087: Skin Picking Triggered By Chronic Skin Rashes

If living with skin rashes weren't enough, compulsive skin picking triggered by those rashes makes everything worse.

It makes your level of shame go through the roof and can have a bunch of other unintended negative impacts on your life. This condition, known more formally as Dermatillomania, is on the OCD spectrum.

And it can cause extra damage to your skin that goes beyond what the rashes will cause.

This is a personal topic because skin picking is something that I live with daily. I considered creating an episode on this topic for a few months, but my own personal shame (that I'm working on) kept me afraid to share.

Recently, I decided that helping just one person not feel alone was more valuable than getting this vulnerable with you.

So if you're dealing with Dermatillomania (skin picking) because of your rashes, or supporting someone who is, I hope that you find this episode enlightening.

You aren't alone.

Or, listen on your favorite app: iTunes (Apple Podcasts) | Spotify | Stitcher | TuneIn | Subscribe on Android

In this episode:

• Dermatillomania — skin picking triggered by rashes
• How skin picking is connected to OCD
• Sharing my personal experience living with this issue
• Some strategies and changes that helped lessen the severity
• The one thing you should STOP doing if you're supporting someone who picks at their skin

Quotes:

“Chronic skin rash conditions like eczema or psoriasis can be a trigger skin picking. It's considered to be part of the OCD or obsessive-compulsive disorder spectrum and is a sign of how your mind deals with stress.”

“If you find yourself picking at your skin for an exorbitant period of time and it's causing scarring, or you're reopening wounds (making it difficult for them to heal), it's best to seek help from a professional.”

Skin Picking Triggered By Chronic Skin Rashes (FULL TRANSCRIPT)

Welcome back to episode #87 of the Healthy Skin Show!

In today's episode, I want to talk about skin picking. I know this can sound like a totally weird topic. But bare with me because it is one of those topics discussed in Facebook groups on skin conditions.

People will share how they feel unable to control the urge to pick at their skin. Whether it's just constantly touching their skin to look for imperfections or to intentional do something to the skin under the guise that you're making things better, the issue is a real one.

Believer it or not, skin picking or dermatillomania can be the result of having eczema, psoriasis, acne, or any of the other skin conditions we talk about here at the Healthy Skin Show.

Skin picking can cause a tremendous amount of stress on top of what is already a very stressful condition. So no matter whether you are dealing with this or supporting a loved one going through this, know that you are not alone.

According to Psychology Today, skin picking affects “up to 1.4 percent of the total population, and approximately 75 percent of those affected are female.”

And I am right there with you (*raising my hand*).

What is Dermatillomania (more commonly called “Skin Picking”)?

When I first saw posts from fellow eczema sufferers asking if anyone else picked uncontrollably at their skin, I realized that I wasn't alone.

I was quite astonished by just how many people would share that they too would do this (many times to their own detriment).

Dermatillomania (also called Excoriation or “skin picking”) is a condition on the Obsessive-Compulsive Disorder (OCD) spectrum that even is found in the DMS-5 handbook. It's essentially a compulsive need to pick at and manipulate your own skin in a way that can result in the injury of your skin.

The more official criteria include (1):

• Recurrent skin-picking, resulting in skin lesions

• Repeated attempts to decrease or stop skin picking

• The skin picking causes clinically significant distress or impairment in social, occupational, or other important areas of functioning

• The skin picking cannot be attributed to the physiologic effects of a substance (eg, cocaine) or another medical condition (eg, scabies)

• The skin picking cannot be better explained by the symptoms of another mental disorder (eg, delusions or tactile hallucinations [psychotic disorder], attempts to improve a perceived defect or flaw in one’s appearance [body dysmorphic disorder], stereotypies [stereotypic movement disorder], or intention to harm oneself [nonsuicidal self-injury])

And believe it or not, it can be triggered by a chronic skin rash condition.

It can also be coupled with obsessive-compulsive disorder tendencies as well as other conditions like trichotillomania, where you actually pull out your own hair.

I want to be clear that this is by no means a complete guide on Dermatillomania (skin picking disorder) nor how to handle it. I'm not a mental health professional so I'm merely sharing my own 30+ years of experience living with this and what I've researched online.

When I see this topic come up in online forums, there's a huge sense of shame around it. I have personally dealt with it (and frankly still live with to this day) and hope that I can continue to lessen its hold over my life.

I think a lot of people have shame around this type of condition and that they think that it makes them sort of broken. Well, I can tell you that you're not broken or weird or anything like that for going through this.

Skin rash conditions are incredibly stressful. And living with the threat of another flair is equally stressful and traumatizing. Sometimes the way your mind deals with the stress is unfortunately not all that productive.

