Picking your skin? Just Can’t Stop?

If you can’t stop picking your skin, you may have a common skin condition called skin picking disorder (spd). Everyone picks at a scab or a bump from time to time. For some, it can be nearly impossible to control those urges.

Although you may be embarrassed by your picking, you should know that this condition affects at least five million Americans. Skin picking disorder (spd) is diagnosed when there are repeated attempts to stop picking, and the picking is distressing or interfering with a person’s social or work life.

For the person with spd, stopping picking is not just a matter of willpower, but with therapy, medication, and dermatologic treatments patients can stop. For most, though, no one treatment will be the magic bullet. Even on treatment patients will experience occasional recurrences.

Triggers

People pick for a variety of reasons. Boredom, itch, negative emotions are all triggers. Many even find the experience of picking pleasurable or stress relieving. Understanding triggers can be a first step in deciding which treatments to pursue. If picking is triggered by a skin condition such as acne, then treating that condition may be the first step. However, if picking is triggered by anxiety or stress then treating the underlying emotional condition may be more effective.

Barriers To Picking

One strategy to reduce picking involves changing your environment to make it harder to pick. Examples include keeping your nails short or making the skin more difficult to access by wearing tight-fitting clothing or long-sleeve shirts. You can also distract yourself with items like stress balls, fidgets, and tangle toys.

Therapy

Cognitive-behavioral therapy (cbt) is a therapy that attempts to produce healthier behaviors and beliefs by identifying unhelpful thoughts and behaviors. A specialized type of cbt has been developed for spd. Studies have shown that cbt for skin-picking can be extremely effective. You can find skin-picking experts at the tlc foundation for body-focused repetitive behaviors.

Medications

No medication has been officially approved by the FDA to treat spd, however, selective serotonin reuptake inhibitors (ssri), a type of antidepressant and n-acetylcysteine (nac), an antioxidant supplement may be helpful.

Nac (n-acetylcysteine)

N-acetylcysteine is an amino acid that can be found at health food stores and on Amazon. This supplement affects levels of glutamate in the brain, helping patients decrease unwanted behaviors. It is strongly suggested that anyone taking NAC also use behavioral therapy as medication by itself is rarely the solution. Side effects of NAC include nausea, indigestion, headache, and abdominal pain and people with asthma should take it with caution as it may worsen that condition. The usual dose is between 1200 to 2400 mg a day.

For more on overcoming spd, visit the TLC Foundation for body-focused repetitive behaviors or stoppicking.

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