SISP is a repetitive behavior defined
as recurrent picking, scratching,
or biting of the skin that results
in damage to the skin and causes a
person some distress or difficulty
in functioning. Also known as self-inflicted
dermatosis or neurotic excoriation
(skin picking) and onychophagia (nail
biting), these behaviors are beyond
the occasional picking of a pimple
or biting of a severed nail. People
who engage in these behaviors can
spend large amounts of time doing
them and cause serious scarring or
other deformity.
In a study conducted by Sabine Wilhelm
and her colleagues at Harvard University
(1998), they noted that the most common
sites for skin picking included pimples
and scabs, red swollen, infected areas,
mosquito bites, and scars. Over half
of their subjects reported picking
at healthy skin. All of the subjects
in this study reported picking at
more than one location on the body.
The following is a list of the most
common picking sites in order form
most to least common:
- Face
- Back
- Neck
- Scalp
- Ears
- Chest
- Cuticles
- Arms
- Legs
Most subjects used their fingers or
fingernails to scratch or squeeze
their skin, while 52% also reported
using implements (e.g. pins, tweezers)
to assist their picking.
SISP often resembles a grooming ritual
where a person scans the skin either
visually or with their hands, identifying
places that they feel should be picked
or removed. Oftentimes the goal is
to make the place smooth by removing
the blemish, scab or bump. What usually
happens, however, is that the place
is made worse due to picking and in
more severe cases, people dig deep
into the skin, often resulting in
significant disfigurement, infection
and permanent tissue damage.