TeenHealthFX - Answers - Compulsively Picking At My Skin

Worries, Fears and Anxiety Disorders / Question
Published: May 20, 2009

Dear TeenHealthFX,

Hi, I can't find any answers from previous questions and I've written in before, I hope this time you can answer me. I have a problem with picking my skin. It's been getting progressively worse from about 4 years ago. I began just nervously scratching myself, but now I pick untill there is no skin left, I pick my scalp and feet where no one can notice. The cuts on my feet get infected frequently and hurt too much to walk on. I want to stop this behavior, but it is hard to calm the complusions to pick, pick, pick. My friends and family don't know that I do this. I am embarrased to ask for help becuase I feel like a weird person for doing this. I understand you have lots of questions to respond to, this is my third letter and I really hope you could help me. Thank you.

Signed: Compulsively Picking At My Skin

Dear Compulsively Picking At My Skin,

What you are describing sounds like Compulsive Skin Picking (CSP), the repetitive picking at one’s own skin to the point where there is some kind of skin damage. TeenHealthFX thinks that it is important for you to reach out for help with this from a mental health professional trained in dealing with these kinds of issues. Clearly this problem is very distressing to you emotionally, and is causing you physical harm as well – so it is important for you to get help. FX can appreciate that it may feel embarrassing to talk to someone about this problem and reveal this side of yourself. It can feel scary and vulnerable, so FX can understand your reluctance. However, FX wants you to remember two things: The first is that therapists are there to be helpful, not judgmental. And the second is that there are many people out there who deal with skin picking and other kinds of compulsive behaviors. You are not alone in doing this and a mental health professional trained in dealing with compulsive disorders will have a great deal of experience working with the kinds of issues you present with – this will be nothing new, shocking or terrible to the therapist you will meet with.

If you live in northern New Jersey and need help finding a therapist you can call the Access Center from Atlantic Behavioral Health at 973-247-1400. Outside of this area you can log onto the US Department of Health and Human Services Substance Abuse and Mental Health Services Administration website for referrals in your area. You can also contact your insurance company to get a list of in-network mental health providers or check with your school social worker or psychologist to get a list of referrals in your area.

More About Compulsive Skin Picking:

This condition is also known as dermatillomania, neurotic excoriation, and chronic skin picking. People with CSP may pick at normal skin variations, such as freckles or moles, at actual pre-existing scabs, sores, or acne blemishes, or at imagined skin defects that others would not be able to see. The face is the most common area that is targeted with CSP, however, any area of the body can be involved. Fingernails may be used to pick with, as well as teeth, tweezers, pins or various other mechanical devices. CSP can lead to bleeding, bruises, infections, and/or permanent disfigurement of the skin. Many people with CSP go to various degrees to ensure that the damage caused to their skin is hidden to others around them. CSP has obsessive-compulsive features that are similar to obsessive-compulsive disorder (OCD), and many individuals with CSP also have OCD. Many individuals with CSP also suffer from body dysmorphic disorder (BDD).

Why Do People Compulsively Pick At Their Skin?

Sometimes skin picking is preceded by a high level of tension and a strong urge to pick, and may be followed by a feeling or relief or pleasure. CSP can be a response to anxiety or depression that a person is aware of, but it can also be an unconscious habit.

Treating CSP:

Treatment often involves cognitive behavioral therapy to become more aware of what triggers the skin-picking and to use alternate coping methods in response to these problematic situations or negative emotions. There are also treatments such as Stimulus Control techniques and Exposure and Response Prevention (ERP) that can be helpful. Finally, medications used frequently for the treatment of people with OCD may be of help in conjunction to various therapy techniques.

Resources:

To learn more, read about Dermatillomania: Compulsive Skin Picking

Signed: TeenHealthFX