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[quote=Anonymous][quote=Anonymous]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" ?    [/quote]

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.

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