Compulsive skin picking in autism, also known as dermatillomania or excoriation disorder, is a condition marked by repetitive picking, often to the point of injury. While this behavior affects many individuals from various backgrounds, there is a growing body of evidence suggesting a strong link between the two.
In children with Autism Spectrum Disorder (ASD), skin picking may present as part of a larger pattern of repetitive behaviors or sensory-seeking actions. These behaviors may not only be misunderstood but can also result in significant emotional and physical challenges if left unaddressed. The good news is, with proper understanding and proactive strategies, it can be significantly reduced
Individuals with ASD often experience the world differently. Sensory processing differences are a hallmark of the disorder, and many individuals are either hypersensitive (over-responsive) or hyposensitive (under-responsive) to stimuli such as touch, temperature, and texture. This makes them more likely to engage in repetitive behaviors.
Common reasons for compulsive skin picking in autism include:
In some cases, the behavior begins in response to a minor issue, such as a scab or pimple, and then becomes a compulsive habit.
Interestingly, compulsive skin picking is also found in individuals with Obsessive-Compulsive Disorder (OCD). In fact, the DSM-5 skin picking disorder is listed under the category of Obsessive-Compulsive and Related Disorders. Many individuals with autism also have co-occurring OCD, which can complicate the picture further.
For some,Dermatillomania might serve as a compulsive ritual to reduce anxiety or a way to gain control in an overwhelming world. For others, it may be purely sensory seeking or habitual. Understanding the root cause is crucial in order to implement the most effective interventions.
Not all picking is the same, and in individuals with autism, it can appear in a variety of ways:
Over time, this can lead to scarring, infection, and even pain, which can interfere with daily functioning. It may also be a source of emotional stress for both the individual and their family.
Fortunately, there are proactive and compassionate strategies that can help reduce or eliminate compulsive skin picking autism individuals. Here are several effective methods:
1. Identify Triggers
Keep a behavior log to look for patterns. Note what happens before, during, and after. Triggers might include:
2. Engage the Hands
Introduce hand-occupying activities that serve as healthy replacements. These include:
These can redirect the compulsion while still satisfying the individual's need for sensory input or movement.
3. Use Visual and Behavioral Supports
For children with ASD, visual schedules and social stories can be incredibly effective. These tools can help:
Behavioral strategies such as positive reinforcement, redirection, and environmental modifications should be employed consistently.
4. Cover Exposed Skin When Appropriate
In some cases, simply limiting access can reduce the behavior:
However, always balance this with comfort, especially for those with tactile sensitivities.
5. Emotional and Sensory Regulation
Dermatillomania can also be a form of emotional self-regulation. Integrating sensory diets or calming strategies into the daily routine can reduce the need for self-injury:
Therapies like occupational therapy, behavioral therapy, and CBT adapted for autism can also be helpful, depending on the individual’s age and cognitive level.
If you're interested in learning more about general picking and ways to reduce it, be sure to visit our related article on Causes and Ways to Help Compulsive Skin Picking in Autism, which covers tips for both skin care and behavioral management.
If the Dermatillomania continues despite your best efforts—or worsens—it’s essential to involve a multidisciplinary team, which may include:
Early intervention is key. Untreated, the behavior may escalate into more severe forms of self-injurious behavior or lead to secondary complications such as infections and scarring.
Compulsive skin picking and autism together are a unique and multifaceted challenge, but with the right tools and understanding, it can be managed. By focusing on both sensory and behavioral supports, improving skin health, and offering meaningful alternatives, families and caregivers can empower their loved ones to lead more comfortable, confident lives.
Whether you’re a parent, teacher, therapist, or individual with autism yourself, know that support is available—and progress is possible.
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