What is your treatment algorithm for excoriation disorder?  

Address underlying concerns to the extent possible. Minimize potential staph colonization. Protect areas when possible. Suggest behavioral therapy, antihistamines and consider gabapentin.

Neurotic excoriation, also known as skin-picking disorder or excoriation disorder, is part of the obsessive–compulsive spectrum. There is no FDA-approved pharmacological treatment. The gold standard, evidence-based therapy is Habit Reversal Therapy (HRT), a form of cognitive behavioral therapy...

I like to use sertraline because typically very well tolerated - start at 50 mg daily and each two weeks increase up to a max of 200 daily if we’ll tolerated or necessary.