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What is self-injurious skin picking or "SISP"?

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.

Learn more about...

What is self-injurious skin picking or "SISP"?
How many people have SISP?
What causes SISP?
Who picks their skin?
When is SISP a problem?
How do we treat SISP?
A Dermatologist's Perspective
Readiness for Change

About Skin Picking...  

Severe skin picking appears to be a way for some people to increase their activity levels when they are bored, or to control their emotions when they are anxious, tense, or upset.


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