Individuals with excoriation (skin-picking) disorder pick at their skin which often results in lesions, infections, scarring and all too often, shame.

People with trichotillomania (TTM or hair-pulling) pull body hair from various regions, which results in hair loss. In both cases, the picking and/or pulling, the individuals have made repeated attempts to decrease or stop the behavior and experience distress and/or impairment in important areas of life functioning.

Why do people pull or pick if it causes such distress & embarrassment? People who pull/pick often experience an urge and/or have a particular sensory need at the site or in their fingers. Sometimes they feel itching or burning sensations that immediately trigger the hand to the site and sometimes they’re fingers just need to be busy.

They may have common thoughts such as, “I need to get this last hair” or “I need to even out this blemish”. Sometimes a certain mood triggers the behavior such as anxiety, boredom or anger. Sometimes the person only pulls/picks in certain areas or while engaged in certain behaviors (e.g. in front of the bathroom mirror, while watching TV).

Although the consequences are often distressing, the individual does experience some sort of pleasure. It feels good to get that last piece of skin hanging off of a nail, to pluck an unruly or bothersome eyelash and/or to even chew on the hair or skin. It sounds odd, but it really isn’t. Most of us have engaged in some sort of body-focused repetitive behavior on occasion.