Occasionally picking your skin — such as popping a spot or picking at an ingrowing hair (even though you know you shouldn’t) — is quite common and generally nothing to worry about.
But for some, skin picking can develop into a chronic disorder known as skin picking disorder — or dermatillomania or excoriation disorder.
Skin picking disorder is a mental health condition where one cannot stop picking their skin. This can severely impact a person’s mental health mental health.
So What Exactly Is Compulsive Skin Picking Disorder?
Skin picking disorder is a mental health condition where you cannot stop picking your skin. It’s also known as body-focused repetitive behaviour, and is related to obsessive compulsive disorder.
People that struggle with the disorder may pick at their skin in various ways including scratching, rubbing, and using items such as tweezers. This can result in sores and cuts which can then lead to scarring; which in turn can add to the psychological struggle.
Many that struggle with compulsive skin picking have periods of avoiding social events and taking photographs due to the appearance of the skin. Skin picking also leads to guilt due to feeling as though the impact is self induced however, the process of skin picking has been described by many as long sessions where one zones out.
The Breakdown’s editor, Hattie, lives with skin picking disorder — and has since she was a child. In a candid conversation, she tells me: ‘I don’t remember a day where I haven’t had a wound or a sore that’s yet to heal. I mainly pick my lips, to the point there is no skin left on them and they are sore and raw and bleeding. It hurts to pick, but it’s almost like I go into this trance with sensations I cannot describe.
‘I feel embarrassed afterwards and hate myself — I know it doesn’t look very nice, and when talking to people I feel like they are staring at my lips. I feel very self-conscious and try to hide it with lipstick.
‘Most recently I’ve started picking off moles and digging into the skin on my legs. I had a large wound for weeks that is now a big purple scar. It’s a reminder of what I continue to do to myself. But in the moment, though I know I’m doing it, it’s like I’m in another world.’
Compulsive skin picking disorder can be a result of various things however it is unclear what the exact causes are. It can be triggered by boredom, stress and anxiety or negative emotions. This can include feelings of shame and guilt or a desire to improve appearance by removing blemishes and spots. Skin conditions including acne, eczema and psoriasis can also cause skin picking.
It can present at any age however it is often presented in early years of childhood or adolescence.
Unfortunately there are many misconceptions about the disorder, leading people to think that skin picking is a form of self harm or the same as obsessive compulsive disorder when this isn’t the case. It is also often dismissed as bad habits, therefore, many do not seek medical advice and can feel very abnormal.
It is important to know that if you are affected you are not alone and it isn’t as easy as just stopping.
When should I see my GP?
NHS guidelines advise you should see your doctor if you cannot stop picking your skin and/or you’re causing serious damage to your skin by picking it; like cuts that do not heal within a few days. You should also speak to your doctor if picking your skin is causing you emotional distress or affecting your daily life.
It’s useful to talk to your GP even if you think it’s not that bad. While it may feel scary, your GP will ask you about your skin picking behaviours and have a look at your skin. If they think you may have a disorder they can refer you for treatment as appropriate.
How is skin picking disorder treated?
Cognitive behaviour therapy (CBT) has been reported by many to be one of the most effective methods. CBT focuses on understanding negative habits allowing you to identify emotional, physical and environmental triggers. You will then look at ways you can adapt behaviour to avoid skin picking.
CBT is available through the NHS by contacting your GP or self referring via an online form if available in your area.
However, wait times can be frustrating — but there are various things that can be done in the mean time.
This includes squeezing a soft ball, or using a Rubix cube and other fidgeting devices to keep your hands busy.
Other things that are helpful include:
- Moisturising and using lip balms to avoid skin being dry and easier to peel. It is useful to ensure you always have some with you as you may have the desire to pick your skin at various times. When there is an urge to pick it is useful to try and moisturise the skin each time. It is also important to keep the skin clean to avoid infection.
- Wearing gloves both when awake and asleep can prevent skin picking. Particularly due to the fact one may not be aware they are picking their skin.
- Ensuring nails are short and filed can prevent cuts. Ensure you do not keep tweezers and pins nearby.
- It is also useful to tell others so that they notice when you are picking your skin. Skin picking is nothing to be ashamed of. It may be good to share articles with a friend/family to ensure they understand better.
In some cases, medicine maybe prescribed to help with skin picking.
Where possible, seeing a dermatologist can be helpful if you have a skin condition such as acne or eczema, or if your skin is badly damaged.
A dermatologist can help manage your skin condition better and provide specialist advice. During a GP appointment a referral may be made if needed, however you can also see a dermatologist privately at a cost to get faster advice.
Other ways to manage the condition include hypnotherapy, facials and Reflexology — however they can be costly.
Importantly, please know that you are not alone. Compulsive skin picking disorder isn’t widely spoken about, but this is something people are actively trying to change.
If you’re struggling, please do seek help. it is scary, but it is also brave. If you need to talk, please call Samaritans on 116 123 — they’re available 24/7.
