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The Best Way To Tell if Someone You Know is Suffering from Skin-picking Disorder

Updated on January 15, 2018
Skinpicking profile image

Iris has been skin picking for 15 years and finally figured out how to stop!

Is your friend or loved one a skin-picker?

If you are a skin picker, self-diagnosing is pretty straight forward: 1) you pick your skin 2) you can't stop 3) it's not the result from another condition (like meds causing ticks). Iit's much harder to diagnose skin-picking as an outside observer, but these questions will give you a pretty good idea whether they skin-pick or not:

  • do you notice skin inflammation or flaws that are pressed or scratched open?
  • at the point when inattentive or focusing on something (for example when watching TV), do their hands keep running over their skin? Do they appear to pluck an area of their skin?
  • do they regularly have skin marks looking like scratched open zits or bug nibbles?
  • do they have red spots appear on the face when left alone, or after heading off to the bathroom?
  • did they grow up around family members that skin-pick? In that case, they almost definitely do, since it's commonly reproduced behavior.


Skin marks that are a consequence of skin-picking. Swollen bumps are from frequent small nibs or squeezing. Smooth red spots that might bleeding are from scratching and oozing spots occur from both when a spot is picked over and over again.
Skin marks that are a consequence of skin-picking. Swollen bumps are from frequent small nibs or squeezing. Smooth red spots that might bleeding are from scratching and oozing spots occur from both when a spot is picked over and over again.

More discrete signs include:

  1. constant wearing of long sleeves or pants: this is to hide the marks or even to prevent further picking.
  2. refusing to take part in certain activities, for example, swimming or going to the beach. This is due to shame over scars.
  3. no skin improvement despite an obsession with skin care. Skin care in this case is more to help with damage control and progress is difficult without recovering from dermatillomania first.
  4. over-exaggerated use of makeup or band-aids. Just like the long clothes, this can be to hide marks as well as to cover up the spots and keep the safe from more fiddling.
  5. compulsive need to pop other people's zits. This one is not as common, but some pickers also move onto the skin of other people.
  6. skin blemishes are highly asymmetric. Bacteria on the finger or damage caused creates more acne and wounds, while not-picked spots are clear. Some pickers have a go-to area and others pick every inch of skin. Acne due to allergies can also be asymmetric, so this clue is not enough on its own.

Assymetry of acne/scars can be a hint.

If a picker focuses on one area to pick, you'll see an asymmetry in skin marks. This can be another sign to look out for. This picture is the left and right side is me after a week of increased skin picking, you can clearly see my picking area.
If a picker focuses on one area to pick, you'll see an asymmetry in skin marks. This can be another sign to look out for. This picture is the left and right side is me after a week of increased skin picking, you can clearly see my picking area.

38% of sufferers are addicted to drugs, alcohol, sugar or caffeine. All of those can be different types of self-medication for a more profound issue. Additionally, the substance abuse and skin picking can be a sign of undiscovered depression/anxiety. Skin picking is a mind-boggling mammoth: it can be both a disorder and a symptom.

Comorbidity

These are different disorders or characteristics that often go together with dermatillomania:

  • Body dysmorphic disorder
  • Anxiety
  • Depression
  • Eating disorder
  • Substance abuse
  • Perfectionism
  • OCD

In some cases, when anxiety gets better, the disorder goes away on its own. But sometimes the skin picking is what causes the anxiety. If you know that your loved one suffers from one of the above, there's a higher likelihood that they indeed suffer from dermatillomania if you also see other symptoms of skin picking.

Behavior
% of respondents
People who have picked their skin to the point of damage
17%
People who are chronic skin pickers
~3%*
Depending on the survey, rates as low as 1.4% and as high as 5.4% have been reported.

But Iris, I still can't tell!

Remember that this condition can be invisible.
We may consider scratching mosquito bites or popping pimples before the mirror. Be that as it may, some of us pluck out the hairs on our arms with tweezers. Others are fanatic about picking the calluses on our feet. Some will even remove little bits of skin on our fingers using clippers.
Yes, it covers a very wide range.
There's a spot over my bellybutton that I continue to pick at and I'm tinkering with my earlobes all the time.
When I pick my face, I apply a thick layer of Vaseline so by the following day, it looks only a bit messy. Kind of like acne in its initial stage. Aside from my mom (who is a picker herself) no one ever suspected it. Even though it's pretty obvious when you see my scratched-open face.


So searching for popped pimples won't cover every single possibility. There are only 2 ways to be sure; talking to the person you're trying to help or a medical diagnosis.

Tweezers can be used. Sometimes invisible areas like the lower back or feet are picked, making it difficult to spot.
Tweezers can be used. Sometimes invisible areas like the lower back or feet are picked, making it difficult to spot.

Be mindful about confronting them

What you need to remember is that skin picking is humiliating. So if you're a skin picker you will do your best to hide it. It's not even that hard to hide. You pick your legs? Wear long pants. You have a spot common spot you pick? Slap a band-aid on it. But this isn't a guide on how to hide a very destructive issue.

If you were thinking about walking up to them and straight up asking "Do you pick your skin?" think again.
What are they gonna say?
"You bet I do."?
No.
There is too much shame connected to it.


Most skin-pickers feel alone. They feel weak for not having the capacity to stop. This is a hard impulse to control and if they're to have a chance for recovery they need your support. Coming off as confrontational can cause them to shut down and prevent them from discussing it with you in the future. If you have a habit of making comments about appearance or behavior, that can act as another obstacle.

Finally, if you think someone you care about is skin-picking, approach the issue with open-mindedness.

Do not diagnose a skin picker against their will. You can never be 100% certain and an official diagnosis is best done by a professional. Give your loved one space if they do not want to talk about the subject.

Did this article help you recognize if someone you care about has Skin Picking Disorder?

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