“Stop picking your face” we say to ourselves, but as the day progresses, we find ourselves scratching, popping and aggravating pimples, bumps and anything that rises above the surface of the skin. Here, my patient and I share a real life journey of skin picking and solutions that have worked.
“I can go an entire weekend without touching my face, but as soon as I’m back at my computer trying to concentrate, I find my hands instinctively going to my face without even realizing it,” says Emily*, a patient who came to see me for her skin picking habit over a year ago.
This is so much more common that people realize. I see many patients in my office who have strong urges to pick their skin, even though they know it creates scarring and infection. That’s why I’m sharing this blog with you. Here are some ways that I help patients in my office to combat this very real (and common) urge.
You Are NOT Alone: It’s Okay to Be Honest About Your Habit with Your Doctor
Fact: It’s estimated that 75 percent of people with a picking disorder are women.
When a patient comes into my office with this issue, she often doesn’t want to admit it initially. So, my goal is to make her feel comfortable and realize she’s not being judged. I’ll say something like, “It looks like you’ve been on the attack!” and then I’ll ask what’s been going on, and if there have been any recent stressors she wants to discuss.
The first objective is to let the patient know she’s part of a team and will have a partner to tackle the habit. It’s not about “curing” the patient or chastising her if she falls off the wagon and has a bad night. It’s about coming up with a personalized strategy that helps that patient feel more in control.
“My skin has gone through ups and downs over the years,” Emily says. “My stress levels cause my picking to flare, but when I follow Dr. Bowe’s advice, my skin always improves.”
Retrain Your Brain to Be Mindful While Keeping Your Hands Busy
Often, this is an unconscious issue so we have to bring mindfulness to the behavior and help the patient realize when he or she is most likely to pick. Many of my patients pick most when they are sitting in front of a computer screen, trying to meet a deadline. Others pick when they finally find time to unwind in the evening, relaxing in front of a TV screen. I often suggest keeping a “Hands off!” sticky note on the computer screen or on the TV remote to call attention to the picking and remind the patient not to engage.
Sometimes just redirecting the patient’s attention to another “neutral” activity can retrain the brain to do something other than pick.
“What makes it difficult for me to stop picking is the fact that I do it without thinking about it,” Emily says. “Dr. Bowe suggested I keep my hands busy with a fidget toy when I’m concentrating.” That habit has been successful in keeping Emily from picking at her skin. Some pickers may use a stress ball or spinner to keep their hands busy.
Use Tried and True Approaches to Skin Care that Minimize Breakouts
I take a “field” approach with my patients. Rather than treat specific spots and chase the breakouts, I focus on keeping the skin healthy and clear. I encourage superficial in-office peels and a topical retinol alternating with an antioxidant.
Spot treating can’t hurt, but it won’t prevent pimples because you treat one pimple in one place, and another erupts in a completely different spot the next day. I’m all about staying one step ahead so no one has to resist the temptation to squeeze!
“Dr. Bowe mentioned that the best way to stop picking is to not have anything to pick,” Emily says. “Now I get monthly peels and use a topical retinol which has helped treat the breakouts.”
Meditate + Upgrade Your Diet
Figuring out what triggers and aggravates the behavior is crucial. Stress is almost always a factor, so I encourage my patients to take out time to engage in calming, tension-relieving activities. Blocking out time to practice yoga, take a spin class or just spending time outdoors and experiencing nature can be incredibly therapeutic during high-stress periods. Patients who pick tend to be very successful, and many are perfectionists. They often feel guilty taking time for themselves, but that’s one of the most critical steps on the road to recovery!
Simply focusing on breathing can also help. Studies show that deep breathing triggers a relaxation response that relieves emotional stress. Just taking a few minutes to take deep breaths can lower cortisol levels and reduce stress all day long. I recommend trying a meditation app like Breethe / or guided meditation on Insight Timer or even the Oprah and Deepak Chopra 21-Day Meditation Challenge.
Ingesting certain plants called adaptogens can also help the body resist stress and lift energy levels. Many of my patients find that stimulants, like caffeine, can exacerbate their picking. I often recommend trying adaptogens like this one to support productivity and focus without relying on extra doses of caffeine (which lead to anxiety, which leads to picking).
Don’t Be Afraid to Ask For Help
When people are battling compulsive picking, getting medical help is essential. I advise my patients to schedule regular appointments for peels or in office light based treatments or to come in as soon as a cyst emerges for a cortisone injection. Often just knowing they’re coming in to see me makes a patient feel in control and accountable.
But there are some extreme instances when a mental health professional may be necessary. According to the International OCD Foundation, picking is a concern when it’s repeated, causes damage, interferes with daily activities and causes distress. In these instances, SSRI medications and cognitive behavioral therapy can work in tandem with a skin care regimen to reduce the urge to pick.
I’m honest with my patients and let them know it’s a journey, but one they will not have to endure alone.
“I’ve been seeing Dr. Bowe every three to four months for several years and my skin has dramatically improved,” Emily says. “My overall skin texture has improved and my acne is much less of a problem. But the biggest change is in my confidence level. I’m not distracted by my breakouts and I can talk to people without having anxiety about my skin.”
*Name changed to protect patient’s privacy.