There has been little research examining clinical correlates of childhood-onset pathologic skin picking in a sample of individuals with a primary diagnosis of pathologic skin picking. Using a sample of 40 consecutive subjects with current pathologic skin picking, we compared subjects with childhood-onset (before 10 years of age) pathologic skin picking to those with later onset on a variety of clinical measures. Symptom severity was examined by assessing time spent picking per day, intensity and frequency of thoughts and urges to pick, and social and occupational functioning. Of the 40 subjects, 19 (47.5%) reported onset of skin picking before 10 years of age. Subjects with childhood-onset had significantly longer durations of illness before receiving treatment and were more likely to pick unconsciously. Symptom severity, comorbidity, and social functioning did not differ between groups. These preliminary results suggest that although onset before 10 years of age is fairly common among people with pathologic skin picking, individuals developing this behavior earlier in life have similar clinical characteristics as those with later onset but may be less likely to seek treatment.