How to overcome dermatillomania, aka skin picking

How to overcome dermatillomania, aka skin picking

Written by Hanna Ibraheem

Skin picking disorder can affect your overall health. Here, we spoke to experts about the steps you can take to overcome it.

We know we shouldn’t be touching our faces. Aside from transferring dirt and grime, the World Health Organisation has flagged it as one of the steps we should follow to avoid spreading coronavirus – and while it’s usually an entirely subconscious habit, there are ways to stop doing it. But what about if you have a skin picking disorder,also known as dermatillomania or excoriation disorder?

“Any time the skin is broken – even if it’s only a small amount – it becomes open to infection,” says Debbie Thomas. “We all have bacteria on our skin. A little like the gut, we need some [bacteria] to balance the skin. On the surface, under normal conditions, the bacteria levels stay low and healthy. However, if the bacteria gets inside the skin it is a very different environment in which the normally harmless bacteria can flourish and reach levels where infection and inflammation will be triggered.”

According to the NHS, signs that you may have dermatillomania includes being unable to stop picking your skin; causing cuts, bleeding or bruising; picking moles, freckles, spots or scars to try to “smooth” or “perfect” them; not always realising you’re picking your skin or doing it when you’re asleep, or doing it when you feel anxious or stressed.

As well as allowing surface or other harmful bacteria to break through the skin’s natural barrier and causing inflammation, bleeding or pain, there can be extreme consequences too, according to consultant psychodermatologist and skin wellness expert Dr Alia Ahmed. “Infection can manifest as collections of pus, and cause other problems like fever, especially if bacteria enters the bloodstream. I usually treat skin infections with antibiotics, in addition to advising good skincare with antimicrobial washes and emollients.”

But why does skin picking affect some people so badly? Dr Ahmed notes that among several reasons, one of the most common is an existing skin problem, like acne. “The feeling of a spot or bump under the skin can lead to some people picking their skin in an effort to remove it,” she explains. “This becomes an issue when picking becomes repetitive and damaging to the skin.”

“There are two main types of skin picking, but these can be interchangeable,” adds Dr Ahmed. “Emotional pickers tend to pick their skin in response to psychological states such as stress, anxiety or anger. Habitual pickers however, engage in these behaviours mainly when bored, idle or feeling tired.” Additionally, she notes that skin picking can also be a sign of obsessive-compulsive disorder if it is occurring in conjunction with other compulsive behaviours, like obsessive cleaning, hand washing or hair pulling. If this is something you’re worried about, speak to your GP or a medical professional.

So how can you overcome skin picking?

“Recognising triggers is important when trying to break the skin picking cycle,” says Dr Ahmed. “I suggest noting when or where you commonly pick. This way, thoughts, feelings, or situations that promote picking can then be identified and dealt with.” Though, she acknowledges that this can be difficult to do on your own, though, it may be helpful to enlist someone you trust to support you or seek the advice of a healthcare professional.

Here, Dr Ahmed shares some tips for overcoming skin picking:

  • If a skin condition like acne, for example, is predisposing you to pick, seek appropriate medical treatment as a first option.
  • Cover your hands/fingers where possible, especially if these are what you use to pick and keep nails short.
  • Keep your hands busy to distract yourself from picking. This could include squeezing a stress ball, clenching and unclenching hands, moisturising or massaging. This less harmful behaviour should replace skin picking over time.
  • Try to resist picking for one minute when you get the urge, and gradually increase the time.
  • Formal cognitive behavioural therapy can be useful to break the skin picking cycle, this is usually accessible through a clinical psychologist or psychodermatologist (for example, habit reversal therapy).
  • Take a look at resources such as, a paid online programme designed to help people stop picking, and Headspace, a mindfulness app to help manage stressful thoughts.

Main image: Getty

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