STOP PICKING - START LIVINGSTOP PICKING - START LIVINGQUESTION: I seem to always have scratches over one leg, that I pick at, it has been for years, I have kept making excuses and even seen doctors, can u skin pick on just one part of your leg?
ANSWER: Everyone has their own pattern. For some people it is just a leg, or an arm or a lip, others cover a wide area. I have never seen anyone who covers 100% of their body, Sometimes there are good clues in the Why There? question. One woman who had relationship fears picked her breasts and told herself that she could never go out with a guy looking like that. For others it started with a mosquito bite that might have been anywhere. Underlying acne or eczema got the picking started for some others. From a treatment point of view it is much the same. Generally if the picking has been going on longer, or covers a wider area it will take more effort to beat it.
Ted A. Grossbart, Ph.D., Harvard Medical School, Boston, MA
QUESTION: please help. . . I have face ,scab,scalp,lip, dead skin,acne picked all my life. I need help to quit but have very little money to receive help. Are there any free services or case studies that i can apply for?
ANSWER: Treatment for picking is very specialized, so it is hard to get serious help in many areas. Add in a small budget and the search is even harder. There are sometimes research studies both of drugs and psychological techniques, but they are rare and you usually need to be in the same location. Keep in mind that the researchers give priority to their needs not yours, so be realistic if you participate. http://trich.org is a good way to know what studies are available. They also have workshops, books, and other programs at modest cost.
Ted A. Grossbart, Ph.D., Harvard Medical School, Boston, MA
We've been contacted by an international feature news agency called Incredible Features (incrediblefeatures.com). They work with many national and international publications, including Time, Newsweek, Psychology Today, and others to cover unique and amazing stories that often don't get highlighted in the mainstream media.
They're presently looking to do a story about Dermatillomania and are in need of someone with a case of skin picking disorder to speak with about their experience.
As always, we welcome and endorse any effort directed at increasing CSP awareness. If you're willing to share your story, please contact Holly [at] incrediblefeatures.com
QUESTION: I have been picking sores all over my body for years already. I crave to pick at sores,so it does not help to cover them up.I am already on antidepressents. Can someone tell me how I could get rid of this habit?
ANSWER: Picking is at once a very sticky and a very treatable problem. Here is a summary of what I have found to be helpful in over thirty years of helping people with this problem. It is from the Skin Deep site, http://grossbart.com: How To Stop Compulsive Skin Picking, Scratching, and Hair Pulling
Question: What is you opinion on the effectiveness of homeopathic or other natural remedies for this condition. Where can I get more unbiased information about the side effects of the drugs ususally prescribed for OCD?
Answer: Judging from both the research studies and my clinical experience, the overall effectiveness of the full range of mainstream and alternative medications and remedies is low. If you are taking them for the picking rather than for depression, anxiety or other OCD Issues, you are likely to be disappointed. The official drug company list of side effects has to list any reported problems, so it is somewhat objective on what side effects people experience, probably less objective on how often they experience them. There is one possible exception to this, a natural, cheap, seemingly safe, somewhat effective product. We will see if it stands the test of time. N-acetylcyseteine 2400-3600 mg. a day, taken for a three week trial period results in some noticeable reduction in urges for about half the people in both controlled studies and my clinical experience. It lasts 3-6 hours in the body, so you can time it to problem times.
Ted A. Grossbart, Ph.D. Licensed Clinical Psychologist Assistant Clinical Professor of Psychology, Harvard Medical School
Question: Hi ... my questions are regarding skincare but I know is affecting all areas of my life... I am a 43yr old attractive , nice , good self image (i thought), but my one vice is that I TOUCH my face EVERYDAY .... and then try to fix it the next morning before I face the world. I guess they call it a Picker, which sounds disgusting, but I cant deny it anymore. I have invested in all kinds of skincare that Im sure has done wonders for my skin - since I torture it everyday. Im not sure if there is an underlying problem, but I feel like I cant control my obsession with trying to squeeze, or find flaws in my face,, or overpluck my eyebrow, ... then im ALWAYS going to bed feeling ugly and disgusted with myself which then turns into eating badly, no sleep and no exercise. Any suggestions..... I would love to invest in this program , but feel like I probably need to correct this habit before I spend more $ on stuff Im gonna sabatoge :( Im afraid any DR. will put me on some kind of anti-depressant which I dont want - I know I am a lil OCD .. when it comes to clean house, organization, I wake up and prepare for the next day (i.e. get my coffee/timer, iron next day clothes, etc) before I can leave the house to start THAT day.... hmm.... Thanks for any suggestions.
