Cutilating my muticles
June 6, 2010 10:49 AM   Subscribe

Help getting treatment for my cuticle picking compulsion (dermatillomania).

So, I've decided to try to get professional help to stop picking at my skin. That's about it. I don't know where to begin or even which kinds of doctors/therapists to seek. Advice? Anecdotes?

I think I may need to change my current medication regimen, as I'm on prozac but still pretty mentally overclocked with anxious compulsive energy, which comes out on my fingers... and in the final straw, my scalp. Getting my hair cut on days when I know I might be scabby somewhere up there is just untenable.

Any tips for stopping the behavior or getting the compulsive impulses under control would be appreciated. I feel like I am sliding toward total OCD, since I have recurring anxious impulses, driven by bodily sensations and otherwise.
posted by Ambrosia Voyeur to Health & Fitness (18 answers total) 28 users marked this as a favorite
I did this in high school. It was replaced by chewing on my pencil. Later replaced by smoking (later replaced with pure, unadulterated anxiety!).

I found going out of my way to take care of my nails/cuticles helped. Use some cuticle oil and take steps to make your cuticles healthy. When the cutilce is happy you will have less a reason to bite them.

Your anxious. That's the culprit. Research this, and talk to dr/s and find a way to deal without (even marginally by biting your cuticles) hamring yourself.
posted by marimeko at 11:06 AM on June 6, 2010

Your = you're

hamring = harming
posted by marimeko at 11:07 AM on June 6, 2010

I do that.
Things that have helped (there is nothing that helps all the time):

- doing my nails With colourful nailpolish (picking would chip them and destroy the look and I hate that so I have a big incentive not to pick)
- removing the pleasurable part of picking. That is, I may pick but may not do x with it.
- remind myself that picking them does not make my fingers or problems smoother (which seems to be my underlying motivation)
- remind myself that it takes only several days of not picking for my fingers to look much better again, so if I don't pick now I'm already that much closer to pretty fingers!
- if all else fails, physically sit on my hands. That's in situations where I keep catching myself at it, when I'm too nervous and distracted
- band aid round the most damaged cuticles
- use hand cream a lot to prevent dryness and in lieu of picking. Rubbing handcream on can also work as a nervous tic!

It's a never ending battle, but I go months at a time without. It helps to be happy. And it helps to remind myself that my fingers are allowed to have imperfect sticky outy bits, just as my personality and my life are allowed to have them; they are a lot prettier than the gnawed off picked off version.
posted by Omnomnom at 11:31 AM on June 6, 2010 [3 favorites]

I have the same problem and I don't have a cure but only some anecdotes.

For me, I always thought I fixate on my cuticles because they look dry and there is always one little bit that if I just pull it off it will make it all better (which of course never works). So I've been trying to replace the picking with applying hand lotion. It still lets me play with my fingers for a minute but it adds moisture so that dry bit is no longer tantalizing me. Results are mixed - sometimes it works, sometimes it doesn't.

About 2 years ago, I decided to Just Say No. Everytime I started to think about it, I firmly told myself "I don't do that anymore". It worked for about 9 months, probably til the weather turned dry again (sigh).

And I tried a trick that nail biters sometimes use: limit it to just one finger. Leave the other 9 alone. That worked too, but that one finger looked bad.

Let us know how it turns out for you and if you've figured out the magic solution.
posted by CathyG at 11:35 AM on June 6, 2010 [1 favorite]

Getting acrylic nails helped me (but I have never bitten them, only picked at them. If you bite, this may not help)... I know this doesn't help the underlying causes, but the thick, long nails made it really hard to do. Add cuticle oil and stuff like marikmeko suggested would be good too.
posted by brainmouse at 11:37 AM on June 6, 2010 [2 favorites]

Response by poster: I should mention that I have long, beautiful nails and keep them well moisturized and polished usually. I carry hand cream and cuticle oil because yes, the dryness bothers me. Overgrooming is not the solution to an overgrooming impulse, I don't think.
posted by Ambrosia Voyeur at 11:38 AM on June 6, 2010

Best answer: Have you contacted the OCD Center of Los Angeles? Looks like they operate on a sliding scale (not sure if they take insurance). If you do check them out, I'd be interested to hear how it goes. Good luck!
posted by scody at 11:40 AM on June 6, 2010

I used to pick at my fingers nervously and bite my nails. I now sit on my hands habitually.
posted by desuetude at 12:03 PM on June 6, 2010

Best answer: My understanding (and I'm no pro) is that SSRIs can be hit and miss in OCD treatment (journal article here). Anecdotally, they did jack shit for my obsessive/ anxiety problems; NMDA antagonists, though, have been the hell awesome.

I like scody's rec, but there's also the Anxiety Disorders Clinic at UCLA Semel Institute in Westwood. The guy who fixed my wagon is at UCLA neuropsych too, but he doesn't do OCD, he does migraine. I expect that UCLA's OCD guys are aware of his research and aware of the front-line new shit; that's been my experience in every single specialty I've gone to at UCLA Westwood.
posted by fairytale of los angeles at 12:05 PM on June 6, 2010

Obviously, if you have migraines and think you can manage to weasel an approach from that angle, MeMail me and I'll tell you who my main man is.
posted by fairytale of los angeles at 12:09 PM on June 6, 2010

I've seriously been thinking about wearing gloves. Maybe one hand at a time, just to make it even weirder. But not having the cuticles available to pick at may be the only solution that works for me. I go through phases of using lots more lotion and cuticle oil and that works temporarily but it never seems to stick.
posted by otherwordlyglow at 12:25 PM on June 6, 2010

seconding acrylic nails--the thickness makes it very difficult to pick.
posted by QuakerMel at 12:39 PM on June 6, 2010

3rding acrylics. I did them for about 8 years and it did the trick.
posted by k8t at 1:32 PM on June 6, 2010

I've done this off and on most of my life. Keeping my hands as busy as possible helps. For me, knitting, weaving, playing solitaire, doodling. When it's been bad, getting to the point where I don't have scabs to pick at makes it much easier.
posted by wens at 1:38 PM on June 6, 2010

Best answer: There's a Yahoo group called Pickaderms where you can likely find resources and support.
posted by oceanmorning at 5:49 PM on June 6, 2010 [1 favorite]

I'm a picker and a chewer, oh, and an ingrown hair digger. My hands, face and body are really embarrassing to me. It's definitely anxiety... thanks for posting this. It's something I've wanted to ask, myself.
posted by sadiehawkinstein at 8:29 AM on June 7, 2010

Response by poster: > seconding acrylic nails--the thickness makes it very difficult to pick.

Thanks for the help, you lot... but I think normal pickers underestimate the compulsive aspect of dermatillomania. If I don't have nails, I go for teeth, needles or blades. And if I'm restrained, I get tense, twitch and panic. It's not a bad habit I'm trying to break myself of, it's a compulsive behavior, and one of a constellation of anxiety symptoms related to body dysmorphia, fibromyalgia, panic disorder, eating disorders and many others, but in my case, those.

I was hoping for some answers from people who've gotten professional treatment for trich, ocd, etc. Hopefully the resources scody and fairytale mentioned can help me find a cbt specialist. It sounds like CBT and group therapy are the best options to tackle first.
posted by Ambrosia Voyeur at 10:30 AM on June 7, 2010 [2 favorites]

I'm not a 'normal' picker (whatever that is). It is definitely a compulsive behavior on my part, but it sounds like we fall in different places on the spectrum. Perhaps we will both find the non-judgmental help we need at Pickaderms. I signed up yesterday.
posted by QuakerMel at 10:26 PM on June 7, 2010

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