Online therapy for excoriation disorder (skin picking) from just $25/session with licensed therapists (PhD, PsyD, LCSW, LMHC, LMFT) specializing in evidence-based approaches including habit reversal training, CBT, and acceptance and commitment therapy. At Grouport, we offer online individual therapy, online group therapy, and virtual IOP options designed to help you understand the triggers driving the picking, develop effective strategies to interrupt the behavior, and heal both the physical damage and the shame that the disorder creates.
Whether you prefer personalized one-on-one care or the shared support of a therapist-led group, our online excoriation disorder therapy connects you to expert guidance from the comfort of your own home. Online therapy is especially well-suited for skin picking because the visible skin damage often creates shame about being seen in person. Starting from home removes that barrier and lets you focus entirely on getting better.
Consistently Recognized as the #1 Online Therapy pick
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At Grouport, we offer a range of online therapy options to help individuals with excoriation disorder understand the triggers and patterns driving the picking, develop effective behavioral strategies to interrupt the cycle, and address the shame, anxiety, and emotional pain that both cause and result from the behavior. Many members choose to mix and match therapy formats.
Online therapy for excoriation disorder: personalized, flexible, and therapist-led. Understand the triggers driving the picking, develop strategies to interrupt the behavior, and reclaim the skin, the confidence, and the life the disorder has been taking from you.
Whether you're interested in group therapy, individual sessions, couples or family therapy, or IOP, or a combination, you'll start by selecting the type of support that fits your needs. You can also choose the care frequency that works best for you. Complete our onboarding form and sign up directly for the plan that suits you best.
After signing up, you'll connect with a dedicated care coordinator who will walk you through available therapists, group options, and scheduling. You'll make the final choice about your care, including which therapists you'll meet with and when, based on your goals, preferences, and schedule.
Attend your weekly online sessions, whether group, individual, couples, family, or IOP, at the cadence that works best for you. Our team will be here to support you every step of the way, ensuring you're happy with your care plan and helping you make changes whenever needed.
Whether you're interested in online group therapy for excoriation disorder, individual therapy sessions, a combination of both, or our virtual IOP for more intensive care, you'll start by selecting the format that fits your needs and schedule. You can customize the frequency of sessions and even pair live therapy with our DBT self-guided program for added support between sessions. Just complete our onboarding form and sign up directly for the plan that suits you best.
After signing up, you'll connect with a dedicated care coordinator who will discuss your mental health challenges, goals, and preferences. They'll walk you through the range of therapy options best suited to your needs for managing excoriation disorder. You'll make the final choice about your care, including which therapists you'll meet with and select session times that are most convenient for you.
Attend your weekly online therapy sessions to build coping skills, mood regulation strategies, and stability tools tailored to excoriation disorder. Our team will be here to support you at every step of the way, ensuring you're happy with your care plan and helping you make changes whenever needed.
Excoriation disorder is a recognized, treatable condition classified as a body-focused repetitive behavior (BFRB) and related to OCD-spectrum disorders. People with excoriation disorder experience strong, often uncontrollable urges to pick at their skin, and despite many attempts to stop, the behavior continues and causes real damage, shame, and disruption to daily life. If these patterns persist, therapy, particularly habit reversal training and CBT, can help you understand the urges, interrupt the cycle, and reclaim the time and skin you've lost to picking.
Common signs to watch for include:
If you recognize these patterns in yourself or a loved one, working with a licensed therapist can help.
Excoriation disorder affects far more than your skin. The behavior, the damage, and the shame create a cascading impact across every area of your life, and the secrecy surrounding the disorder prevents most people from ever getting help.
Repeated picking causes wounds, scarring, hyperpigmentation, and infection. Some people pick deeply enough to cause permanent tissue damage. Infections can become serious if untreated. The visible damage creates a feedback loop: the scars and wounds become new targets for picking, and the distress about your appearance intensifies the urge to pick.
The visible damage drives avoidance of social situations. You may cancel plans, avoid swimming, refuse to be photographed, wear concealing clothing regardless of weather, or withdraw from dating and intimacy. The avoidance progressively shrinks your world, and the isolation it creates generates more stress, which generates more picking.
Excoriation disorder carries intense shame because the behavior feels like something you should be able to control. Most people have never told anyone the full extent of their picking. The secrecy is exhausting: hiding wounds, making excuses, performing elaborate concealment routines. Many people have lived with the disorder for years or decades without seeking help because they believe they are the only one.
