Almost everyone has experienced the urge to pick, poke, or prod at their skin. When Joanna Saporito, a skin-picking sufferer, reached out to me on Instagram, I thought she would be perfect to profile for this blog. Before you hear her story, I want to share my own personal experience with skin picking, because I’m certainly no angel there either. Growing up, I would pick at my breakouts. I loved the immediate gratification that I got from squeezing my skin. My picking accelerated in my twenties when I developed cystic acne. Even though I was an esthetician, and I knew what was appropriate to extract vs. what should be left alone when it came to caring for a client’s skin, I would still mess with my own skin. I knew that cysts develop and heal deep within the skin, which is why they should never be extracted, yet I would pierce mine with my professional tools, causing more damage, irritation, and inflammation in the long run. It wasn’t until I made a contract with myself to stop picking that I began to remove myself from the skin-picking cycle.
Even as an occasional skin picker, I wasn’t able to stop overnight—it took time, practice, and patience. For chronic skin pickers, it’s an even more difficult journey to recovery. Chronic skin picking, which is also referred to as dermatillomania or excoriation disorder, affects a wide variety of people from all different walks of life. In this post, you’ll hear Joanna’s powerful story and learn all about her experience with dermatillomania. You’ll also meet Lauren McKeaney, the CEO and founder of the only skin-picking disorder nonprofit foundation, Picking Me.
What Is Dermatillomania?
According to McKeaney, dermatillomania is a mental illness that’s characterized by compulsive skin picking. It’s a body-focused repetitive behavior (or BFRB) that’s closely related to OCD. Dermatillomania sufferers experience a sometimes uncontrollable impulse to pick their skin. “You just can’t stop picking,” Joanna says. “As much you want to, you just can’t stop.”
McKeaney says that dermatillomania can be broken down into two types: focused and scanning. Focused picking is when you pass by a mirror and catch something out of the corner of your eye, so you become super focused on it, “fixing perceived imperfections for hours.” Scanning picking is when you’re distracted or “zoning out” and your fingers begin to wander, searching for something to pick. “Breaking down the types of picking is important in developing different strategies to manage dermatillomania,” she says.
Joanna has struggled with dermatillomania her whole life. The first signs appeared when she was five or six. She contracted chickenpox, and she began to pick at the scabs that were left behind. She picked at pimples all throughout puberty. She would even pick at the keratosis pilaris on her arms. “I remember I once had a bloodstain on the back of my shirt. This was my whole life. I would be out with friends at a club in the city and I would pick my face. I was bleeding and I couldn’t get it to stop.”
What Causes Dermatillomania?
There is no one, singular cause of dermatillomania. In fact, the complexity and severity of the disorder can vary greatly. “As a dermatillomania sufferer herself, McKeaney says that she thinks of dermatillomania as a way to regulate stimuli around her. “If I’m too up, peeling anxious, or excited, I might start picking. Similarly, if I’m too down, tired, or zoned out, I might find myself picking. Skin picking disorder is my behavior to get me to ‘just right.’ Now, I’ve developed strategies to manage the disorder and I like to say I have it, it doesn’t have me.”
Is There a Cure for Dermatillomania?
There is currently no cure for dermatillomania. However, there are helpful treatments. McKeaney says cognitive behavioral therapy (or CBT) is helpful, as well as habit reversal training (or HRT). There’s also N-acetylycisteine (NAC), which is an over-the-counter glutamate supplement. “It’s believed to help reduce BFRB urges in about 50% of the people who try it,” she says.
For Joanna, effectively managing her dermatillomania meant reducing the dosage of a medication she was taking, as well as establishing a comprehensive skincare routine. When she reached out to me on Instagram, she explained her situation and asked for advice. I directed her to take one of our virtual skincare consultations during which we set her up with a personalized skincare routine. “In addition to working with Renée’s products, and being off this medicine, my life has changed. I still pick, but it’s nowhere near what it used to be.”
Note: if you suffer from chronic skin picking, see a physician. They’ll be able to provide professional advice and create a personalized treatment plan.
