Finger-picking not-so-good
September 23, 2014 3:56 AM   Subscribe

My nearly-three-year-old daughter is developing/has developed the habit of picking at her fingers. What have you used to stop your toddler's harmful habits?

My darling little toddler daughter has a somewhat nervous disposition, and - like me - is an inveterate fiddler of one thing or another most of the time.

Over recent months, this has taken a more troubling turn, however: she has started to pick her fingers, not in anxious moments, but more in idle moments. She is not picking the cuticle or nail, but the skin itself on the bottom and sides of her fingers.

This perturbs me, for two reasons. One: she has picked a couple of fingers so badly that got infected, swollen and sore. Two: my own sister developed a finger picking habit in childhood that she never shook and compulsively tearing at the skin on her fingers has wrecked their appearance and been painful, and been a long term source of shame and unhappiness for her.

We took our daughter to our family GP, who duly prescribed some antibiotic cream, but brushed off our broader concerns - she is often like this, a trait that we generally value as reality checks from medical professionals can be useful for parents, but I feel like she does not appreciate the potential in this particular situation (obviously no one in her family with itching/skin issues!).

We are thinking a trip to the paediatrician might be in order, but before we go there, I thought I would open it up to the hive mind. Have you had issues like this with your toddler? What tactics have you used to overcome these habits? We want to stop this before it becomes a full-blown thing, and we don't want to do something that inadvertently exacerbates the problem or gives her a complex. Current approach is to redirect to playing with her "bear" (her security blanket, which she also likes to play with).

Note: Both she and I have eczema. But the areas in question are not affected by the eczema, and please assume we have a great understanding of eczema and its treatments.
posted by smoke to Health & Fitness (25 answers total) 3 users marked this as a favorite
Don't tell her not to pick. I know it sounds counterintuitive but you will create a bigger problem if you make her feel sad/ashamed/upset about picking.

Since she's a toddler and you're already watching her All The Time, you kind of have an advantage. Redirection is your friend right now. Have a basket of sensory toys/fiddley toys that you keep out of reach. When she starts picking, let her choose a toy. Once she gets the hang of it, you can put a smaller basket out with just a few (rotating) sensory toys that she can go to on her own.

But seriously, kids are super sensitive to adult angst (it's their survival mechanism!) and any upset you project about this is going to amplify the problem.
posted by PorcineWithMe at 4:37 AM on September 23, 2014

Response by poster: Don't tell her not to pick.

" Current approach is to redirect".

I don't want to be the grinch who stole, here, nor sound dismissive of your answer, but I would prefer not to let this derail other answers. We are not telling her not to pick, as stated in the question.

I'm really interested in hearing what worked for other parents, not so much what didn't, but thank you, over and out.
posted by smoke at 4:47 AM on September 23, 2014 [4 favorites]

It's called dermatillomania, and it's a thing. For lots of concrete advice from other parents in the same boat, see the always useful files of the Berkeley Parents Network. The current entries are a little old, but you might consider joining the email list and asking your question there in order to hear from other parents who are dealing with it right now. It's very Berkeley, so be prepared for at least one person to tell you that going gluten free will solve it all, but most of the time you get good, useful, and informed advice.
posted by pleasant_confusion at 5:18 AM on September 23, 2014 [2 favorites]

I have kids who pulled hair and I pick at skin when stressed. It can be an OCD symptom if you're noticing other thing, but is usually anxiety, a more common disorder that's easier to treat. A child therapist like play therapy can give you and her ways to healthily soothe and redirect from skin picking.

I would note it "you're picking at your eyebrows, sweetie," and then ask soothingly about anxieties and offer alternative comfort like a hug, back rub, cup of hot chocolate, watching a favourite film in bed until the kid was calm and secure again.

Three is an age when they can start labeling emotions like fear and worried and you can suggest healthy habits to handle anxiety. Personally I plait my hair and drink tea when I notice I'm picking at skin, but it's a hard habit to break.
posted by viggorlijah at 5:20 AM on September 23, 2014

interested in hearing what worked for other parents

I stopped doing that when my dad bailed out. I didn't do it when he was on business trips. My son started picking after my divorce and stopped after telling me about something horrible that happened to him when I had zero custody. Knew it was something. Just kept gently pressing.

Boy was picking in bed with me one cold morning and said that any rough or sharp spots on his fingers really bother him and he just has to get them off. Smooth them out. The thing I said that got me some traction was "What happens in your head, what do you think about right before you do that?"

His calm answer turned me into "Daddymonster."

