Psychiatry · doi:10.1136/gpsych-2018-000012 · Cited by 5 · see citing works
Bidirectional Behavioral Selection in Mice: A Novel Pre-clinical Approach to Examining Compulsivity
Mitra, S., & Bult‐Ito, A. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.716619 · Cited by 4 · see citing works
Updates in the Treatment of Body-Focused Repetitive Disorders
Whiting, C., Azim, S. A., & Friedman, A. (2023) · Journal of Drugs in Dermatology · doi:10.36849/jdd.nvrn1023 · Cited by 4 · see citing works
Is ACT-Informed Exposure a Viable Treatment for Excoriation Disorder? A Multiple Baseline Study
Thompson, B. L. (2022) · Behavior Modification · doi:10.1177/01454455221091778 · Cited by 3 · see citing works
“Research on pharmaceutical treatments for ExD has been mixed, with reviews suggesting that placebo-controlled trials indicate no clear benefit to pharmaceutical interventions (Schumer et al., 2016; Selles et al., 2016).”
BackgroundSkin picking disorder in a woman with polyarteritis nodosa. Case report
Aranda, M., Suárez, G. M., Henao, A. M., & Lugo, G. F. O. (2019) · Revista Colombiana de Psiquiatría (English ed ) · doi:10.1016/j.rcpeng.2018.03.008 · Cited by 3 · see citing works
Impulskontrollstörungen, Verhaltenssüchte und körperbezogene Zwangserkrankungen
Turner, D., & Tüscher, O. (2022) · PSYCH up2date · doi:10.1055/a-1143-0096 · Cited by 3 · see citing works
Skin Picking Disorder: A Canadian Retrospective Study of 83 Patients
Deschênes, L., & Veillette, H. (2025) · Journal of Cutaneous Medicine and Surgery · doi:10.1177/12034754241303119 · Cited by 2 · see citing works
“5,6,38 Varying results have been found with SSRIs, suggesting that they have better outcomes when concomitant depression, anxiety or obsession-compulsion disorder is present.”
Usmani, A., Szkutak, A., & Keuthen, N. J. (2023) · Current clinical psychiatry · doi:10.1007/978-3-031-29368-9_12 · Cited by 2 · see citing works
Self-Trephination in Cranial Excoriation Disorder
Riordan, C. P., Owusu‐Adjei, B., Daci, R., Phelan, A. L., Mietus, C. J., Kosarchuk, J. J., Lambert, W. A., Qureshi, H. M., Lim, J. C., Mihalek, O., et al. (2024) · Neurosurgery · doi:10.1227/neu.0000000000003004 · Cited by 2 · see citing works
Excoriation disorder as a risk factor for deep brain stimulation hardware removal
Calandrella, D., Rizzi, M., Ferrè, F., & Romito, L. M. (2017) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2017.01.034 · Cited by 2 · see citing works
'Skin Picking Disorder': A case report
Okumuş, B., & Hocaoğlu, Ç. (2018) · Journal of Clinical Psychiatry · doi:10.5505/.2018.48403 · Cited by 2 · see citing works
Abordagem no transtorno de escoriação: um campo em desenvolvimento
da Silva, C. S. (2023) · Debates em Psiquiatria · doi:10.25118/2763-9037.2023.v13.655 · Cited by 2 · see citing works
Martínez-Aguayo, J. C., Middleton, F., Nahuelcura, K., Marcelo Arancibia, M., Meza-Concha, N., Sepúlveda, E., Gepp, A., Escobar, R., & Eva Madrid, A. (2017) · Revista chilena de neuro-psiquiatría · doi:10.4067/s0717-92272017000400221 · Cited by 2 · see citing works
Franklin, M. E., Budzyn, S., & Freeman, H. (2018) · Cambridge University Press eBooks · doi:10.1017/9781108140416.030 · Cited by 2 · see citing works
Kłosowska, J., Żegleń, M., Badzińska, J., & Prochwicz, K. (2025) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2025.106349 · Cited by 1 · see citing works
Gulassa, D. C. R., Amaral, R., Angelo, D. L., de Oliveira, E. C., de Abreu, C. N., & Tavares, H. (2025) · International Journal of Group Psychotherapy · doi:10.1080/00207284.2025.2551504 · Cited by 1 · see citing works
“…introduced solely to manage psychiatric comorbidities, and no medications were prescribed with the goal of treating or mitigating excoriation symptoms directly, as no pharmacological interventions have been approved to date for this specific indication (Schumer et al., 2016; Selles et al., 2016).”
