Adolescence and young adult hoods' reactions to the skin disorder could be critical. This medical problems could be physiologically impacting,and also directly affect their physical appearance in ways that have psychological consequence like anxiety, low-self esteem, and impaired social life. 

Excoriation Disorder Among Adolescents and Young Adults

Acne may lead to some scratching and picking, which may also be associated with comorbid excoriation disorder

State University of New York at Buffalo

Excoriation disorder is not diagnosed if the skin picking is primarily 
attributable to the intention to harm oneself that is characteristic of nonsuicidal self-injury. 

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