Kairos Wellness Collective

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Anxiety Treatment for Excoriation Symptoms

Excoriation disorder, also known as skin picking disorder, is a condition characterized by recurrent and compulsive picking at the skin, resulting in skin damage. The behavior often begins as a way to alleviate stress, anxiety, or boredom, but can become a habit or addiction that is difficult to control.

The exact causes of excoriation disorder are not fully understood, but there are several factors that may contribute to its development:

  1. Genetics: There may be a genetic component to excoriation disorder, as it often runs in families.

  2. Neurotransmitters: Changes in levels of neurotransmitters such as serotonin and dopamine, which are involved in mood regulation and reward processing, may play a role in the development of excoriation disorder.

  3. Cognitive and emotional factors: People with excoriation disorder often report experiencing anxiety, depression, and low self-esteem, which may contribute to the behavior.

  4. Environmental factors: Trauma, stress, or other environmental factors may also contribute to the development of excoriation disorder.

  5. Other mental health conditions: Excoriation disorder often co-occurs with other mental health conditions such as obsessive-compulsive disorder (OCD), anxiety disorders, and depression.

The best treatment for this condition is the COMB technique.  This treatment approach is evidence based for use for individuals with skin-picking disorder or excoriation disorder, also known as dermatillomania. The acronym COMB stands for:

  • C - Comprehension and psychoeducation 

  • O - Habit reversal training (HRT) 

  • M - Mindfulness-based interventions 

  • B - Behavioral modification techniques

Here's a brief overview of each component of the COMB technique:

  • C - Comprehension and psychoeducation: This involves helping the individual understand the nature of their condition, including the triggers that lead to skin-picking behaviors. Psychoeducation also includes strategies for managing the urge to pick the skin, as well as coping techniques for dealing with stress and anxiety.

  • O - Habit reversal training (HRT): This technique involves increasing the individual's awareness of their skin-picking behaviors and teaching them to replace these behaviors with alternative actions. HRT involves several steps, including awareness training, competing response training, and social support.

  • M - Mindfulness-based interventions: Mindfulness-based interventions, such as meditation and relaxation techniques, can help reduce stress and anxiety and promote awareness of one's thoughts and feelings. These techniques can be helpful in managing the urge to pick the skin.

  • B - Behavioral modification techniques: This involves identifying and modifying environmental factors that may trigger skin-picking behaviors. For example, individuals may be encouraged to wear gloves or cover up areas of the skin to reduce the opportunity for skin picking. Additionally, positive reinforcement may be used to reward individuals for engaging in alternative behaviors that do not involve skin picking.

Overall, the COMB technique is a comprehensive treatment approach that addresses both the psychological and behavioral components of skin-picking disorder. It can be effective in helping individuals manage their symptoms and improve their quality of life.

Treatment for excoriation disorder can be challenging, and it may take some time to find the right combination of therapies that work for each individual. However, with persistence and the right support, it is possible to manage symptoms and improve overall quality of life.


To learn more about
OCD therapy, please contact Kairos Wellness Collective today.