To pick or not to pick.

January 21, 2007 3:42 AM

Compulsive skin picking filter. When does skin picking become a problem?

I pick at my skin. I'll spare you all the gruesome details, but suffice to say I pick at various things on various places on my body. I do this both unconsciously (picking at my lips while reading a book), and quite deliberately (before bedtime, picking at pores on my face/chest). It does not interfere with my daily life. I'm not terribly concerned with hiding red marks, and I don't often scar myself.

I've done some research online regarding compulsive skin picking, and while I match a lot of the symptoms, one of the major things that defines it is how it interferes with the picker's life. My SO (hi, honey) is somewhat disturbed by the picking, however, and his concern fuels my own. So my question: when does skin picking become a problem and not just within the range of normal behaviors? Am I making excuses for a behavior I want to continue in, or is it really just as harmless as it seems to me?

No "go see a doctor/therapist" replies necessary. I am in therapy, and when I mentioned skin picking to both my therapist and my psychiatrist neither seemed concerned. I intend to bring it up again in my next session, but in the meantime, what say you, hivemind?

Details that may or may not be relevant: I am on meds for both anxiety and depression.

posted by rosethorn to Health & Fitness (11 answers total)

All the great apes self-groom. Don't sweat it.
posted by flabdablet at 3:57 AM on January 21, 2007

Skin picking is generally linked quite closely with anxiety. If it worries you, trying and direct that nervous energy somewhere else, maybe squeeze a stress ball?
posted by Orrorin at 4:43 AM on January 21, 2007

My email is in my profile. I have a lot of insight.
posted by gokart4xmas at 4:44 AM on January 21, 2007

I;d say it only becomes a problem when the places you are picking are unable to heal and/or scar over. If you are continuously picking at scabs over and over again this will happen. If you are like most people and carry a small amount of bacteria under your nails, infection could be an issue.

Bring it up with your therapist again. If you are concerned about it and they don't address your concerns, that is a problem. (Addressing your concern with the problem is not the same as addressing the problem. Obviously, this is a symptom of something else, not a problem in/of itself.)
posted by Brittanie at 4:51 AM on January 21, 2007

It is a problem the moment you decide it's a problem, and not a minute later. If you are uncomfortable and wish to stop making your SO uncomfortable, this would be an appropriate time to seek some sort of behavioral therapy and get to the bottom of why you pick your skin. It might be anxiety, but it could be other things.

If you suggest that you are seeking help for this and someone tells you it's not a problem, please evaluate whether you want them in your life. Your perception of a problem needs to be taken seriously. And you certainly have a right not to need to convince others that your problems are "real."

If you don't think it's a problem, which I think you might be on the fence about, then it's not your problem. It might be a problem for your SO, which might be awkward. You might find ways to help solve his problem, for instance by not picking when he's in the room.

(I pick too. Just at the face parts and around my fingernails. I try not to do it in public, but sometimes I find myself excavating the beginning of a hangnail. I don't think it's a problem except when I catch a cold or get a hangnail infected. Then I realize that picking introduces extra germs into things. Ew.)
posted by bilabial at 5:00 AM on January 21, 2007

I agree that the picking could be a way of dealing with anxiety. There's something about it that works for you; in other words, you're getting some kind of relief or even 'high' (as strange as that may sound, you're definately not alone) from it that helps you deal with...or avoid dealing with...your feelings and anxiety. Even if it's not the best way of coping, if it works for you and isn't causing significant or lasting harm, then it may not be a problem. However, the fact that your SO is disturbed by it means that it needs to be addressed. And, as a counselor myself, I DEFINATELY agree that your concern over the issue should be taken seriously by your health care professionals, whether they personally have a problem with it or not.
posted by applebomber at 10:49 AM on January 21, 2007

I am a diagnosed OCD-er, and I most definitely suffer from full-fledged dermatillomania. [Read: This is going to be long.] As far as I am concerned, and of course this varies with the areas of your body you are picking, it's a problem if you do it until it bleeds. Compare it to chewing your fingernails--chewing your fingernails a little when you are nervous is no big deal. You don't have to clean up any messes, you don't have to hide it from anyone, etc. Using myself as an example, let's say you pick at the dead skin on your lips. Let's say you do this until it bleeds. Then you have to worry about hiding your mouth from those around you until the bleeding stops, you have to worry about cleaning it up, you have to get up and get a paper towel or something to wipe the blood off. Now, this does not "interfere with your life" by making you unable to drive a car or something because you're picking too much. However, you can't honestly say that if you weren't picking at your mouth, you would still have had to do all the things I just mentioned.

