Advice for scab pickers

[Anonymous]

DD age 9 is a major scab picker and we are struggling with how to help her stop. Her arms and legs are covered in scabs amd they keep getting bigger. At this point we are worried about scarring and infection. Any tips?

[Anonymous]

Therapy

[Anonymous]

are they itchy? I'd treat that and try to cover them. I know that is counter to them healing, but you need to discourage it.

is she anxious? that's a common driver. I'd try to give her other ways to channel anxiety. something else to fidget or squeeze that isn't attached to her like a scab.

[Anonymous]

I'm 44 and a compulsive skin picker (dermatillomania).

I'm sorry I can't provide much solace. I'm on an SSRI and have had up years and down years, but mostly I pick...a lot. I have four or five bad sores right now on my lower legs and scalp. My dad has the same problem. It runs in families and is often comorbid with OCD, which I also have.

I sometimes pick for hours and even use tools (e.g., tweezers). It's not something I can stop or explain. I try to cover up what I can and am open about the rest by explaining my diagnosis.

The most important thing you can do is assure her that she needn't feel shameful about the picking. I'm sorry your family is struggling with this.

[Anonymous]

Anonymous wrote:I'm 44 and a compulsive skin picker (dermatillomania).

I'm sorry I can't provide much solace. I'm on an SSRI and have had up years and down years, but mostly I pick...a lot. I have four or five bad sores right now on my lower legs and scalp. My dad has the same problem. It runs in families and is often comorbid with OCD, which I also have.

I sometimes pick for hours and even use tools (e.g., tweezers). It's not something I can stop or explain. I try to cover up what I can and am open about the rest by explaining my diagnosis.

The most important thing you can do is assure her that she needn't feel shameful about the picking. I'm sorry your family is struggling with this.

I'm curious -- why do you think the SSRI doesn't work? I'm related by marriage to people with this condition, although unlike you they do not acknowledge it IS a legit, DSM disorder. So they don't get treatment. But after reading what you wrote, I wonder if there even _is_ a "treatment" ?

[Anonymous]

Try to get early intervention (cognitive therapy) asap for both dermatillomania and trichotillomania.

[Anonymous]

Anonymous wrote:I'm curious -- why do you think the SSRI doesn't work? I'm related by marriage to people with this condition, although unlike you they do not acknowledge it IS a legit, DSM disorder. So they don't get treatment. But after reading what you wrote, I wonder if there even _is_ a "treatment" ?

PP here (44-year-old). I was perhaps a bit dismissive of the SSRI's effects, which in fact have proven very therapeutic as regards my OCD. I began taking an SSRI about 15 years ago, and I've since changed meds but stayed with the SSRI protocol & have had reduced OCD symptoms. That's the good news.

The bad news is that nothing I've tried (including meds & therapy) has helped my skin picking, which is now classified as an excoriation disorder in the DSM-5. As you surmise, there isn't much in the way of successful treatment.

I've picked since I was very young (well before age 10), and I've continued on and off for 35+ years. There have definitely been years during which I picked very little and things seemed to have improved, but I've always relapsed. There is a great deal of mystery surrounding this condition, because it seems so bizarre. I consider myself a highly logical person, and I like to be in control--yet I can't resist picking.

The reason I mentioned shame is that, when I was very young, I felt I must be crazy to have the urges I did (tics, picking, OCD compulsions). Back then (I was born in 1969), there was no public discussion of things like OCD. I still remember the immense relief I felt upon learning about OCD, and similarly I felt gratified to learn much later that I am not the only person to suffer from skin picking.

Per the Wikipedia entry: "Hindered by shame, embarrassment, and humiliation, they may take measures to hide their disorder by not leaving home, wearing long sleeves and pants even in heat, or covering visible damage to skin with cosmetics and/or bandages."

Indeed, I wear long pants year-round, and I often have bandages on my arms. I have sores on my neck that I try to cover with long hair, or I use concealer when I (rarely) wear my hair up.

The best thing I've done for my mental health is educate myself and begin talking openly about my disorder. I used to be terrified to get haircuts, because I'd have to come up with some creative reason why I had sores on my scalp. Now, I explain that I have an excoriation disorder, and I tell the stylist I have some sore areas to avoid. When I get pedicures, I make sure my sores are covered up and left alone (that often means I don't get the nice massage part...ah well). If a friend says something about my clothes, I say that I have unsightly scars and try to avoid exposing them (I know open sores are distasteful to the general public).

There are different levels of the disorder. Some people only pick at actual spots (acne, hair follicles, mosquito bites). Others, like me, actually create new spots by picking. In general, if an area isn't completely smooth, I want to make it smooth by picking at it. Yes, I realize this is counterintuitive, as the picking itself creates gouges & scabs, but nothing about the disorder truly makes sense.

I try to confine myself to certain parts of the body during certain times. I do attempt to treat the spots with antiseptic creams and bandages, but invariably, I pick certain areas for months until I move on to another area.

I'm happy to answer any more questions about skin picking. I'm sorry I can't be more positive, but if it helps, I have an amazing husband, four beautiful (nearly all grown) children, a successful business, a healthy income, and a wonderful extended family. The skin picking part of my life sucks, but the rest of my life is a joy.

[Anonymous]

Is he on any medications that could cause him to itch?

My DS had OCD, which took a turn for the worse. The doctor upped the SSRI he was taking and he began itching. The doctor was dismissive that it could be a side effect of the SSRI, said it was just part of his "condition." (Itching though was listed as a rare side effect). It was awful--he itched so hard it bled, forming scabs that still itched so he itched some more. The first day of summer camp they called me and said they wouldn't let him swim because he had a skin disorder. His legs and arms made him look like Damien the Leper.

