Pathologic skin picking (PSP), previously known as neurotic excoriation, is characterised by habitual and repetitive self-excoriation of skin. Affecting mainly women with onset in the 20s and 30s, it can lead to significant distress, dysfunction and disfigurement. The extent and degree of self-excoriation is reported to be proportional to the distortion of the underlying personality. Because of the close similarity to obsessive compulsive disorder in phenomenology and pharmacological response to the serotonin re-uptake inhibitor (e.g. clomipramine, fluoxetine and sertraline), PSP has been considered as an obsessive compulsive spectrum disorder.