Ask the Skin Coach: Do you pick at your skin?

By Erin Bair, Licensed Esthetician + Certified Health Coach


As an acne specialist, the clients I see have usually picked at their skin to some degree. For some, though, this crosses the line from a mild desire to end a blemish to a much more serious psychological issue. Obsessive skin picking can lead to infection, disfigured scarring, and social isolation. If you’re a picker, how can you know if you have a skin picking problem, and to what degree?



Breaking the skin picking habit

First, identify the reasons and ways you pick. Most would agree that they want the blemish to clear up faster, right? If that’s you, just know that picking will only make the problem worse and slower to heal. Applying my technique of icing the zit, followed by a medicated spot treatment will speed up the healing process. I also like targeted blue light LED therapy for clearing blemishes at home.


Do you pick in front of the mirror? Put ‘NO PICKING’ notes on the mirror where you’ll see them, and wash your face in the dark. Wear medical gloves so you don’t feel every little bump. Do you pick in front of the TV? Wear cotton gloves so when your fingers touch your face, you’re alerted to the unconscious picking. Picking out of stress? Get a rubber squeeze ball or fidget spinner to keep your hands busy. Ask your friends and family to help keep you accountable if they see you picking.


Many times, simply recognizing why and when you pick and coming up with an alternate behavior to employ in those moments is all it takes. Of course, having a skin care plan to get clear and have nothing left to pick is also pretty critical. Knowing you’re finally on the right track with your skin regimen can be quite empowering. However, some will pick mercilessly at imaginary blemishes and bumps. In those cases, it’s a deeper issue that may require a mental health professional.


Signs you may have a skin picking disorder

Most simply, you probably feel out of control when picking at your skin. Someone with this disorder, known medically as dermatillomania or excoriation, often feels powerless to stop. The condition has been categorized as a compulsive disorder. According to one online resource offering help with picking:


Compulsive skin picking is closely related to several other compulsive disorders. Chief among these are other Body-Focused Repetitive Behaviors (BFRBs). BFRBs are compulsive disorders in which people can cause harm to themselves or to their physical appearance. Compulsive hair pulling (trichotillomania), severe and obsessive nail biting, and repetitive biting of the inside of the cheeks are all BFRBs as well. BFRBs are themselves closely related to OCD. In fact, some scientists categorize them as symptoms of OCD. However, most researchers make a clear distinction between the two, although they agree they are related. In fact, compulsive skin picking is classified independently in the DSM-V, in the category of "OCD and related disorders".


It's official name is Excoriation Disorder. Most BFRBs occur for the same reasons. People with the behavior perform it when they are anxious, afraid, excited, or bored. Some people even feel that such behaviors are pleasurable. Most BFRBs eventually end up negatively affecting a person’s life, whether this is their work or their family and social relationships. All in all, skin picking is a compulsive disorder because it is a behavior that the patient feels like they have to do. They do not feel like they can stop, even though they want to, and often have an incredibly difficult time making changes even when involved in treatments.


I can help get your skin healthy and clear. But behavior therapies, and sometimes even medication is warranted for those with persistent skin picking disorders. If you recognize that you may have a more serious disorder, I encourage you to seek help from a qualified mental health professional to find the relief you deserve.