I got him off the SSRIs eventually, and actually took him to a spa with mineral waters for a few days followed by lots of swimming and plenty of sun and finally the cycle stopped and everything began to heal. It was miserable.

[Anonymous]

OP, I am not as severe as the PP, but also have picked all my life, usually at the skin on my fingertips and cuticles. What I find helpful is

--awareness that it's related to stress. I can see now how I do it more in stressful periods and when things are calm can go for weeks without doing it.

--redirection. I would do my nails, including a base coat, and pick the polish off over a day or two. not attractive, not a way to win friends or influence people, but at least my fingertips weren't raw.

--anxiety reduction techniques. meditation, etc.

[Anonymous]

44yo PP, I'm a picker, too. I'm 42. I don't have other noticeable OCD behaviors, but I do have depression and anxiety issues. The picking is both related and unrelated to anxiety for me.

I'm really impressed with your discussion -- I, too, feel far better about myself now that these things are more openly discussed and if not understood, than at least not brushed off.

Just wanted to say thanks.

[Anonymous]

Another picker here, aged 43. I'm grateful that for the most part I can limit it, but as a child I had terrible eczema and picked and picked and it was a nightmare. Controlling allergen triggers helped my skin itself, and the decreased itching helped me to avoid the picking, but like the PP above I often pick new areas just because they are not smooth. And as I age - and I have fair skin - I have lots and lots of new places that are all of a sudden inexplicably hardened or scaly, and so I pick them, and cause bleeding, then pick the scabs, then cause scarring...it's a vicious cycle.

Thanks to others for sharing.

[Anonymous]

Anonymous wrote:OP, I am not as severe as the PP, but also have picked all my life, usually at the skin on my fingertips and cuticles. What I find helpful is

--awareness that it's related to stress. I can see now how I do it more in stressful periods and when things are calm can go for weeks without doing it.

--redirection. I would do my nails, including a base coat, and pick the polish off over a day or two. not attractive, not a way to win friends or influence people, but at least my fingertips weren't raw.

--anxiety reduction techniques. meditation, etc.

I have this exact same issue. My fingers are awful, just full of scar tissue and callouses. Sometimes, when I get very anxious and/or stressed, I start to pick at my feet. I then "wake up" and remind myself that it is a gross, gross thing to do and I can get myself to stop. I've managed to live with it and keep it under control (matter of perspective, I suppose); however, it's so sad for me to see my kids struggling with the exact same issues. No matter what my parents did (and neither they nor my siblings suffered from the issue -- although all but my mother is diagnosed with depression), they could not stop me from picking. I know what I'm up against with regards to my own children and part of me feels like I should just let it go...

[Anonymous]

Anonymous wrote:Another picker here, aged 43. I'm grateful that for the most part I can limit it, but as a child I had terrible eczema and picked and picked and it was a nightmare. Controlling allergen triggers helped my skin itself, and the decreased itching helped me to avoid the picking, but like the PP above I often pick new areas just because they are not smooth. And as I age - and I have fair skin - I have lots and lots of new places that are all of a sudden inexplicably hardened or scaly, and so I pick them, and cause bleeding, then pick the scabs, then cause scarring...it's a vicious cycle.

Thanks to others for sharing.

This is why I do it and the same reason I mess with my fingernails & cuticuls. I don't like the rough or uneven textures.

Can you put band-aids on the sores? The type that stick all the way around. Also, put some oniment on it so it stays moist, may slow healing but less itch. Part of the problem is at the sore heals it starts to itch so to someone like me, it feels better to pull the scab off to relieve the itching.

[Anonymous]

DH's psych prescribed N-acetyl Cysteine for nail biting. It's a fairly new treatment for OCD-related behaviors. It has helped him some, but he says it is a little rough on his stomach, so he takes it at night. It might be something to look into for your DD.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Another picker here, aged 43. I'm grateful that for the most part I can limit it, but as a child I had terrible eczema and picked and picked and it was a nightmare. Controlling allergen triggers helped my skin itself, and the decreased itching helped me to avoid the picking, but like the PP above I often pick new areas just because they are not smooth. And as I age - and I have fair skin - I have lots and lots of new places that are all of a sudden inexplicably hardened or scaly, and so I pick them, and cause bleeding, then pick the scabs, then cause scarring...it's a vicious cycle.

Thanks to others for sharing.

This is why I do it and the same reason I mess with my fingernails & cuticuls. I don't like the rough or uneven textures.

Can you put band-aids on the sores? The type that stick all the way around. Also, put some oniment on it so it stays moist, may slow healing but less itch. Part of the problem is at the sore heals it starts to itch so to someone like me, it feels better to pull the scab off to relieve the itching.

Finger and cuticle picking pp here. This reminds me of another thing that sort of helps, keeping my hands and cuticles moisturized. It's easier to pick at dry skin. I used to carry around burt's bees cuticle stuff to rub in at idle moments. (now that I have kids there are way fewer of those than when I was a single anxious woman taking metro all the time

I guess that'd fall under redirection. I also carried around some basic manicure tools, like cuticle pushers and nail buffers.

Anyway, that's pretty specific to fingers/nails, but maybe there's a way to apply the concepts for your dd. Honestly, finding a way to frame it for her in an emotionally healthy way is probably the best thing you can do for her. My mom never commented on it, maybe she didn't notice, but I never felt like it was something I'd have to hide from her because she'd hassle me about it, which would have made the anxiety (and then the behavior) worse. As it is, I can now control it fairly well, do not feel as impaired by it as other PPs do, and maybe the way she handled it is one reason why.