Need help with skin picking and healing scabs...

October 1, 2014 5:19 AM

I've been picking at my legs for a year and a half now and I think I could stop if I could just get my legs healed. Looking for suggestions of healing scabs faster and keeping myself from picking.

Anonymous because I'm so embarrassed.

About a year and a half ago I started picking my legs. It's mainly my thighs because that's the area I can see when I sit down on the toilet.

I think it started because I was on a high dose of iron that made me pretty constipated and while sitting on the toilet for a long time I got bored and starting picking at my leg hairs/follicles. I now compulsively pick when I use the bathroom and am having trouble stopping (and am no longer taking iron so I have no reason to just be sitting there). To be fair, I was diagnosed with mild OCD as a child (around 8 or 9 I think) but haven't seemed to have problems with that in particular until now (although I've always been a zit picker). Although, now as I write that, I do realize that I have always found comfort in leg hair plucking with tweezers. Full disclosure: I'm on medicine for generalized anxiety disorder and major depressive disorder.

It's not just the scabs, I also feel bumps on my legs and squeeze them because I'm sure its a hair caught under the surface (which most of the time is true but the squeezing also results in a scab because the skin doesn't want to be opened and then bleeds). I will use tweezers to do this sometimes which causes even more damage.

I think I could stop if I was able to get my legs free of scabs but it's much harder than I thought it would be. I've been to my PCP and showed her and told her I was worried that I had caused infections in my skin. She gave me an oral antibiotic that I was hoping would help me heal up but no dice.

Also, any advice on how to stop? It's disrupting my life because I refuse to wear anything other than pants. I'm happy summer is over but I don't want to let this go any longer.

Completely open to any and all suggestions on how to stop and also how to heal up the damage that's already done.

Thanks so very much!

posted by anonymous to Health & Fitness (21 answers total)

My first thought when reading the title of your post was, OCD. I'd check in with my doc and discuss the compulsion to pick with him/her. You may find help in Cognitive Behavioral Therapy, or a different medication, but your first stop should be a medical professional.

This isn't about your legs.
posted by Ruthless Bunny at 5:25 AM on October 1, 2014 [1 favorite]

What about having something else to occupy you while you are on the toilet? Something to fidget with that is also easy to clean because... toilet.
posted by PuppetMcSockerson at 5:33 AM on October 1, 2014

I have a similar issue. I agree that it's not about your legs, but healing the scabs and having a smooth skin surface gave me a reprieve where I could work through my issues without picking.

My GP gave me topical steroids for scabs on my scalp. I committed to not picking for 48 hours (and had to trim my nails and wear gloves to make it), which gave the steroids time to work.
posted by third word on a random page at 5:33 AM on October 1, 2014 [1 favorite]

Yeah, talk to your family doctor. I had a spot I couldn't stop picking at (just because I hate scabs) and she gave me an anti-biotic cream (even if infection wasn't the original problem, she said the staph etc. on your skin keeps it from healing quickly) to use until it cleared and a cortisone (i.e. topical steroids) cream to start a couple of days after that. In two days there was no scab.
posted by If only I had a penguin... at 5:38 AM on October 1, 2014

Have a stress ball in the bathroom with you. That or silly putty. Train yourself to keep your hands busy in another way. I too felt the relief of hair pulling with my mild OCD. I fall back into it every once in awhile. I am prone to ingrown hairs as well. Using lotion on my legs helps. Dry skin makes ingrown hairs worse (hey! that's something else you can do on the toilet, moisturize!). The thing that works best for me is crocheting. I get the textures and pull that I need, as well as the obsessive counting and focusing on pattern, without doing any damage to myself. Many local libraries have crochet and/or knitting clubs with people in them who would be happy to teach you.
posted by myselfasme at 5:41 AM on October 1, 2014 [1 favorite]

Could you maybe bandage your legs to keep the area covered for a couple of days?
posted by Omnomnom at 5:44 AM on October 1, 2014

Moisturiser definitely. I'm using Beeminder right now to reduce this (my feet! you would think when you leave bloody footprints that you would stop picking, but it is such a stress relief, I feel your literal pain) and that helps because I hate failing at Beeminder. Find someway to reward yourself for streaks - go three days without picking and you get a treat, a week with only one picking, another treat - so that when/if you fail, you can get a small win quickly to get back on healing again.

I hide tweezers and am trying to redirect. It flares up when I'm stressed. What has helped recently is hair brushing - I have tangled long hair so that takes time to brush and then plait, which is soothing. Can you keep a comb in the bathroom? Or painting my nails. Something that is tactile and finicky but neutral or positive, unlike the picking. You might try booking regular massages or feet rubs for tactile comfort as well.

