Do You Suffer From Excoriation Disorder or Skin Picking? How to Stop

Many of us have picked at a stubborn pimple or ingrown hair knowing that it will make things worse. But what differentiates people who pick their skin compulsively?

While the DSM-V estimates that approximately 1 percent of the population meets criteria for excoriation disorder, my hunch is that it is far more prevalent. Most people who engage in compulsive skin picking don’t seek mental health treatment, especially if the skin picking is only triggered by breakouts or lesions. What can begin as a mindless habit however can develop into something that causes significant distress and damage to the skin long term.

Skin excoriation involves picking or pulling at the skin, often resulting in wound creation and skin damage, which makes aspects of daily life more stressful and challenging. Many people who pick their skin attempt to hide the ‘evidence’ so to speak with makeup, clothes, or by simply avoiding other people altogether. The hardest part about compulsive skin picking is that most believe that it will result in better looking skin, despite evidence to the contrary. This belief combined with a predilection for perfection and in some cases anxiety, is a recipe for skin picking and excoriation. If you suffer from skin picking—diagnosed or not—notice what your triggers are. For many people the sensation of something underneath the skin, especially if it is painful, can result in hours spent in front of a mirror obsessively trying to remove whatever might be underneath. The process often results in episodes of anxiety, depression, shame and low self-esteem. Family, friends, and others are avoided because answering questions about what is going on is painful to contemplate.

A big part of skin picking, particularly if it only occurs when there are acne lesions present, is impatience. Time heals all, including the not-so-attractive things about our skin. Healing acne lesions, especially cysts, take time and patience and is much better treated by a dermatologist. In fact the scars from attempting to remove them are likely much more unsightly than the lesions were in the first place. If you feel yourself close to picking, remove yourself from any triggering situations (examining your skin in the bathroom for instance) and find something else to do immediately. Helpful techniques include clenching your fist, squeezing a stress ball, and exercise. If this doesn’t work, do something helpful for your skin. Put on a face mask, treat the spot with medication or a natural remedy like manuka honey—anything that involves taking care of your skin calmly, which is the opposite of picking, squeezing, tweezing, etc.

Finally, rest assured that not all hope is lost! Hyper-vigilance and anxiety about your skin is just that—hyper-vigilance. Skin picking involves at least some degree of obsessiveness and it is likely that you at least in part are perfectionistic or obsessive. These can be wonderful traits to have and they can also have their downsides, like engaging in compulsive behaviors. Practice acceptance that you will never have perfect skin—no one does. Learn to accept this part of yourself that is perfectionistic and extend yourself compassion. If you find yourself attempting to stop picking your skin repeatedly, remember that the goal does not have to be to never touch your face again, but it is to remove the behaviors that are causing distress and pain. Stopping compulsive behaviors comes down to making a choice. As you start to notice obsessing about your skin, notice that you have the choice at any point in time to stop. Repeat whatever self-care habit is helpful, or coping mechanism that reduces picking, and find a dermatologist you can visit frequently. Combined, these efforts should help you on your way to stop the severity of your picking.

Find resources below:

https://www.webmd.com/mental-health/skin-picking-disorder

https://ocdla.com/skin-picking-dermatillomania-trichotillomania-group

https://www.caocd.com/excoriation-disorder