This behavior is about stress and releasing endorphins. You could spend lots of money on therapy and duct-taped mittens or you could identify the source.
posted by Mr. Yuck at 5:36 AM on September 23, 2014 [2 favorites]

Sorry- didn't see that you weren't telling her not to pick. And, I meant having fidget toys, like this for her to play with to get the movement out. Her bear and blanket might not be fidgety enough. I should have linked in my first response. Having fidget and sensory toys helped for my child when she was displaying OCD type behaviors like spinning and patterning.
posted by PorcineWithMe at 5:55 AM on September 23, 2014 [2 favorites]

Fidget toys are great. Play dough is good too.
posted by viggorlijah at 5:58 AM on September 23, 2014

This is anxiety and i find myself doing it when i sit and fester. What helps me is other movement while i mentally untangle myself, i.e. go for a walk while thinking instead of ripping off skin. There seems to be an element of couch glue involved, and if i can break free from that, the picking is easier to consciously stop.
Maybe try asking if she wants to take a stroll around the yard or come help you do something in another room, etc. when she starts picking.
posted by WeekendJen at 6:15 AM on September 23, 2014

Yup, she needs something else to play with to keep her hands busy. Sand Animals maybe?
posted by capricorn at 6:28 AM on September 23, 2014

I understand the desire to get her to stop picking, and infections now are an issue, but it doesn't necessarily follow that she'll be ashamed and unhappy about it if it persists into adulthood.

I've picked since childhood (combination of anxiety and hating the sensation of excess/rough skin in certain places - my dad does it too, interestingly) and also have some other gross-ish compulsive body-related habits, but none of them cause me shame as an adult. I'd much rather have ruined nails and the comfort of the habit.

I wouldn't claim to be a picture of good mental health, but if this turns out to be something that she doesn't shake, it isn't necessarily going to be a source of anguish later in life for her.

As these behaviours can be linked to anxiety/other obsessions or compulsions, though, it might be worth keeping an eye on those things as she gets older. I'd rather my parents had hooked me up with mental health treatment as a reasonably young kid (which I needed then, and which I need a lot more now, partly due to not getting some stuff sorted out earlier) than putting all their time and effort into worrying and nagging me about the stuff I was doing with my body to get a couple of seconds of relief.
posted by terretu at 6:41 AM on September 23, 2014 [3 favorites]

You've probably seen taggies blankets, which have tons of texture ribbon tags for kids to fidget with? With about 15 minutes of work and a little sewing, you can whip up some "taggie pins" or "taggie bracelets" where you use soft fleece and a piece of ribbon folded like a tag and create a SMALL taggie that you can pin to her shirt with a safetypin, or wear on her wrist (velcro or tie closure). Call it her "Fidget Bit" or something and say something like, "Ooooh, your fingers seem fidgety, do you want to use your fidget bit?"

You will have to remind her to redirect her in this scenario rather than just putting something in her hands, but the goal is to help her learn to redirect herself to her fidget bit when she notices herself picking at her fingers, by remembering she has something she likes to fidget with better. But you can do that without shaming; just offer it as an option.
posted by Eyebrows McGee at 6:51 AM on September 23, 2014 [2 favorites]

I do this and do have some issues with anxiety. However if I'm picking at my skin, it's usually not because I'm feeling anxious in that particular moment but tends to happen when I'm bored and don't have anything to distract me. So giving her things to fidget with especially in idle moments might help. Stress makes it worse, but sitting around bored will leave me with terrible fingers more than anything else.

Part of it too is just that I hate the way it feels when I have any imperfections in the skin that might rub or catch on things, so it's weirdly satisfying to get rid of them. Like popping a pimple or something. If my hands are in good enough shape that the skin isn't cracking and there aren't any hangnails anywhere I generally won't feel the urge as much. Or if there is a hangnail, covering it with a bandaid or clipping it off with nail clippers so it's smooth with the skin (instead of tearing it off and making a huge sore) helps curb the urge to pick it off.

And some of it is just a weird sensation I get in my fingers ever since childhood, almost but not quite like an itch in the cuticles/tips of my fingers that I just have to address somehow, whether by picking or just putting some pressure on my nails. No idea if it's normal or just something some people get that makes them more prone to this.
posted by Kimmalah at 6:57 AM on September 23, 2014

1. I am an inveterate adult skin-around-the-nails picker and am currently trying to reform. It's absolutely anxiety related, but does crop up more in moments of being idle. However, I have been shocked by how hard it is to stop. I feel a little scratchy place, or see a little loose place and I sit there and verbally order my other hand not to pull on it and damned if that hand doesn't just do it anyway sometimes. So, this may take time.

2. Although everyone's correct that this is in some way probably related to anxiety, this does not necessarily mean your kid needs therapy. Of course consider it, but there's a lot about the normal life of an almost 3-year-old that's anxiety-inducing. Imagine if you had that little control over your life, were frequently loaded into vehicles without knowing the destination, were instructed to eat a bunch of unfamiliar crap you didn't want, were scolded for doing fun things, et cetera. It's hard work being a toddler!

