Nutrition and Skin Picking

Tasneem Abrahams
Apr 24th, 2015

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The food we eat inevitably affects our overall health. However we often only attribute the effects of diet to our physical health and neglect to acknowledge the impact it can have on our psychological health as well. There has been an overwhelming influx of research over recent years that suggests poor quality diet increases one’s risk for common psychological disorders such as depression and even compulsive skin picking disorder, now named excoriation disorder. Excoriation Disorder is a serious and poorly understood problem. People who suffer from SPD repetitively touch, rub, scratch, pick at, or dig into their skin, often in an attempt to remove small irregularities or perceived imperfections. Skin picking and other BFRBs can occur when a person experiences feelings such as anxiety, fear, excitement or boredom, and this repetitive behavior can negatively impact a person's social, work, and family relationships.

Is food to blame?

While body-focused repetitive behaviors (BFRBs) such as excoriation disorder are gaining increased awareness, our knowledge about the disorder is still in its infancy. For example, even though research has found evidence of some plausible causes for compulsive skin picking, there is still no known single definitive cause. Some evidence points to hormonal imbalances, some indicates the cause is neurobiological, while genetic correlation also holds merit. While we cannot change our genetic make-up, we certainly can influence our neurobiological processes and our hormone levels through diet. Could what we eat therefore aggravate the urge to pick, or even place us at higher risk for developing a skin picking disorder in the first place?

Brain Food

In the field of Nutritional Psychiatry there are observational data regarding the association between diet quality and mental health across the globe, particularly depression. What you eat directly affects the structure and function of your brain and, ultimately, your mood. As yet there is no empirical evidence showing a direct correlation between any specific foods and skin picking, however there are theories linked to the cause of skin picking that can inform a connection with the food we eat or do not eat.


One of the theories centres on the role of neurotransmitter imbalances in eliciting the intense urges to pick that are characteristic of excoriation disorder. Neurotransmitters are the brain’s chemicals that communicate information throughout our brain and body. The brain uses neurotransmitters to tell your heart to beat, your lungs to breathe, and your stomach to digest. There are 2 types of neurotransmitters:

  1. Excitatory: these stimulate the brain, e.g. leads to increased heart rate
  2. Inhibitory: these calm the brain and balance mood, and create balance when excitatory neurotransmitters are active

It is believed that the amino acid glutamate, which occurs naturally  in many foods such as wheat and dairy, acts as an excitatory neurotransmitter in the brain, which means it stimulates areas in the brain or other parts of the nervous system, and that an excess of glutamate contributes to problems in mood and anxiety. The concern is that there is an over abundance of free glutamate (which is more rapidly absorbed than bound glutamate) in processed and packaged foods because of its flavour enhancing properties. Decreasing intake of processed and packaged foods may lower glutamate absorption, which can decrease the urge to pull.

Cholesterol and Fat

Another theory is that hormonal imbalance is to blame for developing skin picking urges. While neurotransmitters are the brain to body messengers, hormones are the body's messengers that travel in the bloodstream between tissues and organs. Our hormones influence many important bodily functions such as energy regulation, sleep patterns and even mood. What most people do not realize is that the building blocks of hormones are actual fats and cholesterol. Maintaining a good level of cholesterol has been driven into us so hard, that just the mere mention of the word has us running to the hills. However most peope are not aware that fat and cholestrerol are actually critical to our bodily processes, particularly for the balance of our hormones. According to Annette Pasternak, the problem is in the balance, in that the modern diet of processed foods and vegetable oils, leads to a high ratio of omega-6 to omega-3, which has been correlated with depression. Eating foods that are high in Omega-3, such as fresh water fish, limiting caffeine, getting enough sleep, and drinking coconut oil are all natural ways you can balance your hormones.

Vitamins and Minerals

When mum says you shoudl eat up all your vegetables you should listen! Fruits and vegetables are our main natural source of vitamins and minerals. A recent study published in the BMJ Open suggests eating five a day is linked to better mental well-being, where 35.5% of participants with high mental well-being ate five or more portions of fruits and vegetables a day, compared with only 6.8% who consumed less than one portion.  Besides fruit and vegetables, cereals with high bran content, oranges and bananas, beans, brown rice and nuts contain contains a complex carbohydrate called inositol, which functions in part as a signaling molecule in insulin regulation, nerve transmission, and calcium, serotonin and cholesterol regulation. It is considered a natural mood balancer, used to treat a wide range of diseases and disorders such as high cholesterol, cancer, depression, schizophrenia, autism, ADHD, psoriasis, diabetic nerve pain and most recently BFRBs like compulsive skin picking.

Balance is key

The important thing to remember is that there is no onle single hero or miracle food. When you look at your plate, ask yourself: is it fresh, is it naturally sourced, and is it colorful? A colorful plate signals a well balanced meal and this is a guideline everyone should follow for optimal health. Avoiding processed foods like refined sugar, processed meat and caffeine and keep your brain and body hydrated by drinking lots of water. It may just also improve the health of your skin or reduce the urge to pick. 




Tasneem Abrahams

Tasneem is an Occupational Therapist, and a graduate of the TLC foundation for BFRBs professional training institute. Her experience in mental health includes working at Lentegeur Psychiatric hospital forensic unit (South Africa), Kingston Community Adult Learning Disability team (UK), Clinical Specialist for the Oasis Project Spelthorne Community Mental Health team (UK). Tasneem is a member of both the editorial team and the clinical staff on Skinpick, providing online therapy for people who suffer from excoriation (skin picking) disorder.

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