Breaking the Silence: Understanding Skin Picking in Men and How to Offer Support

Skin picking disorder, clinically known as excoriation disorder or dermatillomania, is often thought of as a condition that primarily affects women. However, this perception is misleading because men struggle with skin picking too. While a recent meta-analysis found that women do tend to be diagnosed with skin picking more often, a significant percentage of men do too. However, these findings don’t align with the statistics from other related disorders, including trichotillomania and Tourette’s Syndrome where men and women seem to be equally affected. 

It's well-documented that men tend to avoid seeking mental health help in general. There has been speculation that men may indeed experience skin picking at rates similar to women but may be statistically underrepresented and underdiagnosed. A variety of factors are thought to influence this underrepresentation including:

• societal stigma 
• gender norms
• differences in the way the condition manifests

For men living skin picking, this can result in feelings of isolation and shame, as well as missed opportunities for support and treatment. Sometimes, they’re surprised to find they’re not alone after all. 

Stigma and Gender Norms 

Skin picking is often seen as a private struggle, and for men, it can be even more hidden due to societal pressures around masculinity and emotional vulnerability. Men often face social expectations that discourage them from expressing emotions or seeking help for mental health issues. There is an enduring belief in many cultures that men should handle issues independently, without asking for support. This stigma can make it harder for men to openly acknowledge behaviors like skin picking, as they may fear judgment or be perceived as "weak" for needing help.

As a result, a man with visible skin damage may feel ashamed or embarrassed, not just because of his skin, but because he’s aware that his struggle doesn’t align with traditional male expectations. He may experience feelings of frustration and anger because he can’t “just stop”. He may avoid social situations where his appearance may bring unwanted attention. He might even avoid seeking help out of fear of being perceived as weak, overly emotional, or vain, leaving a sense of powerlessness. This avoidance can lead to a vicious cycle of stress, shame, and more picking.

How Skin Picking Manifests Differently in Men

While skin picking shares core features across genders, such as the repetitive picking of the skin that leaves noticeable skin damage, the condition often manifests differently in men. 

Picking Preference - Men typically pick from fewer places on the body than women. They tend to pick more from their face or arms. They are less likely to pick from their  backs, scalp, and chest areas than women.

Family Connection – Men with skin picking are more likely to have a first-degree relative with skin picking.  

Grooming Behavior – Some research suggests that men may view their picking more as a grooming ritual rather than problematic behavior. Picking in women was associated more with compulsion. 

What Can Help?

If you’re a man living with skin picking, know that you are not alone. While it can feel like a lonely struggle, there are thousands of men dealing with the same issues you are. There are things you can do to ease the distress and find relief:

Educate Yourself

The more you know, the more informed your choices can be. Skin picking is a recognized disorder and not simply a “bad habit” or sign of weakness. And there is help. 

Seek Help

Seeking help from a mental health provider who specializes in BFRBs like skin picking is a game changer. Cognitive-behavioral therapy (CBT), specifically Habit Reversal Training (HRT), has been shown to be highly effective.

Seek Support

Joining support groups, whether in person or online, is another effective way to combat feelings of isolation. Support groups are also a great place to find tips for managing triggers, reducing stress, and building a supportive community from people who are on the same journey as you are.

If Someone You Love Has Skin Picking Disorder 

If your male friend or loved one is dealing with skin picking, you can be a tremendous source of support. Support can come in many forms:

• Create a safe space for open, non-judgmental conversations. Encourage them to talk about their feelings and acknowledge those feelings. 
• Avoid telling them things like “just stop” or demanding they go to therapy. If they could stop, they would. 
• Gently suggest seeking professional help or a support group.
• Offer to help them find a therapist or support group if they express a desire to do so. 
• Let them know you can see their struggle. “I hear you” or “How can I help you today?” are powerful words that can help someone who is struggling. 

The Takeaway 

For men living with skin picking, understanding the condition and seeking support can make a world of difference. Compassionate, non-judgmental support can help create a safe environment for healing and growth and pave the way for seeking treatment. Breaking the silence around skin picking in men is the first step toward broader awareness and better mental health for all.

References

1. Farhat, L. C., Reid, M., Bloch, M. H., & Olfson, E. (2023). Prevalence and gender distribution of excoriation (skin-picking) disorder: A systematic review and meta-analysis. Journal of psychiatric research, 161, 412–418. https://pmc.ncbi.nlm.nih.gov/articles/PMC11137851/

2. Grant, J. E., Dougherty, D. D., & Chamberlain, S. R. (2020). Prevalence, gender correlates, and co-morbidity of trichotillomania. Psychiatry research, 288, 112948. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7212053/

3. Scharf, J. M., Miller, L. L., Gauvin, C. A., Alabiso, J., Mathews, C. A., & Ben-Shlomo, Y. (2015). Population prevalence of Tourette syndrome: a systematic review and meta-analysis. Movement disorders : official journal of the Movement Disorder Society, 30(2), 221–228. https://pubmed.ncbi.nlm.nih.gov/25487709/

4. Chatmon B. N. (2020). Males and Mental Health Stigma. American journal of men's health, 14(4), 1557988320949322. https://pmc.ncbi.nlm.nih.gov/articles/PMC7444121/

5. https://www.reddit.com/r/CompulsiveSkinPicking/comments/zu6nzo/do_men_women_pick_equally/

6. Anderson, S., & Clarke, V. (2019). Disgust, shame and the psychosocial impact of skin picking: Evidence from an online support forum. Journal of Health Psychology, 24(13), 1773–1784. https://journals.sagepub.com/doi/10.1177/1359105317700254

7. Grant, J. E., & Chamberlain, S. R. (2022). Skin picking disorder: Does a person's sex matter?. Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists, 34(1), 15–20. https://pmc.ncbi.nlm.nih.gov/articles/PMC7612641/

8. Vöhringer, J., Schmidt, J., & Martin, A. (2017, August). Gender differences in skin picking behaviour and relations to health in a German community sample [Poster session]. 31th annual conference of the European Health Psychology Society (EHPS) , Padua, Italy. https://www.researchgate.net/publication/319443475_Gender_differences_in_skin_picking_behaviour_and_relations_to_health_in_a_German_community_sample