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Skin-picking in children and adolescents, also known as Excoriation Disorder, is when a young person repeatedly picks at their skin, leading to sores or scarring. This repetitive behaviour is often linked to anxiety, stress, or overwhelming emotions, making it difficult to control. Treatment for child and adolescent skin picking can significantly help in managing the urges and reduce the impact this behaviour has on a child’s self-esteem and social life. With the right approach, such as Cognitive Behavioural Therapy (CBT), children can find healthier coping mechanisms and reduce the frequency of skin-picking episodes.
Skin-picking in children and adolescents can start as a response to emotional distress or anxiety. The repetitive behaviour often becomes a way to cope with unpleasant emotions, but it can lead to physical and emotional harm. Over time, skin picking can affect a child’s self-image, causing shame, embarrassment, and social withdrawal. However, with the right treatment, children and adolescents can learn to manage their urges and develop healthier coping mechanisms.
A comprehensive behavioural intervention, like Cognitive Behavioural Therapy (CBT), is highly effective in treating child and adolescent skin picking. The main components of this treatment include:
In this phase, the child or adolescent is taught to become more aware of their skin-picking behaviour and the triggers that lead to it. Awareness training helps the young person recognise their urges and the circumstances surrounding the behaviour, which is the first step toward managing it effectively.
The goal of competing response training is to introduce a behaviour that is incompatible with skin picking. For example, if a child tends to pick at their skin while reading, the therapist might encourage the child to hold the book with both hands, thereby breaking the connection between the urge and the behaviour. Practicing these alternative behaviours when the urge arises is key to overcoming the habit.
Identifying environmental triggers is essential in managing skin-picking behaviours. For example, if a child picks at their skin while looking in the mirror, mirrors can be temporarily removed or covered. Stimulus control strategies help reduce the occurrence of skin picking by addressing the triggers in the child’s environment.
A support person, usually a parent, can play a vital role in the treatment process. They can provide praise and encouragement when the child uses a competing response instead of engaging in skin-picking. A reward system can be implemented to further motivate the child to replace the behaviour with healthier alternatives.
Many children and adolescents with skin-picking disorder also experience anxiety, low self-esteem, and social isolation. CBT helps young people manage these emotions and cope with the urges that drive the skin-picking behaviour. By addressing both the behavioural and emotional components, therapy can significantly reduce the frequency of skin picking.
Skin picking can lead to significant social withdrawal and a decline in daily activities. A key goal of treatment is to help young people re-engage with their social relationships, school, and other important aspects of life. By managing the urges and improving emotional well-being, children can return to the tasks of normal development.