There is no single medication which reliably stops skin picking for everybody, and there is currently no medication specifically approved for skin-picking disorder.

But the evidence has developed considerably.

Research now gives us useful information about N-acetylcysteine (NAC), memantine, SSRIs and several other medications, and important reviews published in 2025 have brought together the growing evidence specifically for skin-picking disorder.

Throughout this page, we distinguish between scientific research and lived experience , including our own survey evidence from people who have actually tried treatments for skin picking.

What does the latest research say?

In 2025, researchers published an updated review specifically examining medication for skin-picking disorder.

They initially identified 192 publications and selected 13 studies involving 289 adults which met their criteria. These included six randomised controlled trials and seven case reports or case series.

Treatments investigated included:

• SSRIs
• N-acetylcysteine (NAC)
• memantine
• lamotrigine
• topiramate
• lithium
• olanzapine
• aripiprazole
• naltrexone
• mirtazapine
  
  

The authors concluded that SSRIs showed particularly promising results for reducing the severity and frequency of skin picking, while NAC was also described as well established in the treatment literature.

Another systematic review published in 2025 examined both medication and non-medication treatments. It also found promising pharmacological evidence for treatments including NAC and memantine, while finding useful evidence for behavioural approaches including CBT and Habit Reversal Training.

This is important because the medication picture for skin picking is not identical to the picture for trichotillomania.

That’s one reason we’ve created separate pages rather than assuming that evidence from one BFRB automatically applies to another.

N-Acetylcysteine (NAC)

N-acetylcysteine — usually shortened to NAC — is one of the most interesting treatments studied specifically for skin-picking disorder.

NAC is a supplement which influences the brain’s glutamate system and also helps replenish glutathione, an important antioxidant.

A randomised double-blind placebo-controlled trial studied 66 adults with skin-picking disorder for 12 weeks.

At the end of treatment:

47% of people receiving NAC were rated much or very much improved

compared with

19% receiving placebo.

Measures of skin-picking severity also improved significantly more in the NAC group.

That’s a meaningful result — but it also tells us something else worth remembering.

More than half of those receiving NAC were not rated much or very much improved.

Even a promising treatment doesn’t work for everybody.

The updated 2025 pharmacological review describes NAC as well established within the skin-picking treatment literature.

A further review published online in 2025 also described NAC as a promising treatment for skin-picking disorder and trichotillomania, particularly because of its influence on glutamate regulation.

But “I can buy this without a prescription” isn’t the same thing as “I don’t need professional advice about taking it.”

Memantine

Memantine has produced one of the most striking recent findings in BFRB medication research.

It is a prescription medication primarily used in the treatment of Alzheimer’s disease and acts on the glutamate system.

A 2023 double-blind placebo-controlled trial involved 100 adults with either skin-picking disorder or trichotillomania.

After eight weeks:

60.5% of participants taking memantine were rated much or very much improved

compared with

8.3% receiving placebo.

That’s an impressive difference.

However, we need to be precise about what it tells us.

Because the trial included both skin picking and hair pulling, we cannot say that 60.5% of people with skin-picking disorder improved. That figure describes the combined study population.

Nevertheless, memantine remains one of the more promising pharmacological possibilities for skin-picking disorder and was included in the updated 2025 pharmacological review.

SSRIs and skin picking

SSRIs include medicines such as fluoxetine, fluvoxamine, citalopram and escitalopram. They are commonly used for depression, anxiety and OCD.

Their role in skin-picking disorder is interesting because the evidence is rather different from the evidence for SSRIs and trichotillomania.

Individual studies have produced mixed findings. Some trials and open studies have reported improvements with SSRIs, while earlier systematic analysis did not establish SSRIs as consistently superior to placebo across controlled trials.

The dedicated 2025 pharmacological review, however, assessed the accumulated evidence more positively and concluded that SSRIs showed the most promising results among the medications reviewed for reducing the severity and frequency of skin-picking symptoms.

So we shouldn’t say either:

“SSRIs don’t work for skin picking.”

or

“SSRIs have been proven to stop skin picking.”

The evidence is more nuanced than either statement.

SSRIs may also be particularly relevant when somebody experiences skin picking alongside OCD, depression or anxiety.

Lamotrigine and topiramate

Lamotrigine

Lamotrigine initially attracted interest following encouraging uncontrolled research.

But when researchers tested it in a double-blind placebo-controlled trial, it did not demonstrate a significant advantage over placebo.

This is a useful example of why controlled research matters.

People can improve during a treatment study for many reasons. Comparing a treatment with placebo helps researchers investigate whether the medication itself is likely to be responsible.

At present, the evidence for lamotrigine as a treatment for skin picking therefore remains weak.

Topiramate

Topiramate has also produced some encouraging findings, but the evidence is much smaller and less robust.

The updated pharmacological review concluded that more research is needed before the role of antiepileptic medicines in skin-picking disorder can be established.

These therefore remain research possibilities rather than established treatments.

Other medications

A surprisingly broad range of medicines has appeared in the skin-picking literature.

