No really... I need to stop picking.
November 25, 2012 7:29 PM   Subscribe

I need to stop picking my face. Now. I don't have much money or time or willpower. But I need to stop. How do I do this?

Currently, my solution is that my husband firmly tells me to stop touching/picking my face whenever he sees me doing it. But, that's a bit straining for me, and I don't think it's really doing much more than making me feel guilty. Plus, he's not always around when I'm doing it.

I don't feel like I need therapy; this is not an emotional problem, but more of an idle habit (at least I'm no longer a nail biter?). I'm also already seeing a dermatologist, but he has no great advice here. I'm taking spironolactone. However, it's making my pretty minor acne much, much worse, and my self-esteem is suffering and feeding into an endless loop of picking.

I've seen a ton of questions on AskMe about this, but none of the solutions have helped. This is a problem I know I have, but snapping a rubberband or obsessing even more over this is not working. I need tough love... or better advice. I said I don't have much money, but at this point, I'd definitely throw money at a solution if it comes highly recommended. Facials? Hypnotism? Whatever... help!
posted by your mom's a sock puppet to Health & Fitness (37 answers total) 28 users marked this as a favorite
This sounds like you might have dermatillomania. I think you would do well to seek a referral to a psychiatrist to discuss possible pharmaceutical and/or behavioral treatments.
posted by chiababe at 7:39 PM on November 25, 2012 [2 favorites]

I pick at my face under two circumstances: I have had too much sugar and I can feel the acne I get from it starting, or I'm under subconscious or conscious stress that I don't feel I can control or abate in any other way. Picking is a self-soothing mechanism that is inherently emotional and, for me, evidence of a minor level of OCD. A few things are helping: drinking tons of water to help with my acne-itch, making sure I have something to work on with my hands, and taking pains to figure out other ways to deal with the stress I often have. Don't discount the possibility that it's emotional for you, too.
posted by These Birds of a Feather at 7:40 PM on November 25, 2012 [1 favorite]

I have tried taking better care of my skin (which still lets me obsess over it) and doing it in ways that will get messed up if I touch the skin -- for example, I use nice soap and then a tea tree solution that dries out the red, irritated spots. This gives me a clear incentive NOT to touch my skin after using the solution, because the oil from my hands will negate its effects.

I am also planning to supplant other tasks for the picking--like flossing! It's hard to floss too much! I think if I did this enough and also did it when feeling like I want to go for the face, then it might help reduce how much I'm picking.

You mention that it's related to a self-esteem loop, which makes me question whether it is completely a habit and not meeting an emotional need of some kind. I realized mine met an emotional need after years of thinking it was a habit. Sometimes it starts as a mindless task and later on begins to tie into self esteem and self worth.
posted by ramenopres at 7:43 PM on November 25, 2012 [1 favorite]

It's probably related to stress, or some sort of compulsive behaviour. I have a mild form of this, probably caused by a mild anxiety disorder, which is paired with mild folliculitis that obviously makes me want to pick at my skin.

I keep the picking in check by avoiding trimming my nails too short, and I use moisturizers and good shampoo to keep the folliculitis in check somewhat. Over the years it has seemed to work.
posted by KokuRyu at 7:46 PM on November 25, 2012

I have some similar issues and find it helpful to have regularly scheduled beauty treatments on the area in question. In your case, maybe a facial. Anyway, I find I leave the area alone because I don't want to look weird to the aesthetician and I can also say to myself "that area is under someone else's care, leave it alone." Then I feel really good when I really did make it a whole month, which spurs me on.

It doesn't always work, and it can transfer the behavior to somewhere else (at least in my case it does when I am particularly stressed out). But over time I've gotten better about it.