The antibiotic ointments make things heal much faster, as do neosporin type bandaids, the pricer ones with special gel. Wearing socks to bed has helped me a lot too and moisturiser inside the socks makes for much quicker recovery. Could you heavily moisturize your legs before bed, and wear pjs (laundered the next day) so that your skin can soak it up overnight?
posted by viggorlijah at 5:52 AM on October 1, 2014 [1 favorite]

I do this too, especially in the winter. Everything others said is good. Keeping my skin moist generally, and keeping antibiotic cream on the scabs (you could reapply in the bathroom as your distraction!), definitely helps. I also keep my nails short and sometimes wear gloves to bed so I don't pick at night.
posted by mchorn at 6:03 AM on October 1, 2014

I don't know, I'd say avoid moisturizer to start, because it could be too easy for you to move from moisturizing the area to picking at it, and focus on physically limiting how much you're touching your legs. Can you put a towel on your lap at home? Do you have a smartphone you can play games on?
posted by deludingmyself at 6:22 AM on October 1, 2014

There has been a lot of work in recent years on this habit, the hair pulling habit, and the nail biting habit. These are all considered similar habits springing from similar reasons, etc. There are various theories out there, blah, blah. What you may want to try is habit reversal training. I'm a nail biter and recently bought a book for teens about stopping hair pulling (there is nothing available about HRT for nail biting because it is considered the mildest and least harmful of the habits). I bought a second book on habit change in general for adults.

I love the one for kids (I do not like books that spend a lot of time on what I consider "small talk" and generally kids' books get right to the point) and I just substitute "nail biting" for "hair pulling." I plan to read the one for adults as well, because it covers multiple kinds of habits - including all three of the habits mentioned above.

The books are:

"The Habit Change Workbook" (that's the adult one)
"The Hair Pulling Habit and You"

Some may say OCD, but from what I've read, these 3 habits are not quite the same as OCD.
posted by AllieTessKipp at 7:13 AM on October 1, 2014

My daughter has trichotillomania, and skin picking is a similar body focused repetitive behavior disorder. They are difficult disorders to treat, because while they seem like they are related to OCD, I've been told they are more impulse control disorders. And while they are associated with anxiety, picking and pulling also frequently occur when relaxed, in a sort of mindless way.

Cognitive behavioral therapy can be helpful. Definitely something to keep your hands occupied can also help a lot. A lot of parents on forums I belong to report good results from supplements. N-acetyl cysteine and inositol are the two most frequently used. We've tried NAC and it has helped a bit, and we're about to try the inositol.

In terms of helping your scabs heal, I wonder if Bio Oil or Mederma, both of which are supposed to help with scars, might help with the healing, also.

Good luck, and feel free to message me if you have any questions!
posted by Bresciabouvier at 7:33 AM on October 1, 2014 [1 favorite]

Dermatillomania - trichotillomania - StopPickingOnMe.com - Skin Picking Strategies
posted by flug at 8:46 AM on October 1, 2014 [1 favorite]

The first thing that ever made a serious impact for me--has given me the space to allow anything to change habits--was about 1200mg of N-acetylcysteine a day and making sure I don't let myself get over-tired, because getting worn out seems to make it worse. But the NAC has been a big deal.

This is definitely not OCD, it's its own thing, but it's hard to find mental health professionals who have experience with it.

While you're starting on it, wear long pants all the time, literally, except when you're in the shower, and do everything you can to keep your hands off your legs. If you're going to wash the area, use a puff or a washcloth. Don't let yourself get to the point where your fingers are looking for something to pick at--that's a little easier. Don't look at it, don't make physical contact directly with your skin until it's healed up a bit. The pattern to look to break is that thing where you run your hand over it feeling for bumps, that thing where you start peering at a spot wondering if there's something there, not just the actual act of picking.
posted by Sequence at 8:47 AM on October 1, 2014

YMMV but I find vitamin e ointment practically magical for healing that kind of small pick to smooth on a couple of days
posted by platypus of the universe at 9:26 AM on October 1, 2014

I used to be a bad acne picker and I finally just stayed in for several days with Neosporin-soaked bandages covering my face until all the sores/scabs healed. So my advice is to cover up your scabs with antibiotic ointment and large bandaids/bandages so you can't see or access them.

