Stress and Skin Picking

Tasneem Abrahams
Apr 22nd, 2016

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Why do we pick our skin? Well the reasons vary for everyone. For some it is habitual i.e. not knowing when they are doing it while others consciously do it in response to stress or boredom. No matter what the reason is, it is important to find out what triggers the skin picking so that one can prevent or at least minimize the urge to do it. Being aware as to why you are doing it will help you address the root cause and treat it accordingly.

Stress Related Skin Picking

Many people report that picking is a response to feeling stressed as picking helps reduce that stress. The inability to stop engaging in this behavior despite wanting to is known as compulsive skin picking disorder or excoriation disorder. According to Anxiety UK, a national registered charity:

"Compulsive skin picking (CSP) is characterized by the repetitive picking of the skin to an extent where damage is caused. It is usually the face that skin picking starts, however it can be carried out on any part of the body. Individuals affected by CSP may start by picking at normal blemishes such as freckles or moles, pre-existing existing scabs, sores or even acne blemishes.”

Further research suggests that anxiety, frustration or stress can trigger this condition. Normally when we are stressed we fail to realize how it is affecting us or to what extent it is affecting us in terms of its impact on our mental and/or physical health. We might think that we are handling a stressful situation well but the stress may be causing harm to the body or mind in other ways that the person may not even be aware about.

So Why Do We Feel Stress?

Just like pain is a human body’s mechanism of responding to a demand or threat, the nervous system also responds to a threat via releasing stress hormones. These include adrenaline and cortisol which prepare the body for an emergency. The heart and breathing rates rise and the brain receives more oxygen. The stress basically helps us handle a tensed situation. For instance, a student has a final exam and is stressed about managing the exam in time and of high quality. In such a case the hormonal reaction will provide the student with a source of energy and will help him get through. However, the negative thoughts he might engage into will affect the hormones adversely. Thus our thoughts play a crucial role in making us feel confident or helpless when faced with a problem. When the situation goes back to normal, the Central Nervous System (CNS) informs the other systems to return to their normal conditions also. However, if this does not happen, the body will remain in a state of emergency. This can result in chronic stress. The student worrying about his exam may have negative thoughts such as not writing a good exam or not being able to finish it in time. Thus negative thoughts make you think that you are failure even before you have started the task.

How Does This Relate To Skin Picking?

Many skin pickers report to experience a sense of release or relief from tension when engaging in skin picking. We then seek out this same feeling the next time we exprience tension or stress. This can lead to one picking the skin as an automatic response to stress or can lead to the person purposely seeking out this feeling through picking. Cognitive Behavioral Therapy is an effective measure to make a person become aware of the triggers that lead to picking and to identify alternate, positive behvaiors. For example, exercise is recommended as a means to exert the extra energy caused by stress. A stress ball can be used to reduce the anger and stress.

Research revealed that 60% of sufferers of skin and hair problems are going through some kind of stress. Dr. Grossbart is a skin psychologist who has an experience of 30 years. He uses the SKIN DEEP approach which is very popular on TV, radio and internet, in the newspapers and magazines. He has even penned down his unique approach in his book "SKIN DEEP: A Mind/Body Program for Healthy Skin".

He suggests a number of tools to treat skin picking. Medication  and supplements is considered a useful means of dealing with the issue.  A good therapist will not only address the behavior change but also the emotional aspects of the condition. Hypnosis and self-hypnosis have also been used to treat the problem and have had a good success rate. However the evidence also suggests the most effective approach to treating skinpicking is to tailor treatment to the specific individual with a holistic perspective, where is is often recommended that a combination of different treatments be used, with cogntive behavioral therapy being the unifying thread between the various treatments.

What can you do about it?

Realizing that you have problem is the first thing that will help you address the root cause. Talk to a family member or a close friend so that you can feel someone understands you and you can get the support you need to overcome this disorder. There are also many useful resources online where you can learn how to cope with stress and strategies for dealing with skin picking. Reading about people going through the same condition can help you feel that you are not alone. There are also resources such as the forums that enable you to connect with others who are suffering from the condition and those who have recovered. Being patient and persistent is the key to success. Do not miss appointments, medicines and therapies. Keep a record of your treatment and discuss every detail with your physician/therapist so that he/she can treat you effectively. Stress related skin picking can become a vicious cycle if not addressed. The more you pick the more stressed you become, which further perpetuate the picking behavior. Finding alternate responses and more effective ways to deal with stress can go a long way in breaking that cycle.










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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