I know this sounds kind of vague so memail if you want more specifics.
posted by cabingirl at 7:48 PM on November 25, 2012

I have exactly the same problem, brought on by stress and worry. The biggest mitigating factor -- for me -- has been to get rid of magnifying mirrors in the bathroom.
posted by Bluestocking_Puppet at 7:49 PM on November 25, 2012 [2 favorites]

My advice is to do anything you can to clear up your skin. If what you're doing isn't working, try something else. Over and over. Until something works.

Things that have worked for me: getting my Vitamin D levels to normal, taking daily zinc, removing all products with dimethicone (it's in most beauty products now), lessening sugar in diet, lessening dairy in diet, and drinking more water.

For me, it's a bad habit -- it's my default way to deal with strong emotions. I used to bite my nails too. Having clear skin helps tremendously.
posted by icanbreathe at 7:50 PM on November 25, 2012 [4 favorites]

Another thing that helps is to practice beginning the action, and then stopping it. I will practice moving my hand to my face (maybe touching the face) and the moving it calmly away. I do this when I'm not feeling like I want to pick at it so that it starts to break the habit cycle that I have built up.
posted by ramenopres at 7:50 PM on November 25, 2012 [18 favorites]

Try the search "skin picking" on amazon (without the quotes) to see if something jumps out at you? It looks like there's a lot of stuff there. nthing chiababe above.
posted by zeek321 at 7:52 PM on November 25, 2012

I have mild case of trichotillomania. I've noticed that it manifests itself most often when I'm under a lot of stress at work and when I'm doing something that requires a lot of concentration (such as reading a difficult book for work) but my hands aren't occupied. I don't seem to suffer from depression, anxiety, or poor self image, though the NIH page to which I linked mentioned that. It's just a weird impulse I get from time to time.

In my case it usually happens when I'm not being mindful. So I try to focus on what my hands are doing from time to time, especially when I'm not working with them. (Obviously, plucking out eyebrow hairs doesn't happen when I'm cooking, typing, doing yard work, or anything else that requires using my hands.) I've heard that people with more severe cases will wear gloves, which makes plucking out hairs a lot harder.

I try not to do it, but if I do, it's a minor problem that at most leaves my eyebrows a bit thin. I have no compulsion to tug out the hair on my head, though when I had a beard I would pick at the hairs near the temples. Are you causing yourself harm by doing this, or is the behavior itself the problem?If the latter, you can look for ways to mitigate the problem, but if it's actually harming your face, then you might want to see a specialist.

BTW, my sister also has mild trichotillomania. It might have a genetic component. If you have siblings, do they feel similar compulsions to pick at their face?
posted by brianogilvie at 7:53 PM on November 25, 2012

Ahh, I do this. I was doing pretty well for a while, but stress and acne (related, natch) have brought it back a bit. Cognitive behavioral therapy techniques are good for combating this; finding ways to keep yourself from touching your face at all may be the most effective (if you don't touch it, you won't feel any flakes or bumps, and you won't inadvertently encourage more to form).
posted by limeonaire at 7:54 PM on November 25, 2012

Yes, there may be a genetic component. My dad used to pick at the skin on his hands, but he's stopped now. My sister picked at her eyebrows during adolescence.
posted by KokuRyu at 7:55 PM on November 25, 2012

Are you picking absently while doing other things, or are you getting lost in front of the mirror?

What really helped me (with the latter problem) was when I moved, and my new bathroom had relatively dim lights that also take a while to fully light up - it helped keep me from noticing blemishes ad hoc. Amazing what a difference that made. Also not having magnifying mirrors, as above.
posted by laeren at 7:56 PM on November 25, 2012

Oh, and if you haven't visited the Stop Picking on Me site, you should! It has tons of good resources and discussion about this!
posted by limeonaire at 7:58 PM on November 25, 2012 [3 favorites]

This is a really fantastic explanation of how one person stopped skin picking. It's a "notepad" on Makeupalley - you may need to log in to see it, but creating an account is free. If you don't want to create an account, memail me and I'll send you a PDF of the page or something. It's really great advice.
posted by insectosaurus at 7:59 PM on November 25, 2012

Response by poster: It's definitely absent-minded picking. I rarely, if ever, pick in front of the mirror. Thanks so far!
posted by your mom's a sock puppet at 8:03 PM on November 25, 2012

I've started to break the habit just by noticing how unattractive it is when other people do it. If I see a co-worker picking at their hair or at their face it's kind of gross (or, my boyfriend picks at his nails, which is absolutely disgusting especially if we're cuddled together and he's doing it over my arm or something, but I don't find it disgusting when I do it at all...).

