Let’s Talk: Skin Picking

The first in a series of “Let’s Talk” blogs, where I discuss issues related to mental health and/or skin conditions, which I don’t feel are talked about enough! I want to raise awareness, break the stigma, and help make people feel less alone and ashamed.

Skin conditions affect more than just your physical health, but your mental health too. This can include dermatillomania - a mental health condition where someone picks, rubs, pulls, or scratches at their skin. Usually compulsively, and causing injury. This skin picking disorder can be associated with OCD, or be a learnt habit from a skin condition. It’s not often discussed. I don’t see it mentioned much on social media. I think this is because it’s shrouded in misunderstanding and stigmatization. Most people who suffer with it do so secretly, with embarrassment and fear of judgement. I know I did. Therefore, it’s important to address this often-neglected side of skin conditions. Let's start to disrupt the stigmatization and feelings of isolation.

Living with dermatillomania can be a heavy burden. It impacts physical health (increasing chances of infection), self-esteem, and relationships. This persistent condition fuels feelings of shame and guilt. This escalates loneliness, depression, and anxiety.

I felt so out of control. Ashamed I couldn’t stop it even though I was stinging and bleeding. My husband would have to hide tools from me, such as tweezers and cuticle cutters (I call them snips). But that doesn’t solve the issue, because I could always find something else. Let’s face it, he can’t hide all the knifes in the house! It got bad and I have scars because of it. I still feel scared sharing this, but I think that’s more reason to do so. There must be so many others who felt, and feel, the way I do. You are not alone. Skin picking served me as a way to self-soothe. Distracting me from itching and dealing with intense feelings. It is often a way for people to release frustration, overstimulation or impatience.

Skin picking reportedly impacts about 5% of people at some point in their lives. This is likely to be grossly under-reported and under-recognised. It’s more common in those with skin conditions like eczema, because there is an ever present trigger.

Habits are formed in the subconscious mind, which is where hypnotherapy works best. Enabling clients to address the underlying reasons triggering the compulsive behaviour. Without having to talk about it. Hypnotherapy improve self-esteem and promotes better stress management. It provides tools to divert attention away from skin-picking. I help my client’s find their own solutions, while decreasing their stress, which fuels the habit. In a supportive, judge free, understanding space.

One of the techniques which helped me was The 3 Ds: Delay, Distract, Decide

1.     Delay the decision to give in to the craving to pick. I didn’t have to tell myself “don’t pick”, but just “don’t pick for 20 seconds”. I gradually increased this set time. Cravings for an unhealthy habit do pass!

2.     Distract your thoughts and attention, do something physical. Whether it’s 10 star jumps or making a cup of tea. I liked to grab my Switch controller and start a game.

3.     Decide, after the set time, if you want to give into the craving or not. Reminding yourself of the advantages of not doing it and reasons you want to stop.

Wearing gloves, moisturising when I started inspecting my skin, turning down the lights, wearing a silicone ring to play with and listening to my favourite music also helped me along the way. Other methods like fidget toys, acrylic nails, wearing a jingly bracelets, and having different strategies for different environments (e.g. bedroom, car, office), can be useful too.

I’m pleased to say today, I’m scab free. Do I still feel the urge to pick when I get stressed? Yes, but I know how to deal with it now. Everyone will find their own personal methods. Hypnotherapy can help you discover what those methods are for you.

For support groups and information, check out Picking Me Foundation and BFRB (Body Focused Repetitive Behaviours).

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