Barber, K. E., Cram, I. C., Smith, E. C., Woods, D. W., & Lee, H. (2026) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2026.02.020 · Cited by 1 · see citing works
Kłosowska, J., & Prochwicz, K. (2026) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2026.152715 · Cited by 1 · see citing works
Phenomenology and Epidemiology of Trichotillomania and Skin-Picking Disorder
Ricketts, E. J., Stiede, J. T., Woods, D. W., Antinoro, D., & Franklin, M. E. (2023) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780190068752.013.5 · Cited by 1 · see citing works
Schienle, A., Wabnegger, A., & Tanzmeister, S. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1645958 · Cited by 1 · see citing works
A genomic study of trichotillomania and excoriation disorder in families
Greenspun, S. R., Milanes, I., Farhat, L. C., Abdallah, S. B., Bok, D. D., Chen, D., Liu, W., Teefe, E., Bloch, M. H., Fernandez, T. V., et al. (2026) · Translational Psychiatry · doi:10.1038/s41398-026-04164-6 · Cited by 1 · see citing works
“Currently, these conditions remain dif fi cult to treat, with limited evidence-based treatments available [12 – 15].”
Evidence-Based Treatment of Pediatric Obsessive-Compulsive and Related Disorders
Grebe, S. C., Bergez, K. C., Lee, E. B., Goodman, W. K., Storch, E. A., & Schneider, S. C. (2020) · Issues in clinical child psychology · doi:10.1007/978-3-030-44226-2_6 · Cited by 1 · see citing works
Richartz, M., Gon, M. C. C., & Zazula, R. (2018) · Revista Brasileira de Análise do Comportamento · doi:10.18542/rebac.v13i2.5903
“Portanto, o presente estudo diferencia-se dos de Lochner et al. (2017), Selles et al. (2016) e Schumer et al. (2016) por incluir estudos de caso e apresentar e destacar os principais componentes das intervenções comportamentais.”
BackgroundWriters, A. M. (2019) · Drugs & Therapy Perspectives · doi:10.1007/s40267-019-00674-0
Psychopharmakotherapie bei dermatologischen Erkrankungen
Messer, T., Haag, L., Juckel, G., & Mavrogiorgou, P. (2019) · NeuroTransmitter · doi:10.1007/s15016-019-6602-2
Trastorno de excoriación en una mujer con panarteritis nudosa. Reporte de caso
Aranda, M., Suárez, G. M., Henao, A. M., & Lugo, G. F. O. (2018) · Revista Colombiana de Psiquiatría · doi:10.1016/j.rcp.2018.03.001
Treatment of Palmoplantar Diseases
Akın, T., Serdaroğlu, S., Engіn, B., & Kutlubay, Z. (2019) · Dermatoz · doi:10.4274/dermatoz.galenos.2018.43534
Obsessive-Compulsive Spectrum Disorders
Ramsey, K. A., Myers, N., Reagan, S., & McGuire, J. (2021) · Reference Module in Neuroscience and Biobehavioral Psychology · doi:10.1016/b978-0-12-818697-8.00082-0
Trichotillomania and excoriation disorder
Scrandis, D. A., & Duarte, A. C. (2021) · The Nurse Practitioner · doi:10.1097/01.npr.0000753840.44209.51
“There is evidence to support the use of cognitive behavioral therapy and habit reversal therapy and both might be the best initial treatment for excoriation disorder and TTM. 18,19 Cognitive behavioral therapy involves learning about unhealthy patterns of thoughts that impact psychologic problems and behaviors.”
InfluentialFricke, S. (2022) · PSYCH up2date · doi:10.1055/a-1646-2774
It gave me the confidence to pursue my career in psychology’
Isibor, M. (2018) · DCP-S Review · doi:10.53841/bpsdcps.2018.1.18.51
Treatment of Trichotillomania and Skin-Picking Disorder
Franklin, M. E., Antinoro, D., Ricketts, E. J., & Woods, D. W. (2023) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780190068752.013.25
REVISÃO DE LITERATURA SOBRE AS MODALIDADES TERAPÊUTICAS DO “SKIN PICKING”
Prado, A. C. R. D. A., Meirelles, L. M., & Vasconcelos, R. (2024) · Revista Ibero-Americana de Humanidades, Ciências e Educação · doi:10.51891/rease.v10i6.14602
Feusner, J., Beatty, C. C., Murphy, C., McGrath, P. B., Farrell, N. R., Núñez, M., Lume, N., Mohideen, R., Trusky, L., Smith, S., et al. (2025) · medRxiv · doi:10.1101/2025.03.10.25323675
“Evidence also supports HRT's efficacy for excoriation disorder, with randomized controlled trials demonstrating symptom reduction 37,38 , though primarily in short-term outcomes.”