3) Can you try on a daily basis to look at her hands and try to smooth out any rough bits, apply lotion, et cetera? When I have a little sharp bit of skin, it bothers me, and I rub it with another finger, and it intrudes on my mind til I pick at it. Nothing to pick = less need to pick.

4) I like the idea of fidget toys and I'd like to see folks in the thread recommend specific ones. I might get some. For, um, a friend. It seems to me like ones where you use your fingertips might be the most effective. Does anyone know of fidget toys to sub in for a picking motion?

5) This depends heavily on your daughter's developmental stage, but I think you can discuss this with her in a non-shaming way. If it was my kid, I'd have a conversation that involved statements like, "Hey, remember when you pulled the skin on your finger and it got really sore? That made you sad, and I was sad too. I don't want your finger to get hurt again, so let's try not to pull skin, ok? If something on your finger is bothering you, show it to me and we'll try to fix it together." I had basically this conversation with my son after he pulled a piece of dry skin on his toe and it ripped down deep in the flesh (don't you hate it when that happens?...) Then you don't harp on it, but you can pair the redirects with gentle reminders. "Oh, should I trim that/put some lotion on it? Now here's a toy I bet your fingers will like playing with. "

On preview: I also am not particularly ashamed by my habit(s), I've just been reading a few of the "how to look like a REAL grownup" threads on AskMe lately, and am simply trying to attain more attractive fingertips.
posted by telepanda at 7:01 AM on September 23, 2014 [1 favorite]

It's probably worth adding that I had other bad habits as a child like nail-biting and nose picking that my parents tried hard to break by scolding me every time they saw me do it. But instead of stopping me it just meant that I learned to wait and do it when they weren't around or I was by myself. I just kind of grew out of on my own and it's always possible that she will too. Even now I find I do the skin picking less and less as I get older (late 20s now).

It hasn't really been a problem as an adult except that sometimes I'm a little self-conscious about how my fingers look. And looking back at the original post, I also have problems with stuff like eczema in case that means anything.
posted by Kimmalah at 7:12 AM on September 23, 2014

My brother and I were both finger pickers. My brother a picker + chewer. My parents dealt with both of us by yelling at us to quit picking, which you're not doing, which is awesome. I managed to substitute for it well by ALWAYS having some sort of fiddly toy in my hand to play with. My brother wasn't allowed to have the fiddly toys to play with because his grades weren't as good as mine and everyone assumed that the toys were a distraction. Guess which one of us doesn't have a finger picking/chewing problem anymore? Guess which one of us does?

Toys that worked really well for me:
Little spring-loaded clips that I could squeeze (in fact I'm playing with one right now!)
Tiny cars or figures, like micro machines cars or itty bitty plastic dinosaurs
Two or three key ring loops attached to one another

Toys that did not work well because they were too distracting:
Anything squishy and moldable, like a small piece of clay
Anything large enough to require two hands to play with
Things like legos that (again) require two hands to use

Even today not having a thing in my hand to fiddle with is a sure way that I will destroy my cuticles or nail polish or cup lid or whatever happens to be in front of me.
posted by phunniemee at 7:16 AM on September 23, 2014 [1 favorite]

This isn't precisely related, but when I was her age, I had a habit of sucking on my finger as an anxiety reducer. It was a problem because it was causing my teeth to change positions and actually physically rotating my finger's natural position because of how often I was doing it.

My mother used 2 strategies to get me to stop. #1, she had me wear a sock on my hand to remind me not to put it in my mouth. #2, she got one of those big 'reward chart' things and put a sticker on for every day that I didn't suck on my finger. After I got to a certain number of stickers in a row, I got to go to a toy store and pick out a special reward (I chose a My Little Pony!) This was extremely effective particularly because I did not have the type of parents who would just randomly buy me toys, this was truly a special occasion.

These strategies were used when I was more like 6-7 years old, so they are probably beyond the capabilities of a 3 year old, but I thought I'd offer them up in case the concepts were helpful since the behavior was quite similar, and it did work. Unfortunately I still needed braces for my teeth by that point. I still have other habits like this as an adult but I'm able to control them to the point where they're not a major issue for me.
posted by treehorn+bunny at 7:25 AM on September 23, 2014

IANAD, but by way of doing various reading on the inherited medical stuff in my family, something that stuck out in my memory was the self-reported relationship between skin picking, nail biting, and/or trichotillomania and food allergies. Eliminating the right foods seems to have caused some people to stop these behaviors. Food allergies can cause anxiety, so that could be the underlying cause of the anxiety piece.

