An excoriation skin lesion is a superficial abrasion or injury to the skin caused by scratching, rubbing, or picking. It's essentially a break in the skin's surface, often resulting from a compulsion to scratch.
Characteristics of Excoriation Skin Lesions
- Appearance: Excoriations can appear as linear scratches, small erosions, or crusted areas.
- Cause: The primary cause is self-inflicted trauma, typically due to scratching. This scratching can be triggered by various factors, including:
- Pruritus (itching): Underlying skin conditions like eczema, psoriasis, or dry skin can cause intense itching, leading to scratching and excoriations.
- Psychological factors: Anxiety, stress, obsessive-compulsive disorder (OCD), and excoriation disorder (also known as skin-picking disorder) can all contribute to habitual skin picking.
- Underlying Medical Conditions: Certain medical conditions, such as liver disease or kidney failure, can cause generalized itching.
- Location: Excoriations can occur anywhere on the body, but are commonly found on easily accessible areas like the face, arms, legs, and back.
- Complications: Excoriations can lead to:
- Secondary bacterial infections: Breaks in the skin provide an entry point for bacteria.
- Scarring: Repeated or deep excoriations can result in permanent scars.
- Hyperpigmentation or hypopigmentation: Changes in skin color can occur at the site of the lesion.
Examples of Excoriation
- Neurotic excoriations: This refers to excoriations caused by habitual picking, often associated with psychological or emotional distress. These are often seen in excoriation disorder.
- Scratching at insect bites: Scratching mosquito bites or other insect bites can lead to excoriation.
- Aggressive scrubbing of acne: Overly aggressive washing or picking at acne lesions can cause excoriation.
Treatment and Management
Treatment focuses on addressing the underlying cause and preventing further scratching:
- Treating underlying skin conditions: If pruritus is the cause, addressing the underlying skin condition (e.g., eczema) with topical corticosteroids or other appropriate medications is crucial.
- Managing psychological factors: Cognitive behavioral therapy (CBT) and other therapies can be helpful for individuals with excoriation disorder or anxiety-related skin picking. Medication, such as SSRIs, may also be prescribed.
- Wound care: Keeping the excoriated area clean and applying topical antibiotics can prevent infection. Covering the lesions with bandages can also help prevent further scratching.
- Moisturizing: Keeping the skin well-hydrated can reduce itching and promote healing.
- Breaking the habit: Habit reversal techniques and strategies to manage urges to scratch or pick can be effective.
