I suffered from Skin Picking disorder since I was 2... I used to pull my hair in my childhood, then acne in my teen years, then my toenails, then back to adult acne.
Last year there were many changes in my life and stress, anxiety and boredom woke up my compulsions uncontrollably. Since I am almost 40 and had scoriated acne / lesions / scars that would never heal, I wanted to put an end to this... I was so sick of it, and embarrassed.
What changed, was that I admitted to have a problem, opened up to ny husband about it and my trusted close family. So I read all there was to read about this, enrolled to this website/program/forum, wrote a diary and talked to a therapist for a couple of months... did some improvement, but always had fallbacks.
Funny how things indeed seem at the beginning of this journey to be impossible, but if you really reach the bottom, the chances things can get better are very good.
Below my manual. It worked for me, so I wanted to share. The first part is a summary of the opera for compulsive toc / picking. And then, what I did to physically help my skin, which was in itself, a big side of my problems.
Picking / psychotherapy:
"Urges" (from skinpick.com)
- Understand why you have them;
- ... Avoid triggers!
On the website, you can download the app, and monitor urges / note down sensations etc in a diary. Helps understand triggers, then try to avoid them.
Why / when:
I have urges mainly when my skin has some mild acne. I start picking when I am bored / anxious / stressed. One thing leads to another...
Understand your triggers:
Stress makes my skin oilier, the pimples tend to appear, and the cycle begins. But if I am left with a lot of time on my own - or simply anxious - I end up creating situations for "picking".
Mirrors or bathrooms with strong light show "defects" and should be AVOIDED (if possible, used in "company").
Ps: Today I go out early, I exercise, I focused my energies on various activities and hobbies ... I stay only a little time at home - and when I am, I focus my time/energy on other enriching activities... I play the piano, do some drawing, I even wash the dishes ... EVERYTHING other that entering a bathroom.
The "addiction" can be "focused" (when you do with the intention - ex.: in front of the mirror), or almost "unnoticed" (unconsciously), like touching the face to feel its "texture", etc.
This light touching contaminates the skin and again triggers the process ... so I now watch films with "anti-stress toys" on my hands. I had a new mania also of itching behind the neck and back (where I reach). My brain kind of created this as "competing response." The correct thing would be to stimulate nondestructive actions, but at the same time occupy hands and brain equally.
It can be ok though to negotiate with yourself "other areas", when you have an urge ... cuticles etc - everything to let the face / area to be rested ... but only as a "crutch" in the process.
Another good trick when the skin is kind of bad is getting a pretty good make up in the morning. Helps improve the self-esteem, and with it on the face, we avoid “touching” it. I have to be careful not to allow this routine to turn into another trigger (staying close to yourself/skin/mirror is never good). I walk into the toilet a half hour before I leave, just to give myself time to get things going.
Today I prefer to use the least possible daytime makeup so that my skin is not “clogged".
When the skin starts to look good, just a minimum of concealer and powder / blush - no foundation! Little makeup, made in a bathroom in low light. On a day-to-day basis, I do my make-up in the car - I think it's even better.
... Those with ocd will always aspire to have a "smooth" skin. So I decided to fight for it by testing various products.
Here is my routine - it cleared my adult acne:
1. Wash my face with soap with salicylic acid.
2. Use the P50 toner from the biologique recherche brand. It cleanses up to the soul, the scent is a bit like vinager ... it helps exfoliate, remove dead cells and debris from make up (which clogs pores). I had some internal pimples/cists on my neck, chest and jaw ... everything came out.
3. Use the vitamin C from skinceuticals - it leaves the skin moisturized but fresh. It is importante to moisturize the skin after cleaning it, it balances it back to normal (if left too dry, it will overproduce oils)
4. I use the egg mellow cream from too cool for school with some teatree oil drops and sunscreen for daytime
5. For the evening, I use instead an MSM cream
* On top of pimples I use only pure teatree oil or the blemish (salycilic acid) from skinceuticals. If the skin does not react, I try the next day salicylic acid gel from neutrogena. I think it's good to switch, it's more efficient ...
(A period that my skin was very inflamed, I used sometimes the led mask from Neutrogena. It was good with cists ... idem the led pen ... I thought that helped to decrease inflammation)
* In open pimples I also use bandaids (hydrocolloid), which help to absorb water / inflammation. Leave it on the skin for 8 hours, and the bumps disappear and healing accelerates
* when I have to remove makeup from the eyes and I have used foundation, I use an oil based makeup remover and the foreo or the sonic brush to clean WELL the skin
What I'm doing aside from this - that helped MUCH:
- 1x every 15 days, a session. I was using 15% at home, but my skin became resistant to the percentage. After 4-5 times, I did it then at the dermatologist with 25-30%. It was great, it rejuvenates, improves texture and also helps dry blackheads and pimples.
* the skin peels already in the 2-3 day (nothing horrible ... with moisturizer it is not so visible!), For max. 5-7 days.
- Alternate with TCA the "dermaroller" (1 week tca, 1 week the roll): I put vitamin C ferulic after the session
- Dermaroller also helps to improve some blemishes and scars (acne cannot be active with this)
I bought 2: 1 of 1mm and another of 1.5mm, the deepest one for the worst scars
- I got some mild improvement from dermarollers, and then upgraded to Vivace (microneeding with radio frequency) - I am now on my 4th month. The theory is the same, but the needles are precise and change from 5mm to 2.5-3mm on each different area of the face. Great too, I found it almost painless, 0 downtime. It lightens blemishes, renews skin, creates new collagen, etc.
Medications - I do not know if they influence:
- I started taking NAC, 1200g x day, 4 months ago. It helps contain "urges" in the brain. It might have helped a bit ...
I never slept again with makeup, and I follow this routine every day, morning and night. My skin still has blackheads and mini pimples, of course, but I avoid looking. I agreed with myself to look at a distance of at least 30cm from the mirror. No one comes so close to our skin to check it ... At night, when the risk of "analyzing" is greater, I enter the bathroom when my husband is still awake (on purpose) ... and he keeps "monitoring me" .
Sometimes I squeeze 1-2 pimples, but the next day I regret it. Every single time. But I think I'm finally able to "reason", even because my skin has improved a lot, and then I can convince myself that it is not worth it! This whole process was long (7 months)... but having good skin is the best incentive not to ruin it. Focus your energy in things that make you feel good about yourself, and slowly, your time will be used for better, you will feel powerful again... and skin picking may become something that “”you used to do”...:)