Skin picking can be an indicator of more serious mental health conditions such as depression and anxiety, or be an accompanying symptom of medical conditions like rheumatoid arthritis and lupus.

Treatment for skin picking can include cognitive behavioral therapy and habit reversal training, in addition to medications which may help alleviate symptoms.

Cognitive behavioural therapy

Skin Picking Disorder, more commonly known by its Spanish name Dermatillomania, is an obsessive compulsive condition and similar to hair pulling disorder trichotillomania. People affected by Dermatillomania typically pick at their skin using fingers or fingernails - occasionally they might use tools like tweezers as well. They frequently pick at any blemishes, spots, scarring or irregularities on their body they believe must be corrected in order to look better and believe they must correct them all so as not look worse.

Cognitive Behavioral Therapy (CBT) has proven highly successful at treating this issue, especially through habit reversal training. This involves altering habits like wearing gloves to stop unconscious picking. Furthermore, keeping a picking log may also help the person identify patterns.

Habit reversal training

Habit reversal training (HRT) has long been used to address nervous habits and tics, such as Tourette Syndrome; more recently it has also been successfully applied to treat body-focused repetitive behaviors (BFRBs) such as hair pulling (trichotillomania) and skin picking behaviors (excoriation disorder). HRT involves teaching individuals how to recognize and tolerate urges for picking, and replacing these urges with healthier activities.

Ideal, such activities should be discrete, easy, and cause no lasting damage. People frequently pick at their face and arms; other areas might include eyebrows, hair, nails and even tweezers.

 

Once they have established healthier alternative behaviors, individuals can stop picking at their hair and/or skin and focus on other areas of their lives instead. Journaling may help facilitate this goal as it allows the person to track their progress over time and serves as an excellent motivator.

Medications

Pathological skin picking, also known as excoriation disorder, can be treated using medications like antidepressants, antipsychotics and mood stabilizers. While they can reduce urges to pick and anxiety levels while decreasing them simultaneously, some side effects may occur such as fatigue and nausea.

A GP will ask questions and examine any areas affected by skin picking behavior, and review your medical history and lifestyle to identify any patterns they believe indicate dermatillomania. If they suspect it exists, they may refer you for further assessment and treatment.

 

Study data showed that antipsychotic drug paliperidone significantly reduced episodes of skin picking while also improving quality of life, family support and depressive symptoms. Another potential medication used to treat skin picking could be neurotransmitter antagonist topiramate; its daily amount spent picking was reduced from 85 minutes a day to 30 minutes and seven patients showed significant improvement on CGI-I assessments.

Counselling

If skin picking has become an ongoing problem for you, treatment options such as therapy or dermatologic procedures could be beneficial in managing it. Your physician can assist in devising a personalized plan tailored specifically to you.

People who pick at their skin may do it out of habit or boredom; or as an emotional release mechanism to cope with negative emotions. Unfortunately, picking can result in pain, scabs, scarring and emotional distress; sometimes leading to social isolation as a result.

While the causes of skin picking remain elusive, research indicates it may be related to several mental health conditions. Skin picking often co-occurs with other behavioral and thought disorders (BFRBs), such as trichotillomania (repetitive hair pulling disorder) or body dysmorphic disorder (an OCD-spectrum disorder that manifests through repeated thoughts about appearance). Furthermore, depression or anxiety may co-occur as well; such disorders can often be treated through cognitive behavioral therapy and psychotherapy approaches.