Skin Picking: Causes, Consequences and Treatments

I Pick My Skin a Little – Do I Have a Problem?

Everyone picks their skin to some degree and at some point, and clearly not everyone who occasionally picks at their skin has a problem that requires treatment. Whether or not your skin picking has become a serious problem, a clinical problem, depends on:

• The amount of time you spend picking
• The damage your habit does to your skin
• How bothered you are by your habit

Basically, if you’re bothered by your habit, can’t control your impulses to pick and find that your habit is causing you skin or social problems, then you have a problem that requires treatment.

How Common Is Skin Picking Disorder?

The true prevalence of the disorder in the general population remains unknown. In one study, 2% of dermatology patients and 4% of college students picked their skin to the point of tissue damage and social impairment.¹

Why Do People Skin Pick?

Skin picking sessions may be conscious or unconscious, and people report skin picking for a variety of reasons, such as:

• Seeking to eliminate blemishes – Many people who skin pick spend considerable time looking into mirrors and trying to eliminate, with fingers or with tweezers – real or imagined blemished on skin, mostly on the face. This prolonged picking attention invariable worsens the blemish site, which can lead to further sessions of picking
• Boredom – Many skin pickers will pick when bored or sleepy, as a form of self stimulation
• Stress – Many skin pickers report feeling tension or stress before picking and relief or gratification immediately after. Many people come to use the relief afforded by skin picking to deal with life stressors in general². In addition to stress relief, some people will skin pick as a way of coping with other negative emotions, like fear, sadness, guilt etc.

The Consequences of Skin Picking

Some of the harms frequently experienced by those with this disorder include:

• Anxiety and depression (frequent co morbidity)
• Sores, scars and possible disfigurement (in some cases skin picking can result in sores that require surgery to treat)
• Embarrassment/shame
• Social withdrawal (people may pass on social activities out of embarrassment over their skin)
• Infection (with open sores the risks of bacterial infections go up significantly)
• Pain after or during a picking session³

Skin Picking Disorder Treatments

The most common treatments for skin picking disorders are differing forms of cognitive behavioral therapy (CBT), like stimulus control or habit reversal training.

• Habit Reversal Training – is a type of CBT that teaches you to become more aware of environmental, emotional and behavioral triggers that often lead you to skin picking. Once you gain a better awareness of what makes you skin pick, you can then learn techniques to overcome your skin picking impulses, such as minimizing your exposure to environmental triggers. For example, If you find that you often skin pick while watching TV alone, then you might be encouraged to avoid this activity

• Stimulus Control – is a type of CBT that teaches you to employ certain strategies in response to urges to pick at your skin. Examples might be wearing band-aids on your fingers or minimizing your exposure to situations, like watching TV or looking closely in the mirror, that frequently cause you to skin pick.

In some cases, medications like SSRI anti depressants and other medications may also be used, often in conjunction with psychotherapy, to help control the symptoms of the disorder.⁴