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.
Question: I have a daughter I adopted at 3 years old from China. She has been with our family now for 6 months. She seems very happy, social and well adjusted but picks every night when she goes to bed, especially her face. You name it, we have tried it to stop her. We have tried talking to her, taking away her favorite toys, no dessert, showing her in the mirror what she has done, spanking, clipping her nails all off, tons of lotion, Mederma and bandaids. Nothing stops it but most of the time she will keep the bandaids on so at least the bad spots can heal, but then she just starts new ones. We are at our wits end.
Qustion: My 86 year old father in law has developed a compulsive skin picking habit and has a belief that bug are living under his skin. He has circulation issues so we worry about Gangrene forming in his leg and foot sores. The meds make him sleep but has done little to interupt the picking cycle. What else can we do??
Answer: This is not fundamentally about the picking. it is secondary to what is called "delusions of parasitosis." In this condition people who can be otherwise quite sane and functional develop a steadfast conviction that they are infested. Symptoms usually start at some point of increased stress. Logic, evidence, and psychological approaches are usually ineffective. Antipsychotic medications are usually quite effective. These are not the same meds usually prescribed and not very effective for picking. The problem is that patients often reject them, saying, "I'm not crazy, the bugs are real." They indeed feel very real. It is sort of like if your car's oil light keeps going on, but you have plenty of oil, the light is broken and giving you an inaccurate story. The key is to find a firm but compassionate way to get him to do a trial on the antipsychotic meds. Some PCP's will prescribe, some derm practices, or you may need a psychiatrist/psychopharmacologist.
Ted A. Grossbart, Ph.D. Licensed Clinical Psychologist Assistant Clinical Professor of Psychology, Harvard Medical School
There are a lot of people suffering from compulsive skin picking who are looking for answers. Some find what they're looking for on Skinpick.com, other websites and forums dedicated to the topic, or books about skin piking. However a lot of people don't find exactly what they're looking for, due to the particularity of their case or any other reason. Plus, not all are ready or willing to get professional help for skin picking.
We decided to help by giving people the opportunity to ask questions about their condition and receive expert advice from a professional.
Hopefully we will help many people just by answering their question. A broader goal is to compile a list of Q&A, which on itself will be very informative and helpful not just to people who send in the questions, but to all readers.
Dr. Ted Grossbart, a known expert on CSP and related disorders, will answer your questions.
To submit a question please visit this page.
Answers will be posted about once a week on this page.
We received an email from Lisa, the director of scars of shame. It's a film about Angela, a 24 year old, struggling with Dermatillomania. To the best of my knowledge, this is the first attempt to increase awareness about the compulsive picking disorder using the film medium.
As I understand, they completed most of the filming, but there's still a lot of work to be done. They need funds to help them with production costs. In addition, they want to take Angela to San Francisco to be part of the TLC skin-picking conference and meet professionals who might be able to help her.
The film was funded by personal investment of the producer and director. You might be able to help them take Angela to the conference and finish the film. Click here to help
My name is Dr. Ted Grossbart. For a few months now I've been offering counseling services on SkinPick.com.
Recently we realized that many people have questions about their condition, but not all of them are seeking individual help. We decided to help these people by opening this "Ask The Expert" page, where you can ask a question about your disorder.
I will post the answers to your questions about once a week (depending on my availability and the number of questions I get).
You can send me your questions by filling up the form on this page.
There's good chance you know Angela Hartlin (the author of FOREVER MARKED: A Dermatillomania Diary.
I came to know that a documentary is coming up, featuring Angela. You can view the trailer here.
When does it come out? And where? Angie, if you're reading this, we would all be happy to know these details.
We've been contacted by Clarabella, an undergraduate student from St. Mary's University College, England. She carries out a study on compulsive skin picking, supervised by Dr. Tig Calvert. She asked us to post about her study and bring in as much participants as possible. So if you can spare a few minutes of your time, this would be very helpful.
It's a study aimed at discovering the various emotional "functions" this disorder presumably fulfills.
Clarabella promised to share the results and conclusions of her study with SkinPick.com, so stay tuned (expected in April 2011).
Healthyplace.com hosted an online interview with Katie R. (21). Katie has dermatillomania, and like in many other cases, it began with acne picking. In this interview, she's talking about life with compulsive skin picking - how it affects her daily life and personal relationships. She also talks about the way she's gone through seeking for help, and her current therapy process (involving habit reversal therapy for skin picking).
The interview is comprised of two parts. First part contains the beginning of the interview, with some intro video, featuring Angela Hartlin. The second part contains the continuation of the interview, and ends with a live Q&A session. Thanks Katie for this interview and your online involvement!