What is your treatment algorithm for excoriation disorder?

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 that ...

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

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.