Also, keep your nails trimmed really short so that it's harder to pick at anything.
posted by Jacqueline at 10:09 AM on October 1, 2014

Obviously, I'm not your doctor or dermatologist, but your description of the nature of the bumps that you like to pick sounds like keratosis pilaris, a fairly common condition where extra keratin is deposited in the follicle. I have this and it's hard to resist picking the plug and trapped hairs out to make the skin smooth again.

In addition to wearing a physical barrier like pants that blocks my absent-minded feeling and picking, two products have really helped to reduce the bumps and promote healing. I use both, but not at the same time. After a shower, I slather on Gold Bond Ultimate Rough & Bumpy Skin Daily Therapy Cream. It's a new cream and I like it better than the better-known AmLactin. I feel like it's stronger and more effective. Then, usually before bed, I wipe my skin with Stridex Maximum Pads (the ones in the red box). The use of these two products has changed my skin radically and my picking is greatly reduced because there's nothing to pick. Both products will also help reduce the post-inflammatory hyperpigmentation that happens after the scab finally heals.

Maybe during the times that you'd normally be picking, you can start a regimen of applying either of these products as a replacement activity. Both products need time to dry/be absorbed, so that may also be a deterrent to picking.
posted by quince at 10:10 AM on October 1, 2014 [3 favorites]

I have a skin/scab/zit picking problem (all over) and after spending all summer with gross looking bloody fingers I've stumbled on a workaround: I paint my nails, then pick all the polish off, over and over. Fiddly enough to meet that need, allows my skin to heal. YMMV.
posted by ApathyGirl at 2:06 PM on October 1, 2014 [1 favorite]

Just to clarify, when I said my doc gave me an anti-biotic ointment, it was prescription stuff, not neosporin/polysporin, which I had tried and didn't work nearly fast enough to help.
posted by If only I had a penguin... at 3:46 PM on October 1, 2014

I did the same thing - hair pulling and skin picking - for a huge chunk of my life. I know therapy or meds are the go-to, but you can stop on your own too. The more you resist the urge, the less you have it after a while. If you're used to picking at your skin or whatever every single time you go into the bathroom, then it's a habit and it can be broken. I know.. I used to get lost and spend hours picking at pores, pulling hairs, etc all that OCD-ish stuff. And scabs.. don't get me started. I was born a scab picker! You're not completely out of control. Like any habit, it can be broken.

As for healing the scabs.. short-term, sorry I can't help. Vitamin E is supposed to be the big skin-healer but I can't verify its effectiveness. But if you have permanent scars from old scabs, a TCA chemical peel will help. A few rounds, actually. If this is something that sounds remotely interesting to you, you have to do a lot of research on it. Chemical peels are not something you do casually. I've tried a lot of products for old scars and most of them are crap. TCA will gradually get rid of that scarred layer of skin. Another thing for old scars is hydroquinone. It is a known carcinogen and you'll have to search for a product that carries it. The ones that do will have no more than 2-4% of it in a cream. It is basically a bleaching agent that's supposed to lighten the hyperpigmentation of scars. I tried it before but didn't use regularly so again, sorry I can't verify its effectiveness.

Again, I can't tell if you only mean current scabs or old scars so all of that might be useless to you.

One more thing... if hair picking is such a problem, you might consider having it permanently removed, although that's a pretty expensive solution.
posted by atinna at 4:20 PM on October 1, 2014

I have had this exact same problem off and on (also on the toilet!), and I also had issues with compulsive leg hair plucking in the past, so I feel like our brains are probably going haywire in a very similar way.

The main thing that has helped me is using AHA treatment for reducing the bumpiness like quince recommends. Amazingly when my skin is not so maddeningly bumpy the need to pick just goes away. This was a big surprise even to me since the picking is clearly also stress related, but if my skin is smooth enough I don't feel the urge to go hunting for ever smaller bumps, I just give up.

I have only tried amlactin. It works for me, but the other options quince mentions sound great too. The only caveat is that it takes weeks to work, so it is not really a short term solution. (Also if you stop using it it takes a month or more for the bumps to come back, so beware of getting lazy and ending up right back where you started). But the good news is that it has really really helped me, so there is hope for a smooth legged future!
posted by insoluble uncertainty at 4:30 PM on October 1, 2014

This is a thing for me.

It's a challenge to not feel absolutely insane over bumps and catches in my skin. My approach is management over treatment; I find putting band aids over problem areas until they heal very helpful. I use the little circle-spot ones. I also have lace gloves for when the compulsion is very bad, and a number of fiddlethings to keep my hands busy.
posted by robot-hugs at 2:21 PM on October 2, 2014