Do you ever find yourself in a stressful situation, picking at the cuticles of your fingers  or picking at your skin blemishes? If so, you are not alone. This habit is called skin picking or dermatillomania – a form of an Obsessive-Compulsive Disorder (OCD). 

This disorder affects 1.4% of the population, about 75% of whom are female. It is similar to other kinds of OCD, with their compulsions – which can include habitual hand-washing, checking stoves, or excessive cleaning or order – all done to help relieve anxiety. A typical dermatillomania behavioral pattern might be having obsessive thoughts about a blemish; searching and scratching; then feeling relief.

Here are three reasons why the habit of skin picking is so hard to break:

  • Your hands and face are close in contact, making it easier to turn to this habit in stressful situations.
  • Compulsive actions, despite being disabling, ‘work’ in the sense that they make anxiety decrease. 
  • Finally, deeply rutted circuits in the brain associate stress with picking – making it ritualistic.

If you tend to pick your skin in the bathroom as a coping mechanism, then before even entering the bathroom, your anxiety can sometimes increase – just from habit. Perhaps when you look in the mirror in the bathroom and see a blemish, your anxiety can go even higher. Then you might attack the blemish by scratching or rubbing and if it gets smaller, or feels or looks ‘different’ anxiety can reduce.  This is similar to the person with OCD who worries about germs and washes their hands five times, then automatically relaxes. The ritual temporarily solves the problem but, unfortunately, the pattern often becomes further ingrained.

With this being said, there are a few healthy ways to quit this habit. Our Montana counseling clinic recommends a few ways to start:

First practice mindfulness. Gauge your stress and anxiety levels on a daily basis in a journal or simply by noticing. The goal here is to stop the autopilot behavior.

  • For example, ask yourself: “Am I feeling vulnerable because I did not sleep well last night?” (Or did I have a difficult interaction or am I hungry?  Notice whatever triggered your anxiety!)  If yes, be mindful that day, creating gentle actions toward yourself. 
  • Also, develop a plan to counter those high anxiety times.  Be aware of where your hands are or perhaps put a Band-Aid on the blemish that concerns you. 
  • In the moment of realizing you are picking at your skin or you want to start, stop and take a break to lower stress.  Take three deep belly breaths, put your arms around yourself for a gentle hug, take a walk for a few minutes or a warm bath for longer.  Another stress reducing exercise is to look around the room and see everything vertical in the room.  This can bring you out of anxiety and into the moment.  Any combination can help.

Work on self-criticism and habitual unsupportive patterns.  Learn how to honor and care for yourself deeply and to stop even the criticism about picking.                 

  • Notice unhealthy habits. Perhaps you are prone to anxiety, and it’s easy for you to be self-critical and perfectionistic. You can practice pushing back against that critical voice and instead practice kindness (especially toward yourself). You might recount what you most admire about yourself — just make sure you include your courage in addressing this issue of skin-picking. 
  • Perhaps you tend to avoid confrontation with others and instead accommodate and then internalize your feelings. You can learn to tolerate strong emotions and learn how to speak up, being assertive rather than accommodating and collapsing. Even though it can seem daunting to do so, letting others know your preferences can reduce anxiety!

Treat the underlying disorder. Make sure you have support to manage stress in your daily life. We have an integrative approach to mental health at the nCenter Bozeman that can help.

  • Counseling sessions can benefit your mental health and overall well-being. At the nCenter, there are Bozeman counselors that specialize in anxiety disorders using EMDR, Somatic Experiencing, CBT and Internal Family Systems to help you break a skin-picking habit.  
  • Along with counseling, the nCenter offers neurofeedback & counseling which can normalize the excessive High Beta in the brain that may be contributing to your anxiety.
  • Be sure to visit our Bozeman counseling services today, and let us help with everything you may be dealing with.

All of these strategies take work and dedication, so remember to start with goals that are manageable for you and remember the adage ‘Progress Not Perfection’.  You are worth it.