1 Trichotillomania and excoriation disorders involve recurrent picking that causes hair loss or skin lesions
Trichotillomania (hair pulling) and excoriation (skin picking), with repeated attempts to decrease or stop the behaviour, are categorized as obsessive-compulsive and related disorders. (1) Hair is pulled commonly from the scalp, eyebrows or eyelashes, and skin is picked from the face, arms or hands. (1) Onset of these behaviours often coincides with puberty. (1) They may be automatic, focused (within conscious awareness) or both. (1) Although not formally recognized by the Diagnostic and Statistical Manual of Mental Disorders (5th edition), other body-focused repetitive behaviours include nail and cheek biting. (2)
2 Hair-pulling and skin-picking disorders affect about 1% to 2% of the population (1)
Most affected people report distress and 25%-33% report functional impairment. (2) They have a 2- to 4-fold increased risk of anxiety, depression and other obsessive-compulsive symptoms. (3) Body-focused repeptitive disorders...