Skin Picking Disorder

Skin Picking Disorder & Addiction, Signs, Risks, Drugs That Cause Skin Picking Disorder

Link Between Skin Picking Disorder and Addiction

Drug addiction can cause a variety of skin problems, including skin picking disorder. Drug misuse and addiction affect every organ in the body, including the skin, which is the largest organ in the body. Skin picking and hair tugging are two typical reactions to illegal drug use’s mental and effects. The use of crystal meth and heroin will leave pus and needle scars on the skin. Fear, restlessness, or crawling feelings cause many users to scratch their faces or arms (skin picking) compulsively. The urge for skin picking is often caused by opiate withdrawal symptoms such as anxiety and goosebumps.

The compulsive desire for skin picking can fade after recovery. However, for specific users, this disorder continues long though they have stopped taking the medications. Skin picking would then be handled as another condition requiring behavioral changes and maybe psychiatric treatment.

Skin picking may also be a sign that someone is struggling with substance abuse, particularly if the behavior is accompanied by other unusual or strange behaviors from the person. Depending on the substance used, the individual may develop skin lesions such as sores, skin patches, or scabs. If you notice yourself or a loved one experiencing these skin issues, it is important to consult a professional

Skin Picking Disorder
The lifestyle choices of an addicted person are hard on the skin. People who use drugs often stay up for days or even weeks at a time. This causes exhaustion, which causes bags under the eyes and other unsightly problems.
Ryan Zofay forming a circle and hugging friends.

Get Your Life Back

Find Hope & Recovery. Get Safe Comfortable Detox, Addiction Rehab & Mental Health Dual Diagnosis High-Quality Care at the We Level Up Treatment Centers Network.

Hotline (877) 378-4154

What Is Skin Picking Disorder?

According to the National Center for Biotechnology Information (NCBI) [1], skin-picking disorder (SPD) or excoriation is often conceptualized as a behavioral addiction in which strange or unusual reward processing may play an influential role. It is a psychiatric condition characterized by excessive picking of one’s own skin. In the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), skin picking disorder is defined as repeated skin picking that is not better accounted for by another mental disorder or dermatological problem and results in skin damage, repeated failed attempts to stop the behavior, and subjective distress or impairment in functioning

Individuals with skin picking disorder scratch or pick at their skin to the level that causes significant personal distress. Some individuals pick at skin that is healthy, while others target skin that appears flawed from pimples, scabs, or calluses. It can become so intense that it causes bleeding, sores, and scars. Some people with this disorder repeatedly scratch to try to remove what they see as some kind of imperfection in their skin.

Skin Picking Disorder (SPD) may be referred to by several names, including:

  • Excoriation
  • Neurotic excoriation
  • Psychogenic excoriation
  • Dermatillomania

What Are the Signs of Skin Picking Disorder?

It’s hard to say exactly when skin picking changes from a mild, nervous habit to a serious problem that needs treatment. 

It may help to ask the following questions:

  • Do you have noticeable scars from skin picking?
  • Does picking at your skin take up a lot of time during the day?
  • Do you feel upset when you think about how much you pick your skin?
  • Does picking at your skin get in the way of your social or professional life? For example, do you avoid the beach or the gym because people might see your scars? Or do you spend a lot of time covering up sores before work or social events?

Get Help. Get Better. Get Your Life Back.

Searching for Accredited Drug & Alcohol Rehab Centers Near You? Or Mental Health Support?

Even if you have failed previously, relapsed, or are in a difficult crisis, we stand ready to support you. Our trusted behavioral health specialists will not give up on you. Call us when you feel ready or want someone to speak to about therapy alternatives to change your life. Even if we cannot assist you, we will lead you wherever you can get support. There is no obligation. Call our hotline today.

FREE Addiction Hotline – Call 24/7

Skin Picking Disorder Risk Factors

Without clear causes of skin picking disorder, individuals look to study factors that can increase an individual’s risk of having excoriation or SPD. Some of the most common risk factors associated with excoriation include:


Research suggests that this skin picking disorder happens more often in women than in men.

Intense Stress

For some individuals, skin picking becomes a way to relieve tension and stress from outside influences. In these situations, skin picking tends to increase when someone is stressed.


Others with skin picking disorder engage in the behavior when stress is low but boredom is high. Without stimulation, picking becomes a way to pass the time.

Dissatisfaction with Appearance

Another risk factor for skin picking disorder is an intense focus on the part of the body. The person may start picking to modify to distract from their physical form.

Can Skin Picking Disorder Lead to Drug Abuse?

Just as there is limited research regarding the number of individuals with skin picking disorder and drug addiction, there is not a clear understanding of the SPD’s ability to encourage drug addiction or lead to a substance use disorder.