So now if I'm sitting in a meeting and idly combing my hair or picking at that rough spot on the side of my face, I can remember that it's gross and cut it out. The trick is just learning to think, where are my hands right now? And make sure they aren't touching your face.
posted by Lady Li at 8:06 PM on November 25, 2012

If it's an idle habit and not a compulsion, maybe just physically preventing yourself for a while would break the pattern. Wear gloves? Wear a facemask? Wear impractically long fake fingernails? (Maybe these would only be a good idea at home.)
posted by hattifattener at 8:35 PM on November 25, 2012

It's definitely absent-minded picking. I rarely, if ever, pick in front of the mirror.

The absolute cure for absent-minded behaviors is mindfulness. Takes a fair bit of practice before it starts spilling over into everyday life, but the sooner you get started the sooner that will happen.

In the meantime, instead of making it your goal to stop picking your face, make it your goal to notice when you're picking your face. And when you do notice yourself picking your face, make it your goal to notice what feelings and thoughts occur to you in that moment, so that instead of getting sucked into a self-loathing thought->feeling->thought loop you can simply watch whatever thought or feeling comes up first arrive, then flower, then dissipate.

I expect you'll find that there will be some variant on "why tf am I doing this again? I am such a weak-willed piece of shit" going on for you. If so, spend some time (while you're not picking your face) reflecting on how unhelpful it might be to practice reinforcing an association between beating yourself up emotionally and beating your face up physically.

It's also a lot easier to modify habits than to drop them altogether, so something else that might be useful is to work out a pre-planned and harmless hand ritual to link to picking your face. For example, practice lacing your fingers together and then tapping your thumbtips on each other ten times. Then whenever you do notice yourself picking your face, jump straight to that ritual instead of wasting time and energy on yet another emotional self-flagellation session. Because despite how it feels at present, this is really not such a big deal and really won't take much effort on your part to fix.
posted by flabdablet at 9:53 PM on November 25, 2012 [3 favorites]

For me what works is to put time into caring for that thing. I pick my nails less when i spend time filing them into a nice round shape, for instance. I'm more apt to notice that I'm about to mess up my work. And when I screw up and pick anyway, it's easier to get back on the bandwagon because I'm already in the habit of taking care of my nails.
posted by salvia at 10:03 PM on November 25, 2012

Pick up another habit that week give your hands something to do:
-Keep a rubik's cube or stress ball around and play with that instead
-practice that neat pencil flicking trick or tap on your keyboard
-try wearing a necklace and when your hand goes up to your face play with that instead
posted by matildatakesovertheworld at 10:30 PM on November 25, 2012

This article Skin-Picking Strategies is one I wrote for TLC (Trichotillomania Learning Center). It was a follow-up to a multi-day workshop for skin-pickers at one of TLC’s annual retreats. I think the original title was originally “50 tools I am using to stop skin-picking and 50 tools I could try” or something like that.

I’ve been dealing with BFRBs (body-focused repetitive behaviors) since adolescence. For me they can manifest both as an absent-minded habit (such as when I’m driving or reading), and in a focused way (such as when I’m tired, getting ready for bed, and in front of bathroom mirror and lights). I've dealt with biting and hair-pulling as well, but skin-picking is my biggest challenge.

