The prevalence of OCD in a dermatologic practice may be much higher than in the general population. OCDs can be debilitating in one's interpersonal, social, and occupational functioning. The obsessions and compulsions typically begin fairly early in life and may consume prolonged lengths of the patient's time to complete daily rituals of washing, checking, touching, arranging, hoarding, or ruminating. Evidence is mounting for support of a neurobiologic basis in the etiology of OCD. In terms of treatment, the psychopharmacologic agents (clomipramine, fluoxetine, fluvoxamine, sertraline, paroxetine) and behavior therapy alone or in combination with SRIs help a significant majority of patients suffering from this disorder. The OCD spectrum of disorders is varied. Patients presenting to the dermatologist will exhibit an interesting array of symptoms, including those who compulsively hand wash, pick at nails or skin, pull body hair, or display other SIB. Increased awareness of these disorders will enable the dermatologist to identify and treat patients with OCD appropriately.