Beyond skin deep: appearance, visibility, and social stigma in skin picking disorder

Purpose Skin-picking disorder is associated with significant psychological distress; however, its social dimensions remain underexplored. The purpose of this study was to investigate experiences of appearance, visibility and social stigma in skin-picking disorder. Design/methodology/approach This paper presents a secondary interpretative phenomenological analysis of interview data from adults living with skin-picking disorder, focusing on how visibility, beauty norms and anticipated social reactions shape shame, concealment and self-concept. Findings Findings highlight how participants experienced their skin as morally scrutinised, socially “jarring” and subject to disgust-based responses, leading to extensive strategies of hiding, self-surveillance and identity negotiation. Appearance emerged not as a peripheral concern, but as a central mechanism through which stigma was intensified and internalised. Originality/value Existing literature describes the psychological burden of skin picking but less often centres on the social processes through which visible skin damage becomes morally judged and socially excluding. By applying the appearance stigma framework to lived experience interviews, this paper contributes a social inclusion account of skin-picking disorder as visible, embodied distress shaped by beauty norms and anticipated negative social reactions.