Do you pick at your skin
compulsively? Do you feel the need to hide the signs from others? If you have
this problem and can’t seem to stop, you could have a skin-picking disorder,
also called compulsive skin picking, dermatillomania, or excoriation disorder.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
“Skin picking disorder
(SPD) is more common than most people realize,” says preventive medicine
physician and wellness expert Sandra
Darling, DO. In fact, the International OCD Foundation estimates that
1 in 20 people have this condition.
That means that in an
average-sized crowd at any major league baseball game in Chicago, San Francisco
or St. Louis, nearly 2,000 people in the stadium are likely affected by SPD.
common, but it takes a toll
If you have this problem,
you’re not alone, but it’s likely that you spend more time alone if
you have SPD. If you’re like many sufferers, you may have visible sores and
even scars from skin-picking behavior.
So you have a secret. And keeping that secret can lead you to isolate yourself from others. This can increase depression and anxiety, which creates a vicious cycle by triggering the urge to pick, Dr. Darling says.
“Most people who suffer
from the disorder do not talk about it, and they rarely seek medical care
because healthcare providers and loved ones often tell them to just stop,”
she says. “They are very good at hiding the disorder because of shame and
What’s most important is the
understanding that, with time and effort, it is possible to overcome the
behavior. For anyone who thinks they have SPD, Dr. Darling offers these tips:
1. Let go of the
“The first step,”
according to Dr. Darling, “is acknowledging that skin picking is a problem
and to stop hiding it. In order to heal, you need to release the shame
associated with chronic picking. This can only happen once the behavior is out
in the open.”
Your behavior may have
started innocently enough — maybe you had a rash or a sore that you
absentmindedly started picking at. Or maybe you worried at a hangnail or other
loose skin around you nails because you were feeling stressed out. But then the
picking made things worse and the cycle began.
2. Consider therapy
Darling’s experience, most people won’t benefit from treatment with
typical antidepressants or
medications for obsessive-compulsive disorder. Instead, she recommends seeking
help from a therapist, but she also cautions that finding the right match for
patient and therapist is very important.
“Ideally the therapist
would be knowledgeable about body-focused repetitive behaviors (BFRBs),
including skin picking,” Dr. Darling says. “A therapist trained in
hypnotherapy can be helpful, as this technique is a powerful way to change
ingrained behaviors and patterned thinking.”
She also notes that there are many resources available — locally and online — including therapists, skin-picking support groups and the TLC Foundation.
3. Manage stress and
Reducing stress is a crucial component of healing.
Toward that end, Dr. Darling suggests practicing stress management on a daily
basis using techniques such as:
- Deep breathing.
- Guided imagery.
These relaxation techniques,
along with a healthy diet, regular exercise and adequate sleep, provide an
integrative approach to the treatment of skin picking disorder.
Those with SPD
“typically go into a trance or ‘zone out’ while picking,” she says.
“In order to overcome the behavior, it’s important to learn how to stay
grounded in the present moment.”
Developing awareness through a regular mindfulness-based meditation practice can help you recognize skin-picking urges when they come up. Instead, you can choose to do something different in those moments such as going for a walk.
can help by understanding
Dr. Darling’s final
words of advice are for those who think they know someone who has SPD.
“Be compassionate and
gentle with the person. Do not simply tell them to stop even if you have the
best of intentions,” she says. “Understand that they want to stop,
but are not able to.”
The best content delivered directly to your inbox.