To address BFRBs, I've tried a lot: talk therapy, peer counseling, mindfulness, took a class CBT class where I learned 80 CBT tools, dabbled in ACT & DBT, been a regular participant in a trich support group (that was the most helpful), changed my diet (also really helpful!) and been to TLC’s annual retreats & conventions (totally amazing). I’ve learned a lot! The best resources have been those I’ve gleaned through TLC and the support group. I’ve significantly reduced the extent to which these behaviors get in the way of my life, and I’ve seen a lot of others also deal successfully with BFRBs.

Few comments directly in response to the original post:

+ It’s not surprising that dermatologists are not much help…even most therapists are unfamiliar with BFRBs (Body Focused Repetitive Behaviors). Clueless medical professionals are, unfortunately, the norm.

+ Check out TLC’s website to see if there might be resources near you, or consider attending just one of TLC’s multi-day retreats or conferences. Or pay the $45/year to become a TLC member; you'll get a packet of 200+ pages of info, and their newsletter which might offer new ideas or perspectives or inspiration a couple times a year. Or at the very least, get on their email list so if they run a day-long workshop nearby you, you’ll at least know it’s happening, and can then decide whether you want to go. Not only will the content likely be helpful, but breaking the isolation is potentially the most helpful thing you can do. You’re not the only one dealing with the self-esteem and cycle you mentioned…just talking face-to-face with others, and being a room with 100 or 300 others who face similar struggles might be the best tool to make an impact on your own struggle.

+ It’s great that you’re thinking about how to enlist your sweetie’s help. I also find that really helpful! I also think you’re probably on the right track to realize that you need more than one tool. My personal experience (and that of many others dealing with this) is that you probably need many tools in your toolbox if you really want to stop or significantly reduce the behavior. And you’ll probably need to keep switching things up…every 2-3 weeks you might need to go back to your list of possible tools and revisit what might work for you now.

+ The suggestions in comments above are all great ones, and many are also listed in my article. Some that come to mind are: the impact of diet/sugar, stress, replacement behaviors, regular facials, changing the environment where the behaviors occur, practicing stopping, using fiddle toys and being mindful of when your hands are busy…I could go on, but just check out the article.

+ The SCAMP model was really helpful for me in thinking about how to reduce my behaviors. There are different components that need to be addressed:

• Sensory (the physical/sensory components, such as your hands feeling a bump or rough spot, or feeling a soreness from acne or a spot you picked yesterday)
• Cognitive (the thoughts, for example you might think Wow, that spot is bumpy or There’s a zit that ‘needs’ to be picked)
• Affective (the emotions that lead up to or precede the behavior, or being tired or hungry or upset), motor, place/environment.
• Motor (like if your hands are used to being busy, how else could you occupy them?)
• Place/environment (if you always pick in the same place, can you modify the setting so you’re doing things less automatically? Like sit in a different chair, or on the other side of the sofa so your usual picking hand doesn’t rest on the arm and reach so easily to your face?)

In response to comments:

+ Close research into BFRBs suggest that they’re not actually OCD, at least not in most cases. There’s some really interesting stories about this, from when researchers starting identifying skin-picking as its own disorder. If you ever go to a TLC retreat or conference, don’t miss Charlie Mansueto’s “Intro” workshop…he talks about how they started out thinking trich was the same as OCD, but 30% of OCD patients would respond to X medications, and none of the trich patients responded…suggests pretty clearly that trich and OCD are not the same thing…though they’re probably siblings.

+ Yes, there’s undoubtedly a genetic component. Trichotillomania actually got a lot of press a few years back when it became the first “mental health” disorder to have a genetic component identified. I think it was this study. So remember it’s not your fault!
posted by quinoa at 11:19 PM on November 25, 2012 [10 favorites]

Another thing that helps is to practice beginning the action, and then stopping it. I will practice moving my hand to my face (maybe touching the face) and the moving it calmly away. I do this when I'm not feeling like I want to pick at it so that it starts to break the habit cycle that I have built up.