Excoriation disorder: Etiopathogenesis, prevalence, symptoms, treatment
Koszuta, K. A., Wasąg, O. R., Dydoń-Pikor, M., Laskowska, P., Pająk, D., Pistelok, A., Koszuta, P., Tkaczyk, M., Witek, J., & Misiewicz, P. (2025) · Humanities & Social Sciences Reviews · doi:10.18510/hssr.2025.13219
“Skin that is damaged can be healthy, but often occurrence of irregularities on its surface, lumps, scars, scabs and dermatological diseases such as acne or eczema, are the trigger for pathological skin picking (Arnold et. al., 2001; Selles et. al., 2016).”
UNCOVERING DERMATILLOMANIA: A REVIEW OF SKIN PICKING DISORDER
Nosek, Ł., Mytych, A., Dziedziak, M., Groszewska, J., Romaniuk, M., Rapior, A., Makowska-Woszczyk, D., Lubomska, K., Jagura, P., & Romaniuk, J. (2025) · International Journal of Innovative Technologies in Social Science · doi:10.31435/ijitss.4(48).2025.4187
Psychotropic Drugs: A Practical Guide for Use in Dermatology
Carmona‐Rocha, E., de Diego-Adeliño, J., Tribó, M. J., & Puig, L. (2025) · Actas Dermo-Sifiliográficas · doi:10.1016/j.ad.2025.104518
Kawahito, M., Murayama, K., Tomiyama, H., Kato, K., & Nakao, T. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1738977
“In contrast, the focused pattern is enacted intentionally to modulate internal states (e.g., anxiety, tension, and disgust) and is theoretically aligned with ACT-consistent procedures (16).”
InfluentialSteinhausen, H.-C. (2026) · Elsevier eBooks · doi:10.1016/b978-3-437-21294-9.00015-6
Yazıcı, M., Kivrak, M., Tekeoğlu, U., & Hocaoğlu, Ç. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15062401
A clinical approach to psychodermatologic conditions: From recognition to treatment
Ajmani, A., Klufas, T., Kuwahara, K., Sun, M., Zhou, A. E., Sabogal, M. A. C., Kels, L. H., Jafferany, M., Chapman, M. S., Sloan, B., et al. (2026) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2026.08.127
MANEJO TERAPÊUTICO E INTERFACE PSICODERMATOLÓGICA NA DERMATILOMANIA (TRANSTORNO DE ESCORIAÇÃO)
Corrêa, G. P., Gerolamo, A. C. S., & Queiroz, M. M. D. G. (2026) · Brazilian Journal of Medical and Health Sciences · doi:10.64597/ww1tgm22
TRICHOTILLOMANIA AND EXCORIATION DISORDER: COMPARATIVE EFFICACY OF HABIT REVERSAL TRAINING
Machaalani, R. M., Pires, P. P. G., Pastorello, E., Thome, A. K. D. U., França, G., Kensy, A. F., Cremonez, C. Z., de Azevedo, F. R. S., de Arruda, M. F. G. P., da Silva, P. B. G., et al. (2026) · Revista de Geopolítica · doi:10.56238/revgeov17n10-036
- Authors
- Selles, R. R., McGuire, J. F., Small, B. J., & Storch, E. A.
- Affiliations
- University of South Florida (US)
- University of California, Los Angeles (US)
- Johns Hopkins University (US)
- Corresponding author
- Selles, Robert R.
- Venue
- General Hospital Psychiatry
- Publisher
- Elsevier BV
- Published
- 2016-07
- Volume
- 41
- Pages
- 29-37
- ISSN
- 0163-8343 (ISSN-L)
- OpenAlex
- W2345419929
- Cited by
- 80
- References
- 59
- Citations by year
- 2026: 9 · 2025: 8 · 2024: 3 · 2023: 11 · 2022: 6 · 2021: 6 · 2020: 7 · 2019: 12 · 2018: 9 · 2017: 9
- FWCI
- 1.48
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- General Hospital Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Social Sciences › Psychology › Clinical Psychology › Body Image and Dysmorphia Studies
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Keywords
- excoriation disorder, skin picking disorder, psychiatric treatment, behavior therapy, lamotrigine, selective serotonin reuptake inhibitors, treatment moderators, treatment efficacy
- MeSH terms
- Behavior Therapy, Humans, Disruptive, Impulse Control, and Conduct Disorders, Skin, Self-Injurious Behavior, Selective Serotonin Reuptake Inhibitors, Excitatory Amino Acid Antagonists
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