Excoriation disorder frequently co-occurs with anxiety, depression, OCD, and other body-focused repetitive behaviors (hair pulling, nail biting). The shame and functional impairment the disorder creates worsen these co-occurring conditions, and the emotional distress from co-occurring conditions intensifies the urge to pick.
Time lost to picking sessions, wound care, and concealment routines can consume hours each day. Concentration suffers when urges are present but you are trying to resist. Visible skin damage can affect confidence in professional settings, leading to avoidance of meetings, presentations, or client interactions.
Excoriation disorder is a time thief. A "quick" picking session can stretch into an hour or more. Morning routines expand to accommodate wound care and concealment. Evenings may be consumed by extended picking episodes. The total time spent on the behavior, its aftermath, and concealment can add up to a significant portion of each day.
Starting therapy when you are already exhausted and unmotivated can feel like a big ask. Here is what your first few sessions typically look like.
Your therapist will ask about your picking: where you pick, when it started, what triggers it, how much time it consumes, and what you have tried. For many people, this is the first time they have told anyone the full truth. Your therapist understands that this is a recognized disorder, not a character flaw, and will respond accordingly.
Together, you will create a detailed functional analysis of your picking: the antecedents (triggers, settings, emotional states, physical sensations), the behavior itself (focused vs automatic, tools used, duration, body sites), and the consequences (temporary relief, shame, wound care, avoidance). This map is the foundation for targeted intervention.
You and your therapist will define what progress looks like for you. This might include reducing picking frequency by a specific amount, eliminating picking at one body site, developing a competing response you can use when urges arise, reducing mirror-checking time, or attending a social event you have been avoiding. Goals are realistic, measurable, and paced to your readiness.
Your therapist will introduce evidence-based techniques tailored to your picking profile: habit reversal training to interrupt the behavioral chain, stimulus control to modify your environment, cognitive strategies for the thoughts that drive picking, and acceptance-based approaches for managing urges without acting on them. You will leave with a clear plan and specific strategies to implement immediately.
See how our therapy options have helped our members experience life-changing results
Stephanie
“Grouport is time flexible and affordable and if it didn’t exist, I don’t know where I would go. I had looked into other places before Grouport and there really wasn’t any option like it.”
Michael
“I highly recommend this to anyone who is struggling with anxiety or depression. The therapists are top notch and have made me feel really comfortable and my anxiety has improved tremendously in only a few sessions!”
Isabel
"I joined Grouport to work on myself and to heal. I’m learning so much at every session! The change I see not only in myself but in my fellow group members is abundantly encouraging and profoundly fulfilling. Group therapy with Grouport is a powerful healing tool."
Sheldon
“I was feeling very down at the end of 2020 and I was ready to do something drastic that I know I'd likely regret. The group definitely helped show me that there are people who feel the same way as I do.”
Nancy
“The therapy from Grouport is high quality and convenient. I am becoming much more self aware and am liking myself more. My relationships at work are better and I’m much happier.”
Emily
“I like the connection you can make with total strangers and the confidentiality it comes with.”
Danielle
"Grouport can help you with your issues. Their therapists are well trained to work with you on your issues. I felt my anxiety greatly improve after only a few sessions. I highly recommend it!"
Glenn
"Grouport's approach to DBT is a real strength. This approach provides tools and methods for working with difficult emotions and getting a handle on them. It has given me hope where other approaches have failed."
At Grouport, our virtual excoriation disorder therapy integrates several evidence-based techniques designed to help you interrupt the picking behavior, manage the urges that drive it, and address the emotional and cognitive patterns that maintain it:
Habit reversal training is the first-line, most extensively researched treatment for excoriation disorder. HRT has three core components. Awareness training helps you recognize the picking behavior as it is happening (or about to happen), including the sensory cues, urges, and automatic movements that precede it. Many people pick without conscious awareness, so building this awareness is foundational. Competing response training teaches you to perform a physically incompatible behavior when an urge arises (such as clenching your fists, pressing your palms flat, or holding an object) for at least one minute until the urge subsides. Social support involves enlisting someone you trust to gently prompt awareness when they notice picking behavior.
Stimulus control modifies your environment to reduce the cues and opportunities that trigger picking. This includes strategies like covering or dimming mirrors, changing lighting in bathrooms, wearing band-aids or gloves over target areas, keeping hands busy with fidget tools or textured objects, applying lotion to make skin less "pickable," and restructuring routines that are associated with picking (such as limiting time in front of magnifying mirrors). Stimulus control does not eliminate the urge, but it reduces the frequency of triggers and makes acting on urges more difficult, buying time for other skills to work.
