Hi Alice,

I have serious problem with picking my face. I'm not proud of it and I want to know the reasons behind it. Sometimes, it's not so bad. Other times, I will sit on the bathroom sink and just pick at blackheads or whatever that I can find and I won't stop for almost a hour. I even catch myself doing it at dinner parties or a friend's house when I take a bathroom break. Do I have a disorder? Or am I just crazy? Please help me out. Thanks.

Dear Reader,

Though many people have found themselves picking at a skin blemish from time to time, this type of behavior can become a concern when it takes up a lot of time in your day, impairs relationships, or results in visible damage to your skin. In your specific case, you mention that you feel your frequent skin picking is problematic. Other people face a similar issue and are sometimes diagnosed with what is known as skin picking disorder (SPD) or excoriation. Because you mention being bothered by this behavior and that you find yourself picking at your skin during inopportune times, it’s certainly worth exploring further — perhaps with the help of a professional.

The disorder is characterized by repetitive touching, rubbing, scratching, picking, or digging into skin, often in an attempt to remove small irregularities or perceived imperfections. The picking usually occurs when a person experiences anxiety, fear, excitement, or boredom, but may also be attributed to other conditions. In the past, have you frequently tried to stop or to reduce the number of times you’ve picked your face? Many people who suffer from SPD have made many attempts to quit picking. When you do pick your skin, does it result damage to your skin (i.e., to a degree that you’d either want to cover it up or camouflage it in some way)? You also mention picking at your face while in the bathroom at a friend’s house or during a social function. Has skin picking (or the result of picking) negatively impacted your relationships with family or friends? Sometimes, folks who frequently pick their skin avoid social situations due to feeling embarrassment or ashamed about the behavior. If any of these notions ring true to you, you’re certainly not alone. SPD is a condition faced by 1.4 to 4 percent of the population, but the causes and severity of the condition can vary greatly between people.

Though SPD can be classified as its own disorder, it’s often accompanied by other conditions like obsessive compulsive disorder (OCD). Skin picking can be triggered by a variety of issues in a person’s life including stress, anxiety, eating disorders, autoimmune problems, substance abuse disorders (such as opiate withdrawal), and developmental disorders (like autism). It is also considered a Body-Focused Repetitive Behavior (an umbrella term for conditions that include trichotillomania and severe nail biting) in which a person causes harm or damage to themselves or their appearance. And, while some people report that the act of picking at their skin is pleasurable, this repetitive behavior can be time consuming and may negatively impact a person's social, work, and family relationships. Because you mention being bothered by this behavior and that you find yourself picking at your skin during inopportune times, it’s certainly worth exploring further — perhaps with the help of a professional.

The good news is that there are a number of ways to address this behavior. Cognitive behavioral therapy is often utilized as treatment for this condition in order to understand the triggers for skin picking, how to cope with it, and prevent it in the future. Medications, such as a selective serotonin reuptake inhibitor (SSRI), may also be prescribed in conjunction with therapy. Contacting a health care provider or a mental health professional to further discuss what you’re experiencing may be the first step to exploring possible solutions. You might also want to check out the Trichotillomania Learning Center’s Skin Picking Disorder page to learn even more.

Alice!

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