How do you talk to your teen about picking at their skin?
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Anonymous
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You need to address it directly with her in honest, matter of fact language. She needs help dealing with this and likely CBT specifically targeted at stopping body-focused repetitive behavior - it is a stress coping mechanism.
https://www.bfrb.org/ |
Anonymous
Eh. Yes and no. My youngest DS constantly bit his nails and picked at the skin around them. He always had gross, bloody, scabby, stubby little fingers. He sometimes had to get sent to the nurse for a pair of rubber gloves to wear because his hands were so scabby and bloody that kids didn't want him to touch anything. And I didn't blame them because we were the same way at home. He always had his own bowl of popcorn during movies. His siblings refused to allow him to pass things at dinner because they didn't want to risk there being blood on the object (happened more than once). Did he want to stop biting his nails and picking his skin? No, of course not, but as his parents we had to overrule his wishes and push forth with treatment. We took him to a therapist who did CBT (cognitive behavioral therapy) and taught him HRT (habit reversal training). The therapist taught him the ARPS method (awareness, replacement/redirection, practice, support). Awareness-He learned to spot his skin picking triggers (boredom & sensory issues) Replacement-He replace the destructive body focused repetitive behavior with something repetitive but not harmful/destructive. For him this was tracing the lines on his palm, writing the ABCs on his palms, doing the alphabet in sing language, or drawing something the therapist called "soothing circles" (an endless circle doodle of sorts). The therapist allowed all these replacement behaviors at first and then slowly had him eliminate them as he became more comfortable (see below) Practice-He learned how to become comfortable with his uncomfortable feelings (boredom & sensory issues) through the practice of the safe repetitive behaviors to the point where she weaned him from having so many options for safe behaviors. Support-She had up set up a rewards system and also taught us lots of positive reinforcement for him when we noticed him doing the safe repetitive behaviors like tracing the ABCs or sign language. When we saw him try to fall back to a destructive repetitive behavior, we were taught how to bring it to his attention, help him verbalize what triggered it, and redirect towards a safer behavior. It was not an instant fix at all and took lots of work on all our parts, but it was successful in the end. He hasn't bit his nails or picked his fingers in many years. He's now 20 and he still uses the ARPS mechanisms. We started him in piano lessons when he was 8, so now we'll catch him playing a piano piece with his fingers on his legs if he's bored. |
Anonymous
| Mine is 9 and has anxiety. Chews her fingernails and finger skin until it bleeds. I feel for her and remind her all the time. Mostly so it doesn't get cracked and infected. I was like that too and now get my nails done. I also picked my skin to scabs under my hair so no one could see but it bled and dried and was awful. All stemming from anxiety. I grew out of it only when I had kids and my hormones went all different in pregnancy and childbirth. |
Anonymous
[b]
Yes, it was NAC. He did take it consistently and I found that the brand was important. The cheaper bottle from Amazon did nothing but the more expensive one from a compound pharmacy did help. |
Anonymous
Thanks for posting OP! No suggestions, but appreciate your thread and I wish you good luck. |
Anonymous
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My 19-year old son still does this! Ugh
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Anonymous
Oh and he does it even when relaxed, mindlessly. It’s like when a girl twirls her hair, he touches, picks his face. |
Anonymous
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Former compulsive skin picker here. You will not make progress on this until the anxiety is under control, and I guarantee you it is not. You probably need to find a new therapist and be more aggressive in treating the anxiety. Talk to a few therapists, find one who has worked with repetitive behaviors before, and consider CBT.
DO NOT talk about the skin picking to her. Ever. The problem is the anxiety; the symptom is the skin picking and ANY focus on the skin picking will make the anxiety worse in the short term (and thus the picking worse). Whoever suggested bribing her - TERRIBLE suggestion. No matter what she says, she doesn't want to be like this. DUH. I blew my mom off time and time again when she asked about it (and honestly, in retrospect, it wasn't often), telling her it was fine, and she was just shallow, but in reality I was constantly trying not to do it and failing. All mom's (very rare) questions or comments did was make me hide it better and feel worse. |
Anonymous
DP… can you please share name of pharmacy for nac? I am a trich sufferer and it is related to skin picking. No amount of “wanting to stop” is enough on its own. Nobody wants to ruin their skin, it’s a compulsion. I hope OP tries therapy and supplements. |
Anonymous
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From what I've read, Skin Picking and Trichotillomania (hair pulling) fall under the OCD umbrella.
I also read Skin Picking is one of the most difficult to stop because the act puts them in a "trance" and is relaxing, and that feeling is desired. I guess for OCD behaviors where they feel the need to knock on a flat surface or whatever, isn't that desired in itself, it's just an annoying compulsion. It's a mental health disorder, not a bad habit. Slapping them or reminding them will just give them more anxiety. She will have to want to stop picking before she will be willing to try alternative behaviors. Maybe seeing a therapist who specializes in this specific form of OCD can help explain why she's doing it. When she's ready, for face picking getting rid of magnifying mirrors and even covering the sink mirror can help. It's true that picking on the face or hands leads to social isolation. Picking on the feet leads to painful walking. Some sufferers can transfer it to only picking where it isn't as obvious, like the scalp or legs or arms, but that can still have social outcomes, like avoiding swimming or wearing shorts. Getting a gel manicure blunts the fingernails, and for some that helps, for others it drives them crazy. For large skin areas, like legs or arms, a hydrocolloid bandage can be worn for 1-2 weeks and is waterproof and will usually heal the wounds. But obviously that doesn't work as easily on the face. I'm sure this is painful for a parent to see and realize their child is suffering from them knowing they have a compulsion, hating themselves and feeling guilty when they give in, trying to hide the results with makeup, avoiding social situations due to embarrassment... But at least try to give her tools to understand why she's doing it and the knowledge that when she is ready, there are some behavior therapies that may help. This is one of the most difficult compulsions to break and many suffer for decades or their entire life, even when they try to stop. |
Anonymous
| PP continued for right above, I agree with the earlier post to treat the anxiety before trying to treat the compulsion. |
Anonymous
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I agree with hydrocolloid bandages. There are small ones for the face. Spot dots.
Not only do they genuinely help with acne, they provide a pleasingly smooth surface and cover up bloody spots. You can touch the spot and kind of check up on it without actually disturbing the healing and cleanliness of the wound. I don't have any kind of severe habit but I do some things derms would disapprove of, and I had ugly acne spots into my 40s. I so wish these hydrocolloids were available when I was young. They are perfect for the bad skin that runs in my family. I've also found that brand doesn't really matter. Off brands work well. Good luck. I think there's a chance these could help. |
Anonymous
Her body, her choice. Not her problem that you think she is ugly. |
Anonymous
| Does she have cystic pimples? I used to try to squeeze then dig with needles to get the core out. Won't heal until it's out. |
Anonymous
I’m the PP and we’re no longer in the DMV so it’s not a local pharmacy. But I would suggest talking to the pharmacist at a compound pharmacy, particularly one that’s independently owned because they might have more control over their stock. I know there were posters in the Special Needs forum that had suggestions too at some point in time. There were other options that helped people. This is very difficult to control. We tried fidgets, hats, gloves, chew necklaces (yep), the wristband, and he’s on guanfacine. |