This happens to me on a regular basis. I work in a public library, and have honestly had to excuse myself to the restroom while on the front desk in order to clean up my bloody lips. I do the same thing with cuticles, blemishes, scars, etc. If this sounds familiar to you--picking until it bleeds on a regular basis, regardless of who you are around/where you are--then it's probably a problem.

Another large factor is why you do it. You said you do it unconsciously. My question is, when your SO brings it up ["Stop, honey, you're going to hurt yourself!"], are you able to stop? Or do you say something like, "Hold on, I just have to get this one little piece of skin..." and ignore his/her request? If it's more like tapping your foot to the point of annoying someone, and stopping when they bring it to your attention, you're fine. If you can't seem to stop until you hit the satisfactory level of smoothness on your lips/face/chest, it's probably a problem.

Do you have any symptoms of OCD? While it's quite possible to have one without the other, I have never met someone in "real life" that only had this compulsion.
posted by starbaby at 12:40 PM on January 21, 2007

I pick at my skin to about the level that you do and have my entire life. I also pull out my hair, almost but not quite to the point where I have bald patches. In my case, I see it as a mild form of OCD, mostly from casual internet research I've done into "the OCD spectrum". This is basically the idea that OCD, trichtillomania (hair pulling), skin picking, and a few other disorders are all related and stem from, essentially, anxiety. If you're already on meds for anxiety, you might want to talk a little bit more to your psychiatrist, especially if (and only if) you can tell them that you notice yourself picking more when you feel anxious. Your therapist should be able to help you with this problem as well. Now, this is assuming that you feel like you have a problem. If you feel like your picking isn't a big deal, then it isn't, whatever your boyfriend thinks. In my case, I feel like I have a problem because I'm leaving permanent scars and calluses on my body. You are the only person who can decide whether you have a problem, because it really is a personal decision where you draw the line. Good luck, either way.
posted by MadamM at 1:50 PM on January 21, 2007

I am a mild skin picker and I will say this: you might not scar or get red spots often now, but as you get older the likelihood of those things happening gets worse (at least on your face). So it might be worth trying to control simply to prevent the anguish of realizing that you've given yourself an ugly scar (or simply the fear that you might have).
posted by ch1x0r at 4:09 PM on January 21, 2007

MadamM: thank you for giving a name to something I've dealt with for fifteen years. I had no idea other people suffered from these sorts of disorders and I'm just completely floored.

When I was in primary school (about the age of eight), I constantly washed my hands. My parents revealed to me a couple of years ago that, at that time, a therapist diagnosed me with OCD. Medication was recommended, but my parents eschewed that and instead designed what you could call a positive re-inforcement strategy, which I remember vaguely. I had a weekly chart, and every time I managed to not wash my hands they would give me a silver star. If I managed a certain number of stars, I got a gold heart. By the time I was nine, I no longer hand-washed (well, apart from legitimate hand-washing) and my reward was a week-long trip to my birth country for my birthday. To this day I am so grateful to my parents for hitting on a strategy that worked so well for me.

At about the age of eleven, I started eyebrow-pulling and still do. Last year I managed to stop for a few weeks, also using a chart (a tick for every day I managed to not pull anything), but I became lazy/complacent and slipped back.

To the OP: thank you for this completely enlightening question. I don't really have any answers for you, save that if it's a problem for you - if you don't like the fact that you do it - then maybe you can capitalise on that and use it as a motivation to design your own strategy and stick to it. The Habit Reversal Training mentioned in the wikipedia article I linked above looks interesting and promising (for me, too). IANAD and all I have is my own experience, but if you want to talk, my email is in my profile.
posted by snap, crackle and pop at 8:02 PM on January 22, 2007

You're welcome snap, crackle and pop! I know there's something amazing about finding the precise term that describes your particular disorder; I'm so glad I could help, even if only a little.
posted by MadamM at 7:03 PM on January 23, 2007