QUESTION: Are there any medications that have success, that are not overly sedating?
ANSWER: Medications of all sorts for picking are notoriously unhelpful and some especially ADD and ADHD medications can make it worse. Some individuals have success with antidepressants, mood stabilizers, and antianxiety meds but none are consistently helpful. They often are of some help with the underlyjng anxiety or depression, but statistically are not very impressive for picking. There is a health food store dietary supplement that about 50% of people find somewhat reduces urges. Go to (http://www.trich.org/dnld/NACarticle_InTouch55_rev.pdf) for more on this one.
Ted A. Grossbart, Ph.D. Licensed Clinical Psychologist Assistant Clinical Professor of Psychology, Harvard Medical School
Hi, I am a 23 yr old woman, generally active and well adjusted but with a annoying and long standing skin picking problem. I pick my face in front of the mirror. I pick under my arms and the area between my breasts and around my nipples to the point of bleeding and scabbing. I am generally targeting whiteheads of blackheads but once there aren't any left I still keep going. I also have psoriasis on my scalp and ears and I pick that compulsively especially when I am thinking or studying. I do have obsessive tendencies, but they are generally manageable. For example I used to have to shower twice a day no matter what and I have recently cut down to once a day with relative ease. I do things like hand-sewing and knitting but these don't quite fulfill the same need and I can't do them while I am studying. I have tried punishments on myself, which doesn't really work. I have tried a reward for a certain length of time pick-free which doesn't really work either. Pure will power only works for a couple of days and only if I have someone else I am doing it for if that makes sense. But it always breaks down. I feel like the psoriasis picking and the zit picking are slightly different problems but certainly related. Meditation just makes me super twitchy and does not replace the picking urge at all. Any thoughts? Hi, Here is an overview from the Skin Deep site (grossbart.com).
Question: Hi Doc, This isn’t exactly skin picking but close and it is making me miserable. I have this persistant itchy, red rash around the bottom of my scrotum and all around to the top of my penis. Looser underwear helped a little bit as have various creams and powders, but nothing helps very much. Several dermatologists have agreed it is something called “red scrotum syndrome, ” a well known problem apparently, but notoriously hard to treat. They have each given up on me. Do you have any experience or suggestions on this one?
Answer While red scrotum is a source of great frustration to the dermatology community, it is often quite responsive to psychodermatology approaches like Skin Deep (http://grossbart.com). I have worked with seven or eight guys both here in Boston and by phone and Skype. In all the cases there were feelings about some aspects of their relationships or sexual lives that were key to getting relief. One guy was guilty about an affair, another conflicted about having kids, one guilty about masturbation, and another who felt his wife was symbolically cutting off his balls. In each case they needed to be feeling the conflict in their hearts and confronting the issues to stop feeling the conflict via their red itchy scrotums. That work plus using relaxation, imaging, and hypnosis and self hypnosis provided significant to near total relief.
QUESTION I am a wound care specialist and deal, more often than I expect to, with problems related to picking. I have had a patient who I believe quite literally picked his nose away. He had a wound on his little finger down to his bone. Even though his wounds were extreme I could not get others involved with his care (doctors) to believe they were self inflicted wounds. You would be shocked at the catalog of investigations he had done and the specialists he saw. Another woman developed abscesses and needed extensive wound care. She tried to take legal action because I suggested she was self harming (by picking). I appreciate these are extreme but I deal with many patients who pick at wounds and as a nurse find it difficult to get the doctors, that I need to interact with, to believe me. I wondered if you have 4 recent references that would give me some: statistics, relationship between picking and self harming behavior and treatment options.
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