Another thing to add to this is some sort of vocal reinforcement of your actions. If you say it enough you can make it true. So, either when doing a fake training reach, or when you realize you really are about to pick at your face, you say something like:

"My hands are dirty, I do not want to fuck up my skin."
"Picking my face is a terrible habit, I am destroying my skin."
"My pimples will heal better if I leave them alone."

Etc. etc. Get in the habit and you can say this to yourself whenever you feel the urge coming. You are letting your aware / conscious self talk your unconscious self out of the behavior.
posted by Meatbomb at 1:02 AM on November 26, 2012 [1 favorite]

This will only help with the physical part, but like These Birds of a Feather, I tend to pick when my skin is feeling uncomfortable. Dry, itchy, acne coming in. I have had great success with keeping OTC hydrocortisone, polysporin with analgesic, and topical anaesthetic like lanacaine. Also finding a good, light moisturizer...I like Clinique dramatically different gel. I still have the habit part, but less so.
posted by sarahkeebs at 4:59 AM on November 26, 2012 [1 favorite]

I sympathise. I find it really uncomfortable when I have a spot, to the point where I want to drive it and the infection out of my skin and get rid of the yuck. I used to absent-mindedly pick my lips as a child (my sister did it and I copied her), but this has happened when I started to get spots in my early 20s.

Things I have found helpful:
- cutting nails very short
- not using the bathroom at work with good lighting and being mindful of it in changing rooms
- keeping things clean - washing make-up brushes, making sure all my make-up is off (I get more spots when I've been away somewhere where I can't cleanse everything off).
posted by mippy at 7:03 AM on November 26, 2012

Do you normally paint your fingernails? You could cut your nails really short and then paint them with a couple layers of polish. They will feel unusual enough when you're touching your face that you will notice that you're picking at yourself.
posted by zoetrope at 7:24 AM on November 26, 2012

When you catch yourself picking, get up and wash your hands, and maybe also your face. Your hands carry bacteria to your face, and cause acne. Keep your nails very, very short. Substitute flossing, gum chewing(not at the same time), playing with worry beads or something else in your hand. You're less likely to pick at your clean face. If you have a tendency to also chew your nails, use antibacterial soap and/or alcohol sanitizing gel - it tastes awful. And get adequate sleep; being tired makes it worse, as does stress, of course.
posted by theora55 at 7:53 AM on November 26, 2012

This is going to sound a bit odd, but it helped tremendously when I needed to stop absently rubbing my eyes throughout the day -- start wearing makeup. Just enough so that touching it might mess it up and get makeup on your fingers or under your nails. If it's just an absent habit, this might help remind you not to touch your face at all.
posted by Margalo Epps at 10:12 AM on November 26, 2012

I know someone who used hypnosis to alleviate her symptoms of picking her face and claims that it worked really well for her. No symptoms at all.
posted by luciddream928 at 11:01 AM on November 26, 2012

Put a rubber band around your wrist and snap it hard every time you catch yourself picking. Repeat for any habit you want to break.
posted by cmoj at 11:19 AM on November 26, 2012

Go get acrylic nails done at a salon. I'm not kidding.

I used to absentmindedly pick the scabs on my scalp when I read. At one point, I decided that I wanted to try to look more 'girly' (whatever that means) and got fake nails. I ended up getting acrylic nails (because that's what the nail person who was free when I walked into the salon specialized in), and it turns out that they are too thick to be effective picking tools! I tried to still pick my scalp, but got frustrated with the ineffectiveness and eventually just stopped even trying.

I think other sorts of fake nails are thin enough that one can still get enough sensation in the finger tips to pick, but acrylic nails defeated all my attempts to pick.

Just so you know what to expect: The nail stylist will glue on fake nail tips to the desired length, then will fill in the rest of the nail with a powder/liquid mixture. You will need to go in every few weeks to get more fills, but it shouldn't be that costly in either time or money. Keep 'em on for a few months and your habit will be broken.

