“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.

Skin Picking at Desk

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.

fidget spinner skin picking

“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!

Yoga and skin health

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.”

Dr. Whitney

*Name changed to protect patient’s privacy.

You are NOT alone in the primal urge to pick at your face- especially if you have a below the surface blemish or bothersome zit. BUT, here’s our real-world, skin-saving guide to allowing your skin to heal without making it worse!

Sometimes we’re our own worst enemies when it comes to our skin. If you’ve ever been obsessed with a blemish, you understand the self-sabotage. And maybe this sounds familiar: “When I consciously pick at my skin, I know deep down that it won’t help, but somehow I convince myself that this one time picking will suddenly make the breakout less apparent,” says Emily, a self-described chronic picker who has consulted Dr. Whitney Bowe, author of The Beauty of Dirty Skin, for help.

“I can’t tell you how many of my patients avoid eye contact, feeling some shame that they’ve “attacked’ a pimple and tell me how embarrassed they are—it happens all the time,” Dr. Bowe says. “If you’ve picked, the first thing I want you to realize is that you’re not alone. I probably have this conversation once a day in my office!”  

This two-part installment will reveal what drives this all-too-common behavior and how to treat it—and how one woman has overcome her picking compulsion.

Part 1: Picking—a Fight

There’s actually a good reason why it’s so difficult for us to leave our skin alone: “Popping a pimple or picking at your skin offers relief and gratification that rushes the brain with calming neurotransmitters like dopamine and serotonin,” says Natalie Gluck, MD,  a physician and board-certified psychiatrist in New York City. “In some cases people experience tension that can only be relieved by picking.”

The problem is that any time you pick, squeeze, pop or otherwise handle your skin, you risk infection and scarring. You’ll prolong the amount of time it takes a pimple to heal and spread oil, dirt and bacteria on your skin that can cause more breakouts—creating a vicious cycle. So a hands-off policy is one your dermatologist will always advise.

That being said, dermatologists are also human and understand that ignoring a blackhead or letting a whitehead run its course is not exactly realistic for anyone within arm’s reach of a magnifying mirror. There are, however, a few dermatologist-approved strategies that can be effective for anyone who wants to reform her picking habit.

5 Ways to Beat the Urge to Pick Your Zits for Healthy Skin

Get the red out.

If you reduce the inflammation, the blemish will be less glaring and less inviting to pick. Treat the area with a cold compress and hydrocortisone to calm the swelling and redness.  Spot treating with tea tree oil can also dial down the red, as tea tree oil acts as an anti-inflammatory. One of Dr Bowe’s new favorite spot treatments is this roller ball that coats just the right amount of salicylic acid and essential oils to dial down the red.

Make a note.

Before you get in a trance and spend too much quality time obsessing over your pores, put a reminder on a sticky note and put it on your mirror. Seeing the phrase “HANDS OFF” or “NO PICKING” may remind you to stop before you start.

Hit the spot.

If it’s oozing or juicy, you might consider a a blemish treatment containing salicylic acid or benzoyl peroxide to start the healing process and dry it up. If you can, apply something that coats the pimple with a visible layer so you’re less apt to touch it.  Dr. Sandra Lee, a dermatologist at Skin Physicians & Surgeons in Upland, CA who is known as Dr. Pimple Popper, advises her patients to put a band-aid on the blemish if they can stay at home. The bandage acts as a literal barrier to picking and help them resist the urge to do more harm.

Know when to squeeze.

If you absolutely cannot keep your hands off, only touch a whitehead—the inflammation is at the surface and popping it is less likely to cause scarring or discoloration than handling a solid red cyst. Very gently apply pressure to release the pus, as soon as you see the white at the surface or if you see blood, stop immediately and apply a cold compress followed by a spot treatment.

Call your dermatologist.

“Often making an appointment to see me can help my patients stop from attacking a pimple because they know they’ll be seeing me soon,” Dr. Bowe says. “And a simple cortisone shot can make a deep cyst disappear in a few hours.”

Can’t stop?  Consult your dermatologist if this may be a true medical condition.

Determine if picking is causing you mental distress. “Sometimes picking is a form of obsessive compulsive disorder called excoriation disorder,” Dr. Gluck explains. “Picking becomes a clinical condition when it causes extreme distress or you spend significant time doing it.” A visit with a mental health specialist can determine if medication or cognitive behavioral therapy (CBT) will help with the underlying anxiety. But focusing on a single pimple isn’t a disorder—in most cases people stop once the blemish heals, Dr. Gluck explains.

Consider this unconventional but popular way to get your pimple fix:

As a testament to how alluring the satisfaction of picking can be, Dr. Pimple Popper  has a YouTube channel with more than 4 million subscribers!  Logging on and getting a vicarious thrill from watching a trained professional clear a blemish is much safer than doing self-harm and may reduce your urge to pick. “I think watching my videos is actually relaxing and decreases anxiety in those with skin picking disorder,” says Dr. Lee. “People tell me that watching these videos calms them.”

Dr. Bowe’s Bottom Line: If you can’t make it to a dermatologist, follow the advice above and take a proactive approach to your skin. Spot treatments aren’t a long-term solution. “You treat one spot and another erupts the next day in a different location,” Dr. Bowe says. Instead, she addresses the face as a “field” and uses ingredients like salicylic acid or retinol to the entire area. “This way you stay ahead of the game and you won’t find yourself struggling to resist the temptation to squeeze!”

Stay tuned for our next real woman’s story about finding solutions to picking. Plus, hear how Dr. Bowe’s expert support helped her cut down on aggravating her own beautiful skin.

 

@DrWhitneyBowe

RT @DrOz: Could you be buying fake beauty products online and not know it? @DrWhitneyBowe reveals what could be in these counterfeit items.…

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