Iris has been skin-picking for 15 years and finally figured out how to stop!
Is Your Friend or Loved One a Skin-Picker?
If you are a skin-picker, self-diagnosing is pretty straight forward:
- You pick your skin.
- You can't stop.
- It's not the result of another condition (like meds causing tics).
It's much harder to identify a skin-picking problem (dermatillomania) as an outside observer, but these questions should give you a pretty good idea:
- Do you notice skin inflammation or flaws that are pressed or scratched open?
- When they are inattentive or focusing on something (for example when watching TV), do their hands keep running over their skin? Do they appear to pluck an area of their skin?
- Do they regularly have skin marks looking like scratched-open zits or bug nibbles?
- Do red spots appear on their face when they are left alone, or after heading off to the bathroom?
- Did they grow up around family members that skin-pick? It is a very impressionable disorder.
More Subtle Signs of Dermatillomania
- Constant wearing of long sleeves or pants: this is to hide the marks or even to prevent further picking.
- Refusing to take part in certain activities, for example, swimming or going to the beach. This is due to shame over scars.
- No skin improvement despite an obsession with skin care. Skin care in this case is more to help with damage control and progress is difficult without recovering from dermatillomania first.
- Overuse of makeup or band-aids. Just like the long clothes, this can be to hide marks as well as to cover up the spots and keep the safe from more fiddling.
- Compulsive need to pop other people's zits. This one is not as common, but some pickers also move onto the skin of other people.
- Skin blemishes are highly asymmetric. Bacteria on the finger or damage caused creates more acne and wounds, while not-picked spots are clear. Some pickers have a go-to area and others pick every inch of skin. Acne due to allergies can also be asymmetric, so this clue is not enough on its own.
Remember that this condition can be invisible.
We may consider scratching mosquito bites or popping pimples in front of the mirror. Be that as it may, some of us pluck out the hairs on our arms with tweezers. Some of us are fanatic about picking the calluses on our feet. Some of us will even remove little bits of skin on our fingers using clippers.
Yes, there is a wide range.
There's a spot over my bellybutton that I continue to pick at, and I'm tinkering with my earlobes all the time. When I pick my face, I apply a thick layer of Vaseline so by the following day, it looks only a bit messy—kind of like acne in its initial stage. Aside from my mom (who is a picker herself), no one has ever suspected it, even though it's pretty obvious when you see my scratched-open face.
So searching for popped pimples won't cover every single possibility. There are only two ways to be sure: talking to the person you're trying to help or a medical diagnosis.
Asymmetry of Acne Scars Can Be a Hint
Comorbidities of Dermatillomania
These are different disorders or characteristics that often go together with dermatillomania:
- Body dysmorphic disorder
- Eating disorder
- Substance abuse
In some cases, when anxiety gets better, the disorder goes away on its own. But sometimes, the skin-picking is what causes the anxiety. If you know that your loved one suffers from one of the above, there's a higher likelihood that they indeed suffer from dermatillomania—especially if you also see other symptoms of skin picking.
Be Mindful About Confronting Them
What you need to remember is that skin-picking is humiliating. So if you're a skin-picker, you will do your best to hide it. It's not even that hard to hide. You pick your legs? Wear long pants. You have a spot common spot you pick? Slap a band-aid on it. But this isn't a guide on how to hide a very destructive issue.
If you were thinking about walking up to them and straight up asking, "Do you pick your skin?" think again.
What are they gonna say? "You bet I do!"?
There is too much shame connected to it.
Most skin-pickers feel alone. They feel weak for not having the capacity to stop. This is a hard impulse to control and if they're to have a chance for recovery they need your support. Coming off as confrontational can cause them to shut down and prevent them from discussing it with you in the future. If you have a habit of making comments about appearance or behavior, that can act as another obstacle.
Finally, if you think someone you care about is skin-picking, approach the issue with open-mindedness.
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.