CBT for excoriation disorder targets the thoughts and beliefs that maintain the behavior. Common cognitive patterns include permission-giving thoughts ("Just one more, then I will stop"), beliefs about skin perfection ("My skin needs to be completely smooth"), the belief that picking will fix a perceived imperfection, and the self-critical thoughts that follow episodes ("I am disgusting, I have no self-control"). CBT helps you identify these thought patterns, evaluate them realistically, and develop alternative responses that do not lead to picking.
ACT for excoriation disorder helps you develop a different relationship with picking urges rather than trying to eliminate them entirely. The core insight is that fighting urges often makes them stronger, while learning to observe urges without acting on them allows them to pass naturally. ACT teaches mindful awareness of urges (noticing the sensation without judging it), cognitive defusion (recognizing "I need to pick" as a thought, not a command), and values-based action (choosing behavior aligned with what matters to you rather than behavior driven by momentary urges). ACT is especially helpful for people who have found that willpower-based approaches consistently fail.
AEBT combines the behavioral techniques of habit reversal training with the acceptance-based principles of ACT, creating what many clinicians consider the most comprehensive treatment approach for body-focused repetitive behaviors. AEBT recognizes that picking is maintained by both behavioral patterns (habits, triggers, routines) and experiential avoidance (using picking to escape uncomfortable internal states). By addressing both simultaneously, AEBT produces outcomes that exceed either approach alone. This integrated model is increasingly considered the gold standard for excoriation disorder treatment.
DBT skills provide practical tools for managing the emotional states that trigger picking episodes. Distress tolerance skills help you survive moments of intense urge, anxiety, or boredom without resorting to picking. The TIPP technique (temperature, intense exercise, paced breathing, progressive muscle relaxation) can reduce physiological arousal quickly enough to interrupt a picking episode in progress. Emotion regulation skills help you identify and process the feelings (stress, frustration, emptiness, understimulation) that the picking has been managing, so you no longer need the behavior to cope.
Every Grouport therapist is a licensed, accredited mental health professional with specialized training in body-focused repetitive behaviors, OCD-spectrum conditions, and behavioral interventions.
Our therapists typically have over a decade of clinical experience across diverse settings, with specialized expertise in excoriation disorder, body-focused repetitive behaviors, OCD-spectrum conditions, and behavioral interventions, and evidence-based interventions like CBT, interpersonal therapy, behavioral activation, and social skills training.
We continually evaluate outcomes through internal studies and outcomes studies with researchers from leading universities such as Carnegie Mellon, University of Essex, and University of Cologne.
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80%of our members start with moderate to severe mental health symptoms
70% of our members feel significantly better within just 8 weeks
50% of our members achieve remission levels within just 8 weeks
80%
of our members start with moderate to severe mental health symptoms
70%
of our members feel significantly better within just 8 weeks
50%
of our members achieve remission levels within just 8 weeks
Group, individual, couples, family, IOP, and teen therapy — all online, all therapist-led. Mix and match care options to fit your needs — and get discounted pricing when you bundle.
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Excoriation Disorder often co-occurs with other mental health conditions. Our licensed therapists are experienced in treating a wide range of challenges, and many members address multiple concerns simultaneously through our flexible therapy options.
Grouport provides online group therapy, individual therapy, couples therapy, family therapy, teen therapy, intensive outpatient program (IOP), all held virtually over video chat. We also offer a DBT self-guided program. Many members combine multiple therapy types to best fit their needs.
Excoriation disorder (also called skin picking disorder or dermatillomania) is a DSM-5 diagnosis classified under obsessive-compulsive and related disorders. It involves recurrent picking at your own skin, resulting in tissue damage, despite repeated attempts to decrease or stop the behavior. The picking causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. It affects approximately 1-2% of the population and is more common in women.
Not exactly, but they are related. Excoriation disorder is classified in the DSM-5 as an obsessive-compulsive and related disorder, meaning it shares features with OCD but is a distinct diagnosis. Both involve repetitive behaviors that are difficult to control. However, OCD is driven by intrusive thoughts (obsessions) and the compulsions are performed to reduce anxiety about those thoughts. Skin picking may or may not involve obsessive thoughts; it is often driven by sensory experiences, boredom, stress, or an automatic habit. Treatment overlaps but is not identical.
Yes, every Grouport therapist is accredited and licensed. Our network includes Licensed Psychologists (PhD, PsyD), Licensed Social Workers (LCSW), Licensed Mental Health Counselors (LMHC), and Licensed Marriage and Family Therapists (LMFT). Our therapists specialize in evidence-based approaches including habit reversal training, CBT, ACT, and stimulus control.