My n=1 horse in this race is that I was a chronic skin picker (little skin bumps) and hangnail chewer from early childhood on. I found out I cannot tolerate wheat and I am a lot calmer now. Interestingly, I think my fingers are less dry and produce fewer hang nails and frayed cuticles now that I've changed my diet, so even if I have a moment of stress there is less to go after. I've seen this change in members of my family who are in various stages of adjusting their diets as well. It's kind of fascinating.

Good luck, I know it was very stressful for my family to watch me go after my skin as a kid, as it was for my to watch one of my daughters do it (she's 9 now and has stopped with our diet change. I never fussed at her).
posted by Lardmitten at 7:26 AM on September 23, 2014

Another skin picker here. In contrast to some of the other commenters above, I am horribly embarassed by it, and am, in fact, picking at my feet right now as I type with the other hand from the anxiety of admitting to this. But I want to help you, and your daughter, move past this.

I primarily go after my feet - toenails, the skin around toenails, soles, and heels. However, I'll get going on my fingers, too - fingernails, skin around them, cuticles. I vividly remember being yelled at for it when I was a kid, which resulted in more anxiety, which led to more picking. So I'm really glad you're not doing that.

What you want to do is help her find other means of self-soothing. (That's what you want to google for.) For me, rocking, singing, and tapping all help. What works for one person won't necessarily work for another, though, so you'll want to explore a variety of different options via the google, to help your daughter find something that works well for her.
posted by The Almighty Mommy Goddess at 7:36 AM on September 23, 2014

We got my son a bag of small polished rocks. Every morning, he picks out a rock and puts it in his pocket. If he has the urge to pick at his fingers (he would also pick around his mouth) we taught him to take out the rock and rub it like a worry stone. Took about a month and now he does neither picking nor the rock worrying.
posted by Jacob G at 10:11 AM on September 23, 2014

Apologies if this is too obvious, but the pediatrician will be more in tune with toddlers' issues than the GP. I suppose it was travel time or appointment availability etc. that led you to the GP instead of to the pediatrician.
posted by JimN2TAW at 11:06 AM on September 23, 2014

I have this/do this and did it much more frequently as a kid (I was a big finger picker and inside-of-cheek chewer). Like your daughter, while mine may have been anxiety related on some level, it was not something I consciously did when feeling anxious. Instead I mostly did it when I was bored. I most associate these behaviors with church and other situations where I was asked to sit quietly with nothing to occupy me for long stretches, for the sake of what the adults in my life wanted to do.

From the perspective of your situation right now, I'd suggest giving her something specific to occupy her when you notice her doing this. Especially something she could do with her hands, even if it's an iPhone game or pen and paper to draw with. You could especially concentrate on the patterns of when she tends to do it, and avoid long idle stretches of time. In fact, I would say that if you ask a lot of her in terms of attention span and being still/quiet while the grownups do X or Y thing she can't meaningfully participate in, that's probably the source of all this and you should be more mindful of that.
posted by Sara C. at 11:33 AM on September 23, 2014

A lot of people with dermotillomania/trichotillomania pick when anxious and when bored, but boredom is a form of anxiety for some people too (aimless mind-wandering and rumination). So I would start thinking about this more generally as a symptom of anxiety and not just a bad habit.

Redirection is good, but I would also start with toddler-appropriate approaches to anxiety management. The little-kid version of cognitive behavioral therapy, whatever that is (I don't know but I'd guess it has to do with naming worries and acknowledging them). Maybe this will be her only symptom, but she could also be prone to fully-fledged OCD and you can't lose by teaching her skills that will come in handy for the rest of her life.
posted by epanalepsis at 2:01 PM on September 23, 2014 [1 favorite]

I do this to a certain extent, although not so bad it's ever caused permanent damage or scarring.

One small thing I find helps me is to keep my hands well moisturized and to immediately trim any little dry or hanging skin. Basically you want a smooth surface where there is nothing to "catch" your nail on that you then want to pick at. Some goes for picking at my nails. This does take pretty much daily maintenance, although not more than a couple minutes. I don't know if this will help your daughter but I doubt it could hurt to try.
posted by whoaali at 8:23 PM on September 23, 2014

One small thing I find helps me is to keep my hands well moisturized and to immediately trim any little dry or hanging skin. Basically you want a smooth surface where there is nothing to "catch" your nail on that you then want to pick at. Some goes for picking at my nails. This does take pretty much daily maintenance, although not more than a couple minutes. I don't know if this will help your daughter but I doubt it could hurt to try.

I am a terrible and chronic picker and yes, this; it's the desire to tidy things up. So keep'em tidy and the desire won't be there anywhere near as much.
posted by Sebmojo at 9:19 PM on September 23, 2014

Response by poster: Thanks, all.
posted by smoke at 4:48 AM on September 25, 2014

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