Duyen often picks and peels calluses and flaking skin from her fingertips until the skin is smooth. This habit leaves her hands scratched, scabbed, thickened, and her fingertips painful and cracked.

Master, Doctor Pham Van Duong from Tam Anh Cau Giay General Clinic diagnosed her with skin picking disorder, also known as pathological skin picking. This condition is part of the obsessive-compulsive related disorders group. Individuals with this disorder often experience tension or an urge before performing the behavior. After picking or peeling the skin, they feel temporary relief, but the tension quickly returns.

Pathological skin picking disorder is more common than many realize, often linked to other mental health issues. A study of over 10,000 adults in the US, conducted by the University of Chicago and the University of Cambridge, reported that about 2,1% of individuals had the disorder at the time of the survey, and 3,1% had experienced it during their lifetime. More than half of those affected were women. Over 63% of patients also had generalized anxiety disorder, 53% had depression, and nearly 28% suffered from panic disorder. This indicates that skin lesions are often just the tip of a more complex mental health issue.

Commonly affected areas include the face, lips, scalp, arms, hands, or any skin area with acne, calluses, scars, or scabs. Many individuals use their fingernails, tweezers, or sharp objects to pick at their skin. The consequences extend beyond skin lesions; they can lead to infections, scarring, soft tissue deformation, and psychological impact. Patients often experience accompanying symptoms of anxiety, insomnia, and reluctance to socialize.

Duyen's follow-up visit after three months of treatment. *Photo: Tam Anh Cau Giay General Clinic*

According to Doctor Duong, pathological skin picking disorder often begins in adolescence or early adulthood, periods marked by psychological and hormonal changes. Many cases start with skin lesions such as acne, calluses, or insect bites. Over time, the skin picking behavior becomes a reflex to relieve stress, anxiety, or physical discomfort. Many patients seek dermatological care for persistent wounds, but the root cause stems from a mental health disorder. If treatment focuses solely on skin lesions while neglecting psychological factors, the condition often recurs.

Doctor Duong developed a treatment protocol for Duyen that combines medication and psychotherapy. The patient was guided to identify situations that trigger skin picking behavior and learned to replace it with other activities: squeezing rubber balls, knitting, journaling, or practicing relaxation techniques. Concurrently, her skin lesions received care to reduce the risk of infection and scarring.

After three months of treatment, Duyen's frequency of skin picking significantly decreased. Her damaged skin areas gradually healed, no new lesions appeared, her sleep quality improved, and her anxiety lessened.

Doctor Duong noted that many people mistake pathological skin picking disorder for a bad habit. Individuals who pick their skin to the point of bleeding, scarring, pain, or significant life impact, but cannot stop, should seek specialized medical attention early.

By Thanh Ba