Office Talk: Navigating Doctor's Appointments When You Have Skin Picking

Walking into a doctor's office when you live with skin picking disorder can feel uncomfortable and maybe even a little scary. The thought of a healthcare provider examining your skin, asking questions, or maybe  commenting on it can trigger feelings of anxiety or shame. It’s an often-cited reason for people to avoid seeking help. In fact, a recent study found that almost half of people with skin picking avoid seeking treatment. What’s even more concerning is that when they did seek help, they often felt that the visit was not helpful. 

But here's the good news: appointments with healthcare providers don’t have to stress you out. They can be opportunities for healing, support, and better care. With the right approach, you can turn potentially uncomfortable conversations into productive partnerships for your wellbeing and get the resources you need.

Understanding the Medical Perspective

Skin picking disorder, also known as excoriation disorder or dermatillomania, is a recognized mental health disorder that affects millions of people. Unless your first visit is with a psychiatrist or therapist, you are probably seeing a provider who is looking at your skin through their medical lens of expertise and may ask a lot of questions that don’t initially make sense to you. 

It helps to remember that doctors and dermatologists see a wide range of skin conditions daily and they’ve likely encountered skin picking before. When a doctor comments or asks questions about your skin, they're typically trying to assess the situation and determine the best treatment approach. Their questions and observations aren't judgments; they're part of their diagnostic process.

Preparing for Your Appointment

Preparation is your greatest ally. Before your visit, take some time to jot down key information you want your provider to know. Things like when your skin picking started, what triggers it, patterns you’ve noticed, how often you pick, and which areas of your body are affected are all helpful. 

Consider too what you hope to gain from the appointment. Are you looking for medical treatment for skin damage? Mental health support? Both? Having clear goals helps you steer the conversation towards meeting those needs.

Opening the Conversation

Being proactive about discussing skin picking can transform the dynamic of your appointment. Rather than waiting anxiously for your doctor to notice and comment, consider mentioning it yourself. You might say something like, "I wanted to talk to you about my skin. I've been struggling with compulsive skin picking, and I'd like to address both the skin damage and the underlying behavior."

This approach puts you in the driver's seat and signals to your doctor that you're ready to work collaboratively on the issue.

Responding with Honesty

If your doctor asks about your skin, honesty truly is the best policy. You don't need to share every detail of your emotional experience, but being straightforward about the picking behavior helps them provide better care. 

Remember, you're not confessing to a crime. You’re describing symptoms of a real, diagnosable disorder. There’s an old adage in mental health that goes something like this: you can’t change something until you acknowledge its existence. Many people find that saying it out loud to a healthcare professional actually reduces shame and opens the door to real solutions.

Asking for What You Need

Be your own advocate. It’s important to know that not every care provider you see will be well-versed on the latest treatment protocols for skin picking. Or they may focus on topical treatments rather than considering the underlying psychological factors. It doesn’t make them a “bad” provider. It means that their training and your needs may not align but they can still be a powerful ally in your journey. 

Another way to look at is like this: All MDs are licensed to practice medicine, but they are not experts in every specialty. And to be fair, most general practitioners are not experts in psychiatry and skin picking is a mental health condition. Can your GP still help? Absolutely! They may be crucial in helping you care for your skin especially if the wounds are infected. They can also help refer you to a mental health specialist who can address the psychological side of skin picking. And it’s ok to ask them for that too. Remember, good healthcare is collaborative. 

Setting Boundaries

While being open is helpful, so are boundaries. Sometimes, clinical questions or comments can sting, even when well-intentioned. And speaking up about it is OK. If a doctor's comments feel judgmental or unhelpful, it’s ok to let them know. They might not realize certain language creates discomfort for you. Most providers will welcome this feedback because they want you to be comfortable and motivated for treatment.

Building a Supportive Healthcare Team

The ideal treatment scenario involves a care team that addresses all aspects of skin picking. Depending on your needs, that team might include your GP, a dermatologist, a therapist, or maybe even a psychiatrist. Your medical provider can treat the physical effects of skin picking while a therapist trained in treating BFRBs like skin picking can address the psychological components of the disorder. Together, they play key roles in a comprehensive treatment plan. 

Don't be discouraged if you need to try a few providers before finding the right fit. Everyone is different in who they connect with, and you want people on your team who you trust. Providers like that are worth the search! 

Moving Forward with Confidence

Seeing your provider doesn’t have to be something to dread or avoid. With a little preparation and self-advocacy, you can turn an uncomfortable moment into an opportunity for care, collaboration, and support. 

At SkinPick, we have a team of experienced therapists who understand skin picking and can help you get on the path to healing. Using evidence-based approaches, they can help you find healthy ways to manage your skin picking and navigate those uncomfortable conversations. And, with therapy sessions online, you can see your therapist when it’s most comfortable and convenient for you. If the fear of finding a provider who “gets it” is holding you back from seeking treatment, SkinPick is here to help.

References

1. Gallinat, C., Moessner, M., Haenssle, H. A., Winkler, J. K., Backenstrass, M., & Bauer, S. (2019). Help-seeking attitudes and experiences in individuals affected by skin picking. Journal of Obsessive-Compulsive and Related Disorders, 23, 100483. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S2211364919301034

2. Tucker, B. T., Woods, D. W., Flessner, C. A., Franklin, S. A., & Franklin, M. E. (2011). The Skin Picking Impact Project: phenomenology, interference, and treatment utilization of pathological skin picking in a population-based sample. Journal of anxiety disorders, 25(1), 88–95. https://pubmed.ncbi.nlm.nih.gov/20810239/