CBT/HRT for Excoriation (Skin‑Picking)

Educational content only. BFRBs respond to HRT/CBT. Coordinate with dermatology for wound care when needed. See our Medical Disclaimer.

Overview

Excoriation disorder involves recurrent picking causing skin lesions and distress. Urges can be triggered by tension, boredom, or tactile irregularities.

Why HRT/CBT helps

Awareness training: identify high‑risk contexts (mirrors, bathrooms, bedtime).
Stimulus control: cover mirrors, keep nails short, use bandages/barriers, fidgets.
Competing responses: hand occupy (putty, knitting), clench, or sit on hands briefly.

Journaling prompts

Context → urge (0–100) → barrier/competing response → outcome.
One environment change that helped was…
If I picked: what led up to it, and what repair/compassion step did I take?

Use quick logs; see How to Journal.

Selected readings

ComB (Comprehensive Behavioral Model) applications to BFRBs.

When to seek care

Infection, scarring, or functional impact warrant medical and behavioral care coordination.