These fake nails are not easy to remove, either. You have to commit some soaking time to really get rid of them, so you aren't going to be able to just remove them in a fit of desire to pick.
posted by Brody's chum at 11:23 AM on November 26, 2012

Response by poster: Thanks for the great answers so far!

I've gotten a stress ball at work for idle hands, but I'm realizing that my face just gets itchy a lot. Also, sometimes it's painful. Those are the two biggest reasons I've reached for my face so far today. I'm currently using a CeraVe moisturizer for me face and the CeraVe moisturizing cleanser, but maybe that's not enough? I have only been on spironolactone for about a month and was doing well before I was picking at some of the blemishes. Now it's spread again.

I try not to wear makeup a ton because I suspect it may make things a bit worse with daily wear. I definitely don't have an eye rubbing problem, nor do I stand in front of the mirror and pick.

Any ideas on what to do about the itchy skin? Moisturizer recs that won't make the acne worse?
posted by your mom's a sock puppet at 1:26 PM on November 26, 2012

For me, an itchy face usually means I'm reacting to something in my environment (could be grass pollen, could be certain perfumes); popping an antihistamine pill and splashing my face with cool clean water usually deals with it.

When bits of me get persistently itchy, I usually find that using a small amount of anti-dandruff shampoo on my showering washcloth helps a lot.
posted by flabdablet at 4:40 PM on November 26, 2012

I wonder if you're sensitive to one or more of the ingredients in your moisturizer; that could definitely be making the dryness worse. In my case, for instance, I'm allergic to formaldehyde, so I can't use cosmetics with formaldehyde-releasing preservatives. I would definitely suggest trying to find an all-natural alternative to your current moisturizer. I've been using JĀSÖN's Hydrating Hemp Pure Natural Hand & Body Lotion on both my body and my face (hemp helps soothe itchy skin), although it's a little heavy for more oily parts of the face. Desert Essence's jojoba oil (available at Trader Joe's) is also great as a facial moisturizer, and a little bit goes a long way; jojoba oil is very similar to the skin's natural sebum.
posted by limeonaire at 6:04 PM on November 26, 2012

So smart that you're tracking where and when you have urges, and that you're noticing the physical sensations that precede them. Nice work!

Interestingly, and contrary to my expectations, when I stopped regularly using soaps and moisturizers on my face, I had less urge to pick, less acne and itchiness. I now don't ever really soap up my gets wet in my daily shower, but no soap, no moisturizers. Paying less attention to it seems to have been working for me the past few years. Not what my esthetician would have initially recommended, but it's working for me.

If you might have a physical or medical problem contributing to the itchy sensations, might be worth trying to address the underlying issues, with the help of a qualified medical professional. While the urge may not disappear completely, getting rid of such a trigger will likely go a long way towards reducing the frequency of the behavior.

Good luck!
posted by quinoa at 11:10 PM on November 26, 2012

I use Cetaphil, and I have a body soap for people with eczema (you can get it at CVS) that is hyper-moisturizing. I had problems with makeup and so I went to a store and asked them what to get. If you want to wear makeup, I would recommend being willing to pay for it to get something that works. I use Clinique and I mix it with moisturizer. Then I take it off right away when I get home. Neutrogena products are advertised as being gentle, but they absolutely make my skin break out.

I think you are right that having more moisture in the skin might help. I know when I have been in moisture-heavy climates, my skin has been much better and a lot of the problems cleared up. Maybe a humidifier would help.
posted by ramenopres at 5:53 AM on November 27, 2012

This is my favorite "fidget" these days -- the smaller size of the Tangle toy. It's pleasantly bumpy, which might give your fingertips the texture they're seeking, and it's small enough that you can keep one in your pocket, one on your desk, etc.
posted by The corpse in the library at 10:13 PM on December 1, 2012

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