How To Stop Picking At Acne

Psychiatric researchers have developed a new term for compulsive picking at pimples, blackheads, and whiteheads that keeps them from healing. This term is psychogenic excoriation. Some children, teens, and adults who have acne pick at their skin so many times that not only does healing become impossible, the acne lesion morphs into a skin ulcer that heals to leave an ugly, dark mark and even a permanent scar. The darker the skin, the darker the mark left by this practice.

What Is Psychogenic Excoriation? Why Do People Pick At Their Pimples?

Psychogenic excoriation is a behavior that is also labeled as acne excoriée, compulsive picking, dermatotillomania, neurotic excoriation, pathological excoriation, primary excoration, self-injurious skin picking, and self-mutilation. It affects about 1 in 50 people who have acne.

Often the individual who constantly picks at acne isn't even aware that he or she is doing it. Affected people may notice that there are numerous, dark, hyperpigmented patches of skin where they have picked at acne that eventually healed, but they may somehow not see the red, oozy, ulcerated patches of skin they are constantly irritating now.

Psychogenic excoriation is almost always a co-morbidity, that is a concurrent illness, with some other diagnosable psychological or psychiatric complaint. People who pick at acne constantly often suffer bouts of depression, crying spells, mood swings, and altered states of consciousness. In elementary age children, the picking usually increases during times of stress. In adolescents, psychogenic excoriation is often more frequent during leisure time. In adults, picking at acne may be more common during periods of moderate to major depression.

Psychological Associations with Psychogenic Excoriation

Psychogenic excoriation isn't just picking at a single pimple that has become particularly annoying. It is a process of picking at acne all over the body repeatedly, not just on the face, but often also on the arms, chest, neck, shoulders, inner thighs, and groin. Essentially everyone who develops the habit has some kind of diagnosed or diagnosable psychological conditions, most commonly:

• Alcoholism or alcohol dependence

• Anxiety

• Depression

• Obsessive-compulsive disorder

• Oppositional defiance disorder, or

• Some combination of the above.

In the experience of doctors who deal with the condition on a regular basis, essentially everyone who has full-blown psychogenic excoriation has some other psychiatric diagnosis. The methods used to treat psychogenic excoriation, however, also work for people who have a less severe "bad habit" of pimple picking that they simply want to get under control.

People who are diagnosed with psychogenic excoriation often are offered antidepressant drugs of the selective serotonin re-uptake inhibitor (SSRI) class, but people who simply have a habit they want to change may not need any drugs at all to stop picking at their pimples.

How to Reverse the Habit of Picking at Your Pimples

The process of habit reversal, whether it is for full-blown psychogenic excoriation or just a garden variety bad habit of picking at your pimples, usually requires four steps. You could go through these four steps with the help of a therapist, but most adults can easily do them on their own and most parents can help their children through the process without outside help.

• Make a point of becoming aware of how often you pick your pimples. This means keeping a diary. Every time you pick at your skin, jot down a note of what time it is, what part of your body you are picking at, what you were doing when you started picking at your skin, where you were when you started picking at your skin, and how you felt when you were picking at your skin (for example, "happy," "busy," "bored," "tired," "sick to my stomach," and so on). Then take a look at your list at the end of the day and at the end of the week. Sometimes simply making a commitment to keep a diary of your activities changes what you do. For one, if you know you'll have to write it down after, you might not want to pick at that pimple.

• Choose some activity that you will do every time you get an urge to pick at a pimple. This has to e some lawful, safe, inexpensive, and healthy activity that makes it impossible for you to pick at your skin. Some possibilities are sitting down at the piano and playing Chopsticks, or shuffling a deck of cards, or touching each finger of one hand to the corresponding finger of the other hand until the urge to pick at your acne goes away. You could also take inspiration from people who are quitting smoking and drink a large glass of water, go for a short walk, or do a few puships.

• Avoid the activity that is associated with the urge to pick at your skin. If you find that you pick at acne when you are home alone brooding in silence, find something to fill the silence, or find something to do around the house. If you find that you pick at your skin after you are scolded for a habit you cannot or don't want to change, or after visiting with a difficult family member, when you get a new assignment on the job, or when you can't have a drink or a smoke, you may need some professional help in finding alternative activities that are healthier for your skin and more productive for your life as a whole.

• Share your learning with others. As yet, there are no Twelve Step Groups for Pimple Picking Addiction — but you could always start the first. Working with a good therapist will help you find appropriate social outlets for discussing your skin issues and maybe getting greater insight into other psychological issues you can change to improve your life. We're sure there are online support groups, but be careful. They might just keep you in the loop, rather than help you kick the habit.

Overcoming the habit of constantly picking at your skin may not be easy, and you may require some professional help along the way. Overcoming the psychogenic excoriation, however, is possible, and you may improve your life in more ways than you ever imagined along the way.