How do you treat this disorder?

Obsessive-compulsive disorders have been theorized to be associated with a deficiency of the neurotransmitter serotonin in the brain. Not surprisingly, patients with neurotic excoriations and trichotillomania who have an underlying obsessivecompulsive disorder have been shown to respond to serotonin reuptake inhibitors such as fluoxetine (Prozac). Isolated case reports have also reported success with various other medications including doxepin, pimozide, and olanzapine. Hypnosis and behavioral modification treatment has also been used with anecdotal success.

Arnold LM, Auchenbach MB, McElroy SL: Psychogenic excoriation. Clinical features, proposed diagnostic criteria, epidemiology, and approaches to treatment, CNS Drugs 15:351–359, 2001.