Is skin picking a form of self-harm?

Occasional skin picking is common. For example, once in a while, you might find yourself mindlessly picking at your nails or scratching those itchy mosquito bites on your arms. But some people engage in harmful, repeated skin picking or scratching that they have trouble controlling. 

In these instances, it could be a form of self-harm and/or a sign of a mental health condition called skin picking disorder (also known as dermatillomania or excoriation disorder). Research shows that this condition typically starts in adolescence and occurs in about 3% of the general population. 

If skin picking becomes difficult to control or causes distress, therapy can provide support and strategies to help people manage their behavior.

When skin picking is a form of self-harm

Yes, skin picking can be a form of self-harm, especially when someone uses it as a way to cope with emotional distress, manage anxiety, or punish themselves. 

More specifically, skin picking could be a form of self-harm when it’s difficult to control and it:

• Isn’t triggered by a health concern (like an itchy rash)
• Is repeated and causes visible tissue damage or lesions
• Causes distress and interferes with a person’s daily, occupational, and/or social functioning
• Feels difficult or impossible to stop

It’s important to remember that these symptoms could signal the presence of skin picking disorder. But this is different from the mild or occasional skin picking that many people engage in. 

For example, a person without skin picking disorder might pick at a bump, scab, or pimple out of habit or because they find it uncomfortable. But a person with skin picking disorder may engage in the same behavior for different reasons.

For them, skin picking can be a way to release uncomfortable emotions. This behavior, when repeated, can be a form of self-harm that can lead to serious injuries, infections, scarring. Other potential negative consequences include permanent scarring and an increased risk of emotional distress, shame, or social withdrawal.

The care you need, when you need it

Learn how Rula can support your mental health journey

Subscribe

I agree to receive emails from Rula and accept the terms outlined in Client Email Consent and Privacy Policy.

Underlying causes of self-harm and picking skin

We don’t yet fully understand what causes self-harm and skin picking. But research suggests that it might be caused by a combination of:

• Genetics: Having a close relative, like a sibling or parent, who also has skin picking disorder may increase your risk.
• Biology: Skin picking disorder may be associated with differences in the areas of the brain that control behavior and habit formation.
• Psychology: Research shows that skin picking disorder is often accompanied by other mental health conditions like obsessive-compulsive disorder (OCD) or depression. So, for some people, skin picking can be a way to cope with other mental health symptoms, boredom, or stress. 

Coping with the urge to pick at your skin

If you’re experiencing skin picking and find it hard to stop, there are some things you can do to help regulate your behavior. For example:

• Keep your nails clean and trimmed so it’s harder to scratch or pick at your skin.
• Remove objects you might feel tempted to use to pick at your skin from your environment
• If possible, wear gloves, and do your best to keep your hands busy with something you enjoy when you feel the urge to pick (like knitting, reading a book, cooking, riding a bike, squeezing a stress ball).
• Identify your triggers, and develop alternative coping strategies, like deep breathing or grounding techniques.
• Instead of trying to quit picking “cold turkey” or completely, set a timer, and see if you can resist the urge to pick for longer periods of time.
• Maintain a simple skincare routine with moisturizer to reduce irritation, but be mindful of excessive focus on skin. 
• Tell someone you trust that you want to stop picking, and ask them to gently remind you of that goal when they see you engaging in the behavior. 

Treatment for skin picking and self-injury

Left untreated, skin picking disorder can be difficult to manage and may persist over time. So, in addition to the self-management strategies listed above, you may benefit from professional help to manage this behavior. 

Treatment for skin-picking disorder typically includes:

• Cognitive behavioral therapy (CBT): CBT can help you interrupt unhelpful thought and behavior patterns and learn new coping skills. This can help reduce the urge to pick and enhance your ability to regulate stress.
• Habit reversal training (HRT): This approach is often used in conjunction with CBT. It’s designed to help you uncover the underlying reasons for an unwanted behavior (in this case, skin picking) and choose a healthier replacement behavior.  
• Medication: While there are no medications designed specifically for treating skin picking disorder, medication can be helpful for alleviating the symptoms of co-occurring mental health conditions, like depression or anxiety. It’s important to work with your provider to determine if medication is right for your unique needs.

Find care with Rula

Chronic, uncontrolled skin picking can be a form of self-harm that can negatively affect your health and well-being in many ways. It can lead to physical complications, like infections or scarring. And it can affect your mental health and ability to function in daily life. Fortunately, with the right support, you can regain control of your behavior and overcome skin picking disorder.

At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best. 

Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 10,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we’re here to help you make progress — wherever you are on your mental health journey.

Find a therapist with Rula