In many ways than one, skin picking disorder itself resembles alcohol or drug addiction:

  • Uncomfortable or intense emotional states tend to trigger both skin picking disorder and drug or alcohol use
  • Individuals find it challenging to end sin picking and substance abuse on their own
  • While engaging in skin-picking and substance use may result in short-term relief, they tend to cause long-term shame and guilt

Some individuals may engage in alcohol or drug abuse as a form of self-medication to treat their skin picking disorder. They may mistakenly believe that using alcohol or drugs will stop the urge to pick. However, substance abuse often adds more problems to a person’s situation in the long run and can make excoriation symptoms even worse in some cases.

When someone finds an imperfection on their skin, such as a scar or scab, they may develop skin picking disorders. They begin picking at the spot, causing more damage to the area and preventing healing. This leads to a vicious cycle in which the skin-picking addiction wins. Skin picking is particularly dangerous for those suffering from meth mites (also known as meth sores) or heroin itching.

Illegal drugs like methamphetamine, cocaine, and heroin negatively impact your skin’s health. Heroin is a central nervous system (CNS) depressant that delays heart rate, blood circulation, respiration, bodily functions, and metabolic rate [2].

Irritation from heroin and meth mites can cause skin sores to worsen, and someone with a skin picking disorder will continue to pick at them. Worse yet, the stress of withdrawal may cause someone to pick at their sores, scabs, or skin even more, especially if they have anxiety or skin picking disorders.

First-class Facilities & Amenities

World-class High-Quality Addiction & Mental Health Rehabilitation Treatment

Rehab Centers Tour

Renowned Addiction Centers. Serene Private Facilities. Inpatient rehab programs vary.

Addiction Helpline (877) 378-4154

Proven recovery success experience, backed by a Team w/ History of:


Years of Unified Experience


5-Star Reviews Across Our Centers


Recovery Success Stories Across Our Network

  • Low Patient to Therapist Ratio
  • Onsite Medical Detox Center
  • Comprehensive Dual-Diagnosis Treatment
  • Complimentary Family & Alumni Programs
  • Coaching, Recovery & Personal Development Events

Drugs That Cause Skin Picking Disorder


Meth Sores

Popobly the most common drug that causes skin picking disorder is methamphetamine or “meth” (also known as crystal meth). Skin lesions are relatively common in someone who abuses meth regularly.

The skin picking often leads to very noticeable open sores, often referred to as “meth sores” and are due to a combination of physical and psychological side effects related to repeated abuse of meth. Meth sores look like ulcers and open wounds. 

Meth Mites

Methamphetamine can cause delusional parasitosis, a disorder in which the user believes they are covered with parasites crawling over their body, known as “meth mites” or formication. This is a common hallucination experienced by meth users where they hallucinate that bugs or insects are crawling on their skin. Meth mites are caused by a surge of serotonin in the brain, leading to a psychotic episode. (Serotonin is a feel-good neurotransmitter that, when experienced in high doses, can cause euphoria and alter perception). However, not everyone to uses meth will have the experience of meth mites. Someone must use meth five or more days a week for six months or longer to experience meth mites.

Skin Picking Disorder
One obvious reason substance abuse causes common skin problems is that fact drugs are toxic pollutants to the body. It doesn’t matter whether you are slamming tequila or shooting heroin, every substance you put into your body has a profound impact on your skin’s health.

Meth Rash

Because crystal meth weakens the immune system, the body has a difficult time fighting off infections. Someone with low immunity and poor personal hygiene is a perfect candidate for meth rash. Meth rash can occur on the face, but it usually develops under the arms, on the back and shoulders, and between the legs. This is because the sweat that is filled with the toxins from the drug sits on the skin and festers. When there is friction (like under the arms), it helps to grind bacteria back into the skin, which produces a bright red, itchy, bumpy, burning rash.

Meth Mouth

This continuous skin picking, combined with poor hygiene, a compromised immune system can lead to lesions and skin scabs. Meth also causes blood vessels to tighten, which leads to a slower healing time of the skin sores. When meth sores happen in someone’s mouth, it is referred to as “meth mouth” [3].


Cocaine, commonly known as crack cocaine is a highly addictive drug known to cause skin picking disorder, depending on how it was consumed, such as injecting, snorting, or smoking it.  

When someone injects cocaine, necrosis occurs. The death of the skin cells is a common side effect of injecting the drug. 

Injecting cocaine can also lead to hypersensitive reaction rash or skin infections that lead to pustulosis (pimple-like bumps that pop and bleed).

Users who smoke cocaine can have blackened palms or fingers, referred to as “crack hands”.

Cocaine users can also experience a sensation called “cocaine bugs” which is similar to “meth mites”, which can lead to serious skin picking and self-mutilation [4].

Common Skin Problems Caused by Cocaine Abuse

Vasculitis and Retiform Purpura

  • It is damage to the blood vessels due to inflammation. This causes a dark, speckled pattern on the skin. Vasculitis can lead to a condition known as Retiform Purpura. Retiform Purpura is a more intense version of Vasculitis. Fortunately, this type of bruising and ulceration is reversible when it comes to cocaine use. Your body will slowly recover if you quit using the drug. 


