Your Dermatologist Might Be the First Person to Notice Your OCD
By: Jessi Kiefor, MA, LMHC, NCC | Pillars of Wellness
Most people don’t walk into a therapist’s office and say, “I think I have OCD.” They walk into a dermatologist’s office with cracked, bleeding hands, thinning hair, skin that won’t heal—and nobody connects the dots.
When OCD Shows Up on the Skin
OCD and body-focused repetitive behaviors don’t always look like what people expect. OCD doesn’t always look like someone checking locks or counting tiles. Sometimes it looks like a dermatology referral.
Some of the most common physical presentations include:
- Excessive Handwashing — Contamination OCD can drive someone to wash their hands dozens, sometimes hundreds, of times a day. The result can be cracked, raw, damaged skin that dermatologists see regularly without ever knowing the cause.
- Skin Picking (Excoriation Disorder) — A body-focused repetitive behavior closely related to OCD, skin picking involves compulsive picking at skin, scabs, or perceived imperfections. It may cause significant scarring and can be extremely difficult to stop without the right treatment.
- Hair Pulling (Trichotillomania) — Compulsive hair pulling that results in hair loss. Like skin picking, it falls under the OCD-related umbrella.
- Psoriasis — Stress is a known trigger for psoriasis flares, and compulsive picking at plaques is common in people with OCD and body-focused repetitive behaviors.
These clients are sitting in dermatology waiting rooms right now receiving treatment for the physical symptoms while the underlying driver goes unaddressed.
Why the Gap Exists
OCD is one of the most misunderstood and underdiagnosed mental health conditions. Many people living with OCD have never been told what it actually is. They may feel shame, hide behaviors, and spend years being treated for the consequences rather than the cause.
Dermatology providers are uniquely positioned to change that. A patient with chronically damaged hands from washing is not just a skin-care issue. A patient losing hair from pulling is not just a cosmetic concern. These are clinical presentations that point directly to a behavioral health need, one that evidence-based treatment can actually address.
When dermatology and mental health work together, clients get the full picture of care they deserve.
What Effective Treatment Looks Like
OCD and body-focused repetitive behaviors respond well to Exposure and Response Prevention (ERP), the gold-standard treatment for OCD. ERP helps clients gradually reduce compulsive behaviors by facing the urge without acting on it, breaking the cycle that keeps the behavior going.
Treatment is structured, skills-based, and clinician-guided. It is not about willpower. It is not about just stopping. It is about rewiring the brain’s response to discomfort through direct, supported practice.
Many clients who have struggled for years see meaningful progress once they finally receive the right kind of care.
Closing the Gap
If you are a dermatology provider and you are reading this, you may already be thinking of patients this applies to. Connecting with a specialty mental health provider who understands OCD and body-focused repetitive behaviors can be one of the most impactful referrals you make.
If you are a client who has been treated for skin or hair concerns and something here feels familiar, you are not alone. What you are experiencing has a name, and effective treatment exists.
OCD & Anxiety Exposure Services at Pillars of Wellness provides specialized, evidence-based care for OCD and related disorders. We welcome referrals from medical providers and are available to consult on clinical fit.