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 find themselves picking at a skin blemish from time to time, this type of behavior may 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 a problem for you. Other people also face a similar concern and are sometimes diagnosed with what is known as skin picking disorder (SPD), dermatillomania, or excoriation. Because you mention being bothered by this behavior and that you find yourself picking at your skin during inopportune times, you may find it’s worth exploring further — perhaps with the help of a mental health professional or health care provider.

Signs of SPD might include repetitive touching, scratching, or picking of the skin, often in an attempt to remove small marks (such as scars or freckles) or perceived imperfections. The picking usually occurs when a person experiences anxiety, fear, excitement, or boredom, but may also be attributed to other conditions such as obsessive-compulsive disorder (OCD). Skin picking could be triggered by a variety of issues in a person’s life including stress, anxiety, eating disorders, autoimmune problems, substance abuse disorders, and developmental disorders. It’s 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. While some people report that the act of picking at their skin is pleasurable, this repetitive behavior may have the potential to be time-consuming and negatively impact a person's social, work, and family relationships. 

Before going directly to a health care provider, it's worth taking some time to reflect on your skin picking tendencies. In the past, have you frequently tried to stop or to reduce the number of times you’ve picked your face? When you do pick your skin, does it result in 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? Thinking about the answers to these questions may help you decide on what you'd like to do next or provide information to a health care provider.

The good news is that there are a number of ways to address this behavior. Cognitive behavioral therapy is often utilized as a 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 a way to explore possible solutions. 

Alice!

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