My Life Living With Dermatillomania

To be honest with you… as I'm sharing all of this with you, I'm like, “What the heck am I doing putting out there this huge thing actually that I have spent so much of my life hiding?”

But I wanted to let anyone know who feels really alone and really ashamed right now that you're not.

Living with skin picking doesn't mean that you are helpless and that you're just going to be an outcast. You also shouldn't feel like you can't ever be productive (especially if this is costing you a lot of time right now).

I have certainly spent a lot of time and energy working on myself to minimize these types of behaviors that tend to be incredibly counterproductive and can cost me many hours out of a day. At my worst, I'd lose up to 6 hours a day!

My issues started as a little kid and it seems to run in my family (so there may be a genetic predisposition). I have lived through periods of my life with terrible shame from being constantly humiliated and bullied in grade school as a result of these types of concerns.

As an adult, I will pick at my jawline, my cheeks, and even my lips endlessly looking for a flaw in the skin. Or I'll rake my nails across my scalp over and over looking for something that I can scratch at because it's not smooth. I have done this in the past until I bled.

My dyshidrotic eczema did not trigger skin picking, but it certainly made it more complicated.

But here are other people with eczema or psoriasis or something like that which triggers the condition. Unfortunately, skin picking is how their mind opts to deal with stress.

It's worth noting that these types of issues are very difficult to control.

If you find yourself picking at your skin for an exorbitant period of time and it's causing scarring or you're reopening wounds making them difficult to heal, seek help from a professional. Find someone who has experience dealing with these types of conditions who can help you work through them and hopefully find a different way to address stressors.

Also, if you're supporting someone who's going through this, understand that skin picking is not something that you can just choose to stop.

It doesn't work that way.

No one CHOOSES to do this.

I recognize that can be difficult for someone who doesn't have a compulsive tendency to understand. I would have loved to have stopped years ago, but it is not that simple.

Another notable point — shaming someone who is skin picking (or deals with any type of compulsive behavior) about it doesn't help them to stop. It will likely make them worse.

Tips That Worked For Me To Deal With Compulsive Skin Picking

Some recommendations may work for you while others may not work at all.

Either way, I think it's important to seek help from a professional if you're losing a lot of time, finding that this behavior is destroying your confidence further and if it's causing serious harm to your skin.

There's literally NO SHAME in getting help.

When I was 19 years old, I went to seek help for obsessive-compulsive disorder (OCD) because I would lose up to six hours a day getting “stuck” in compulsive and repetitive behavior.

At the time, I was recommended antidepressant therapy. After two different antidepressants, I found that the drugs made everything worse (including symptoms like depression and agoraphobia that I didn't have before).

All of the behavioral change techniques did not work for me either.

What ultimately helped me the most were lifestyle changes that I embraced (that have allowed me to become a much more functional human being). I realized at the time that they were a small “price to pay” compared to being trapped by my OCD.

I changed my diet and got rid of a lot of junk and processed foods, and I started exercising.

Removing gluten from my diet gave a substantial boost.

Incorporating breathing practices (I discuss my 3 favorite ones HERE) and mindfulness was a big help.

Going to talk therapy really helped a lot because it taught me skills to better address the uncomfortable feelings that I was dealing with. It also helped me deal with some of the trauma that I'd experienced as a kid being endlessly bullied by kids (some of whom were supposed to be my close friends).

Here's a great video that may be helpful — https://www.youtube.com/watch?v=ieSBwEzbe-s

This is what helped me learn to thrive living with skin picking and compulsive tendencies. I'm not saying that what professionals could share with you won't work. The recommendations just didn't work for me, but they very well could work for you.

And that's the beauty of the Healthy Skin Show, right?

We are each different and so that's why knowing that there are different ways forward can be so helpful.

Wherever you are on your journey, I want you to know that you are not alone.

If you have no idea what this type of behavior feels like — I'm so happy for you and grateful that you'll never have to deal with it.

I wouldn't wish it upon my worst enemy.

But if just one person here needed to read a story and feel like someone really *gets* them — I get you.

I know what this is like. You don't have to feel ashamed and alone about what is happening to you.

It makes sharing what has felt for a large majority of my life like something to be very shameful all the more worth it if it helps just one person.

I hope this episode is helpful and I would love to hear from you!

If you have been dealing with skin picking, please share what your experience has been below in the comments!

I promise… no judgment.

If you know someone who's dealing with dermatillomania and needs to hear this, please share this episode with them.

Like I said, if I only help one person feel less alone… that has made this very private share all the more worth it.

Thank you so much for tuning in and I look forward to seeing you in the next episode!

REFERENCES

1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, Va: American Psychiatric Association; 2013. 254-7.