Clinical characteristics and medical complications of pathologic skin picking

Brian L. Odlaug, Jon E. Grant

Research output: Contribution to journalArticlepeer-review

140 Scopus citations


Objective: This study sought to detail the phenomenology and medical consequences of pathologic skin picking (PSP). Method: Sixty subjects (11.7% males) with PSP (mean±S.D.=33.7±11.6 years) were assessed. Subjects seen in a pharmacological study as well as those from an ongoing outpatient longitudinal study comprised this sample. Subjects were assessed for current and lifetime psychiatric comorbidity (using the Structured Clinical Interview for DSM-IV Axis I Disorders), clinical severity (using the Clinical Global Impression - Severity scale) and psychosocial interference due to picking (using the Sheehan Disability Scale). Clinical characteristic data, including time spent picking per day, sites picked and medical complications directly resulting from skin picking behavior, as well as family history, were also obtained. Results: The mean age (±S.D.) of onset for PSP was 12.3±9.6 years. The face was the most common area picked. Subjects reported picking a mean of 107.6 min each day. Scarring, ulcerations and infections were common. Few had ever sought psychiatric treatment for their behavior. Current comorbid Axis I psychiatric conditions were found in 38.3% of the sample. Trichotillomania (36.7%), compulsive nail biting (26.7%), depressive disorder (16.7%) and obsessive-compulsive disorder (15%) were the most common current comorbid conditions. Conclusion: PSP appears to be time consuming and frequently associated with medical complications. Research is needed to optimize patient care for individuals with this behavior.

Original languageEnglish (US)
Pages (from-to)61-66
Number of pages6
JournalGeneral Hospital Psychiatry
Issue number1
StatePublished - Jan 2008

Bibliographical note

Funding Information:
This research was supported in part by a Career Development Award (K23 MH069754-01A1) to Dr. Grant and by NIDA (R01 DA019039). Part of this research sample was also supported by an unrestricted educational grant from GlaxoSmithKline to Dr. Grant. Dr. Grant received no honorarium and does not have any other financial interest in GlaxoSmithKline.

Copyright 2008 Elsevier B.V., All rights reserved.


  • Neurotic excoriation
  • Pathologic skin picking
  • Psychogenic excoriation


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