Chronic Skin Picking

Picking or scratching at blemishes or unwanted bumps on your body can be a normal part of daily grooming behaviors. However, for some people this behavior can become excessive to the point that scabbing, skin discoloration, scarring, and even infections can develop. Chronic Skin Picking (CSP) is when a person repeatedly touches, rubs, scratches, bites, or picks at the skin. People may pick at the skin anywhere on the body; however, some of the more common places that people pick are the face, arms, hands, and fingers including the cuticle bed and nails. People with CSP do not wish to cause themselves pain or harm in any way. Instead, they often report their picking as a pleasurable or satisfying activity that can result in long periods of picking without the person realizing the negative impact they are having on their appearance. Because of this, many people with CSP have mixed feelings about their behavior. On the one hand it can feel very satisfying to successfully pick a blemish or bump that was bothersome. However, the negative impact on their appearance and what others think of them often causes feelings of shame and embarrassment about the behavior afterward.

Why Can’t I Just Stop?

CSP can be very frustrating not only to the person who is picking, but to family members and loved ones who do not understand why the person cannot “just stop picking.” Learning to stop is more than just a game of willpower, because picking is more complex than just a bad habit.

Because this is often hard for others to understand, parents of children or adolescents who pick may resort to punishing their child whenever they pick. Unfortunately, this is rarely effective because CSP is not a willful or defiant behavior.

Learning How to Stop Picking

Research has shown that Cognitive Behavioral Therapy (CBT) is one of the most successful ways to help people learn how to stop picking. CBT starts by helping you understand the emotional and physical triggers, situational factors, and associated behaviors involved in the picking. After understanding those triggers, alternative coping strategies are taught to each person with their triggers kept in mind, therefore not every person will benefit from the same coping strategies. These strategies are meant to provide competing motor responses that will direct you away from picking or strategies to help you cope with emotional triggers more effectively. An example could be having something to occupy your hands with such as a rubber ball or small fidget toy during times when urges to pick are higher. If you tend to have more emotional triggers for your picking, then the strategies might involve learning how to more accurately identify your feelings and what to do to help you process them more effectively.

For some people, modifying the physical aspects of your surroundings helps to reduce the urge to pick. For example, by covering mirrors in bathrooms or other high picking areas, you can prevent yourself from looking closely at your face and finding the imperfections to pick at.

Determining the reasons for each person’s picking is an essential part of helping find strategies best suited for that person.  When working with children or adolescents who are picking, parents are heavily involved in the therapy to help them understand their child’s behaviors. This helps provide parents with support and feedback on how they can best help their child in learning how to stop picking.