These include:

• naltrexone
• olanzapine
• aripiprazole
• lithium
• mirtazapine

Some reports describe substantial improvements.

The difficulty is that much of this evidence comes from individual case reports or very small case series.

A dramatic improvement in one person is interesting. It may even point researchers towards something important.

But it cannot tell us how likely that medication is to help the next hundred people with skin-picking disorder.

The 2025 pharmacological review therefore concluded that further research is needed before firm conclusions can be drawn about these less commonly studied medications.

What about ADHD medication and skin picking?

This is an emerging area of research rather than one in which we currently have firm answers.

A 2026 review examined reports involving people with ADHD taking stimulant and non-stimulant medication and found a complicated picture: skin picking and related BFRBs have been reported as both improving and worsening in association with ADHD medication.

The evidence currently includes case-based reports and remains too limited to conclude that ADHD medication either treats or causes skin picking generally.

If you notice a substantial change in your skin picking after starting, stopping or changing ADHD medication, that is worth discussing with the healthcare professional prescribing it.

Why does glutamate keep appearing?

Both NAC and memantine affect glutamate signalling, although they do so differently.

Glutamate is the brain’s main excitatory neurotransmitter and plays an important role in communication between nerve cells.

The promising findings involving NAC and memantine have increased interest in glutamate-modulating treatments for BFRBs.

That doesn’t mean skin picking is simply caused by “too much glutamate”.

Human behaviour and neurobiology are considerably more complicated than that.

What we can say is that glutamate has become an important avenue of skin-picking medication research.

Scientific research and lived experience

Clinical research tells us what happens to groups of people under controlled conditions.

But lived experience tells us something different.

Our own surveys allow us to hear from people who have actually tried medication and supplements for skin picking.

We can ask:

• Did your urge to pick change?
• Did you actually pick less?
• How long did it take before anything changed?
• Did the improvement last?
• What side effects did you experience?
• Would you choose to take the treatment again?

Throughout our medication information we therefore distinguish between:

Scientific research — findings from published clinical evidence.

Lived experience — what people who pick their skin tell us actually happened to them.

A person’s experience doesn’t prove that a medication works generally.

But neither should someone’s experience be dismissed simply because researchers haven’t yet studied the question they’re describing.

The interesting bit is often where the two meet.

Medication alongside behavioural treatment

Medication isn’t the only treatment with evidence behind it.

Behavioural approaches — particularly those incorporating Habit Reversal Training (HRT) — remain important treatments for skin-picking disorder.

Research reviewed in 2025 found encouraging results for behavioural approaches including CBT and Habit Reversal Training.

Medication and behavioural treatment don’t necessarily have to compete.

A medication might reduce the strength or frequency of urges enough to make behavioural strategies easier to use.

Behavioural treatment can also help you understand what happens when you don’t pick, recognise situations in which picking is less likely, and build upon the things that already help you successfully leave your skin alone.

For some people medication may help considerably.

For others behavioural treatment may be more useful.

And some people may benefit from both.

The useful question isn’t necessarily:

“Which treatment wins?”

It is:

“What helps me spend more time not picking?”

Before trying medication or supplements

Please discuss prescription medication, changes to existing medication and appropriate supplementation with a suitably qualified healthcare professional.

This is particularly important for children and young people, during pregnancy or breastfeeding, when taking other medication, or if you have other physical or mental health conditions.

NAC being available as a supplement does not mean it is automatically suitable for everybody.

And remember:

If a treatment helped somebody else but doesn’t help you, that doesn’t mean you’ve done anything wrong.

Even the better-performing treatments in clinical studies don’t work for everyone.

References

Grant, J.E. et al. (2016). N-Acetylcysteine in the treatment of excoriation disorder: A randomized clinical trial.

Grant, J.E. et al. (2023). Double-blind placebo-controlled study of memantine in trichotillomania and skin-picking disorder. American Journal of Psychiatry, 180(5), 348–356.

Lee, D.K. & Lipner, S.R. (2022). The potential of N-acetylcysteine for treatment of trichotillomania, excoriation disorder, onychophagia, and onychotillomania: An updated literature review. International Journal of Environmental Research and Public Health, 19(11), 6370.

Modanlo, N., Yan, X. & Bourgeois, J.A. (2025). Pharmacologic Management of Skin-Picking Disorder: An Updated Review. Journal of the Academy of Consultation-Liaison Psychiatry, 66(5), 417–428.

Modanlo, N. et al. (2025). New and emerging pharmacologic treatment options for skin-picking disorder. Archives of Dermatological Research, 317(1), 469.

Treatment strategies for skin picking disorder: Efficacy of pharmacological and nonpharmacological approaches — A systematic review and evidence mapping. (2025). JAAD Reviews, 3, 124–127.

Goldin, D., Salani, D.A. & Valdes, B. (published online 2025; print 2026). N-Acetylcysteine (NAC) for Trichotillomania and Excoriation Disorder: An Overview.

Loftus, H. et al. (2025). A systematic review of nonpharmacological treatment options for skin picking disorder. Clinical and Experimental Dermatology, 50(2), 299–306.