Excoriation disorder involves two distinct picking styles, and most people engage in both. Focused picking is intentional and conscious: you scan your skin for imperfections, feel a bump or texture, see something in the mirror, and deliberately pick at it. It often involves a trance-like focus and the use of tools. Automatic picking happens outside your awareness: you find yourself picking while watching TV, reading, driving, or sitting in a meeting without realizing you started. Effective treatment addresses both types because they have different triggers and require different intervention strategies.
This is the most important question, and the answer is that excoriation disorder is a neurobiological condition, not a willpower failure. The picking is maintained by multiple mechanisms: it provides temporary relief from tension or distress (negative reinforcement), it can produce a satisfying sensory experience (positive reinforcement), it becomes an automatic habit wired into your neural pathways, and the shame it creates generates more emotional distress, which generates more urge to pick. Telling someone with excoriation disorder to "just stop" is like telling someone with depression to "just cheer up." Professional treatment works because it addresses the mechanisms maintaining the behavior, not just the behavior itself.
Yes. Excoriation disorder and trichotillomania (hair pulling disorder) are both classified as body-focused repetitive behaviors (BFRBs) and share many features: both involve repetitive self-directed behaviors causing physical damage, both have focused and automatic subtypes, both are triggered by similar emotional states, and both respond to the same treatment approaches (HRT, stimulus control, ACT). Many people have both conditions. If you also experience hair pulling, your therapist can address both simultaneously.
Many people see meaningful reduction in picking frequency within 6-8 weeks of consistent habit reversal training. Achieving stable, long-term management typically takes 3-6 months. Some people benefit from longer-term therapy if the disorder is deeply entrenched, connected to significant emotional triggers, or co-occurring with other conditions like OCD, anxiety, or depression. Excoriation disorder is typically managed rather than "cured"; the goal is to reduce the behavior to a level that no longer causes significant damage or distress, and to have effective tools for managing flare-ups.
Finding the right therapy starts with understanding your needs. If you need focused, personalized treatment to map and interrupt your specific picking patterns, individual therapy is ideal. If you benefit from breaking the secrecy and connecting with others who understand, group therapy is powerful. For severe cases, our virtual IOP offers multiple weekly sessions. Not sure where to start? Schedule a free call with a care coordinator.
We offer flexible therapy options with straightforward pricing:
Online Group Therapy: Averages $32/session ($140/month).
Online Individual Therapy: Averages $103/session ($448/month).
Online Couples Therapy: Averages $114/session ($492/month).
Online Family Therapy: Averages $148/session ($640/month).
Virtual IOP: Averages $311/week ($1,348/month).
Online Teen Therapy: Averages $103/session ($448/month).
DBT Self-Guided Program: One-time fee of $500.
Payment Options: Monthly, Quarterly (Save 10%), Biannually (Save 15%). No long-term commitment. Switch therapists anytime. Cancel anytime!
Yes. We offer separate therapy groups for Adults (18+) and Teens and Adolescents (under 18). Our teen therapy programs are tailored for adolescents. Skin picking often begins during adolescence, and early intervention prevents the behavior from becoming deeply entrenched and the scarring from becoming severe. Teens may feel especially ashamed and isolated by the behavior, making professional support critical.
Excoriation disorder develops through a combination of genetic, neurobiological, and environmental factors. There appears to be a genetic component (it runs in families and co-occurs with OCD and other BFRBs at higher-than-expected rates). Neurobiologically, it may involve differences in the brain's habit and reward circuitry. Environmental triggers include stress, anxiety, boredom, understimulation, and dermatological conditions that create texture or sensation on the skin. It is not caused by poor hygiene, attention-seeking, or lack of willpower.
Our therapy outcomes are backed by outcomes studies with researchers from leading universities such as Carnegie Mellon, University of Essex, and University of Cologne. 80% of our members start therapy with moderate to severe symptoms. Within just 8 weeks, 70% of members see clinically significant reduction in anxiety and depression, and 50% achieve remission levels.
You can cancel your subscription at any time. No long-term commitment is required. Simply email us at support@grouporttherapy.com and we will send you a quick cancellation form to fill out. If your sessions occur within the member portal, you can also cancel under the manage subscription tab.
Whether skin picking has been consuming your time, damaging your body, and stealing your confidence, or you're ready to understand the urges and break the cycle, therapy can help you take back control. Start building a life where your hands, your time, and your sense of self no longer belong to the picking.