  • It is the hardening of the connective tissues. This forms a splatter pattern on the user’s body.

Churg-Strauss and a P-ANCA positive Wegener granulomatosis-like syndrome

  • Churg-Strauss causes rashes to show on the skin, and the same can be said for a P-ANCA positive Wegener granulomatosis-like syndrome. These conditions cause the skin to look speckled and dull. It will also look like there’s a lot of bruising going on. This basically means that the skin and the blood vessels underneath are damaged. In worse-case scenarios, this may lead to necrosis.

World-class, Accredited, 5-Star Reviewed, Effective Addiction & Mental Health Programs. Complete Behavioral Health Inpatient Rehab, Detox plus Co-occuring Disorders Therapy.

CALL (877) 378-4154

End the Addiction Pain. End the Emotional Rollercoaster. Get Your Life Back. Start Drug, Alcohol & Dual Diagnosis Mental Health Treatment Now. Get Free No-obligation Guidance by Substance Abuse Specialists Who Understand Addiction & Mental Health Recovery & Know How to Help.


Opioids like Heroin often lead to skin lesions in people who inject the drug on a regular basis. In addition, for someone injecting heroin or any other drugs, looking for a vein can lead to venous sclerosis, which can lead to permanent scarring of the skin known as “road lines”. 

The repeated injections can also lead to cellulitis, skin infections, skin abscesses. These infections can become severe if not treated medically. This may also lead to skin picking around the injection site. 

Someone who uses heroin also engages in “skin popping” where the drug is injected subcutaneously under the skin instead of into the vein or intramuscularly into the muscle. This can expose the person using the drug to necrotizing skin lesions and continued skin-picking of lesions and scabs. “Skin popping” leaves distinctive circular sores on the skin’s surface. The sores are often easily infected and can leave permanent scars. 

Lessons and scabs may also become the target for obsessive skin picking when a user is restless, nervous, or craving a drug. There is also an increased risk of inflammation of the soft tissue (cellulitis) under the skin if a person continues to pick and also has poor hygiene.

People who are withdrawing from this drug can also experience a sensation of “crawling out of their skin” where users may use skin picking as a way of relief from the side effects and drug cravings associated with detoxing from heroin. However, skin picking can also provide a temporary release from their anxiety and restlessness. Skin picking is also common when withdrawing from other medications such as opiates. 

Find the Right Treatment Plan at We Level Up NJ

Getting help for dual co-occurring conditions such as skin picking disorder and addiction may seem like an overwhelming process, but it doesn’t need to be. For example, someone suffering from dual diagnosis disorders such as anxiety and meth or heroin addiction may also suffer from skin picking disorder. By acknowledging the problem and seeing the benefit from dual diagnosis treatment, a person can improve the symptoms of skin picking disorder.

Like substance dependence, skin picking or hair tugging are compulsive, self-destructive habits. We Level Up NJ provides dual diagnosis recovery services that are uniquely designed to assist the patient in resolving mental disorder and substance abuse issues[5].

Skin Picking Disorder
Addiction robs even the most health-conscious person of the ability to make good choices. Nevertheless, you can at least make the effort.

Treating only one condition is like treating only one part of a problem. The best solutions look at the complete picture. Co-occurring conditions deserve special care and attention to ensure the symptoms subside with time. 

If you or a loved one is dealing with skin picking disorder and substance abuse issues, it may be time to call us. We Level Up NJ professionals know many useful methods for treating co-occurring mental health disorders and substance addiction. So reach out to a representative today to get started.

Experience Transformative Recovery at the We Level Up Treatment Center.

See our authentic success stories. Get inspired. Get the help you deserve.

We Level Up Treatment Centers for Drug Alcohol Rehab Detox Behavioral Mental Health Dual Diagnosis Therapy
We Level Up Treatment Centers for Drug Alcohol Rehab Detox Behavioral Mental Health Dual Diagnosis Therapy
We Level Up Treatment Centers for Drug Alcohol Rehab Detox Behavioral Mental Health Dual Diagnosis Therapy
Voluntarily testimonials from the We Level Up Treatment Center network vary. Not intended as a guaranteed treatment or outcome as each person's journey is unique.

Start a New Life

Begin with a free call to an addiction & behavioral health treatment advisor. Learn more about our dual-diagnosis programs. The We Level Up treatment center network delivers various recovery programs at each treatment facility. Call to learn more.

  • Personalized Care
  • Caring Accountable Staff
  • World-class Amenities
  • Licensed & Accredited
  • Renowned w/ 5-Star Reviews

We’ll Call You


[1] NCBI –

[2] NIDA –

[3] NIDA –

[4] SAMHSA –

[5] We Level UpDual Diagnosis Treatment