You've written an important article, one that may help and comfort other sufferers of this disorder as well as informing the vast majority who have no clue excoriation even is a disorder.

Disclaimer: this is not an area of expertise for me. I never had much success as a therapist in treating OCD or specific compulsions like excoriation or trichotillomania. Many patients will not admit to having those symptoms, even when they cause distress, because they are afraid to give up the relief they get from the behavior. The tension-discharge quality of the experience is, as you observe, very much like an addiction.

I believe these compulsions are related to the self-stimulating behaviors seen in ASD children, who often display multiple OCD symptoms in adulthood. As with most psychiatric disorders, there is clear evidence of genetic predisposition.

There are several medications that can be helpful, as can cognitive-behavioral and other therapies. I hope you'll get some help; it's a bear of a compulsion to beat on your own.

Retired psychologist, wordsmith, teacher, MFA candidate. Buy me coffee:

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