Joanna’s Daily Skincare Routine:
AHA/BHA Blemish Control Cleanser: Reduces bumps and blemishes with a blend of salicylic, lactic, and glycolic acid
Balancing Skin Tonic: Witch hazel, geranium, and niacinamide (vitamin B3) hydrates the skin and diminish post-breakout discolored marks and scarring
Anti-Bump Solution: Visibly reduces the appearance of acne, blemishes, and painful bumps that form deep within the skin.
Vitamin C & E Treatment: This antioxidant-rich formula helps fade hyperpigmentation left behind from picking. “I think I just went through two bottles,” Joanna says. “I love it.”
Total Eye Repair Crème: Improves dryness, fatigue, and the appearance of wrinkles around the eye area.
Weightless Protection SPF 30: A lightweight sunscreen for oily and sensitive skin that won’t feel greasy, cause blemishes, or clog the pores.
She also uses a fidget toy and rubberized gloves to prevent picking. (On that note: our No Picking! Twisty Toy is designed to keep your hands busy and off your face to prevent picking).
How Do You Suggest Resisting the Urge to Pick Your Skin?
There are three things I personally do if I feel the urge to pick my skin.
- The first is to take a pause and take a breath. When you pause, ask yourself if you’re going to be helping or hurting the situation. I can assure you, as can anyone who repeatedly picks their skin, the aftermath—the scabbing, bleeding, and oozing—is most likely going to leave a discolored mark. Discoloration can last for months (or longer). Sometimes that pause is enough to prevent excess picking.
- After pausing, try to recognize what you’re feeling. Are you nervous? Are you stressed? Try to identify the emotions you might be feeling that might be triggering you to pick your skin.
- The third thing is to ask yourself if there’s something else you can do in the moment to channel your energy away from picking. I personally like to get fresh air, keep my hands busy with a twisty toy, or mediate.
McKeaney also has advice to share. For focused picking, she recommends altering your environment. “This could look like covering your mirror with a scarf or love notes, dimming your bathroom light or unscrewing a light bulb, staying arm’s length away from a mirror or splashing water on the bathroom sink so you are less likely to lean in, bring and set a timer in the bathroom, or shower and change by nightlight.”
For scanning picking, she suggests using blockers and barriers. “Tight clothing like turtlenecks, leggings, or long sleeves with thumbholes can be helpful,” she says. She also recommends acrylic nails, which make picking more difficult, as well as using fidget toys, applying bandages or hydrocolloid patches, putting gaff tape over your nail beds, and wearing jingling bracelets and perfume on your wrists to use your other senses. All of these things can bring awareness to your fingers.
What Should I Do If I Already Picked My Skin?
If you’ve already picked your skin, you want to avoid further irritation and scarring by simply leaving it alone. Try not to touch it anymore. If it’s a whitehead you’ve squeezed, you can use a drying spot treatment, such as my Night Time Spot Treatment, which will help close up the skin and accelerate the healing process. You may also consider putting a pimple patch or small, circular bandage over the spot, so you don’t see it, and you’re not tempted to touch it.
If you’ve picked to the point of bleeding, you might apply some Neosporin to accelerate the healing process and keep the wound clean. Whatever you do, avoid acid-based ingredients, since the skin is already broken, and you don’t want to irritate it any more.
“There is freedom beyond this,” Joanna says. “There is no shame in this because we all suffer from something. I think there’s been a lot of shame, especially with women who do this. People will tell you, ‘just stop.’ Well, if it were that easy, don’t you think I would? I would just love to stop picking, but I can’t.”
“Be gentle with yourself after a picking episode, McKeaney says. “The disorder already gets to tear you apart and it doesn’t need a minute more of your time. Choose yourself over the mental illness that chose you, #PickingMe over skin picking. Aim for progress over perfection. Set mini-goals to experience mini wins, build on that progress, living in that momentum, that’s where happy happens. Know that you’re not alone and in fact, have a whole community behind you at Picking Me Foundation. I validate your struggle and am sending you much love and support. Please reach out anytime firstname.lastname@example.org!”
Celebrity Esthetician & Skincare Expert
As an esthetician trained in cosmetic chemistry, Renée Rouleau has spent 30 years researching skin, educating her audience, and building an award-winning line of products. Trusted by celebrities, editors, bloggers, and skincare obsessives around the globe, her vast real-world knowledge and constant research are why Marie Claire calls her “the most passionate skin practitioner we know.”