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Dermatillomania / Skin Picking Disorder Treatment

    

Skin Picking Disorder (Dermatillomania)
Cognitive Behavioral Therapy (CBT) is the most effective treatment for Skin Picking Disorder (Dermatillomania)

In our previous article on Skin Picking Disorder (also known as Dermatillomania or Excoriation),  we wrote about a classification system for skin picking. Let’s review “The ABC’s of Skin Picking”:

An “A” is something that almost anyone would pick. This could be a piece of dry skin hanging off your arm, a pus-filled whitehead on your chin that pops at your mere touch, or a scab that’s barely hanging on which you can easily detach.

A “B” is a “bump”, pimple, scab, etc. that only a skin picker would pick, frequently causing it to bleed, ooze, scab, and possibly become infected. This in turn will cause two additional problems – it will cause the picker significant distress, and it will give him or her something new to pick at later. In our experience, clients with Dermatillomania classify at least 50% of their picking as “B’s”.

“C” stands for “Create”, meaning the individual with Dermatillomania is not picking at anything objectively “real”, but in the process of picking at her skin, she “creates” something such as a blemish, scratch or scab. A “C” is something that only someone with Dermatillomania would pick. There is often nothing apparent on the skin, but the picker starts picking or scratching, and in the process creates a wound.

Treatment for Dermatillomania / Skin Picking Disorder

Unfortunately, there are very few psychotherapists who understand Skin Picking Disorder, and even fewer who know how to treat it appropriately. The sad truth is that most therapists have never even heard the terms “Dermatillomania” and “Excoriation”, and their initial response to an individual presenting with the symptoms of this condition is either to suggest SSRI anti-depressants, or to simply say “stop doing that”. Of course, if it were that simple, nobody would suffer with with this often misdiagnosed condition.

As with most Obsessive Compulsive Spectrum Disorders, the most effective treatment for Dermatillomania is Cognitive Behavioral Therapy (CBT).  When treating Dermatillomania with CBT, the two most useful techniques are Habit-Reversal Training (HRT) and Mindfulness Based CBT.  Increasing awareness of one’s picking patterns is central to the process of Habit Reversal Training, and is generally done by keeping skin picking logs. These logs help the individual to identify picking patterns that they previously may not have realized or understood.  For many with Dermatillomania, Habit Reversal Training may also be made easier if they use “habit-blockers” such as gloves, which help to provide a barrier to unconscious picking.

Mindfulness Based CBT for Skin Picking Disorder

The central thesis of Mindfulness Based CBT is that much of our emotional distress is a function of over-reacting to unpleasant, unwanted feeling states that are a normal part of the human experience. The goal of Mindfulness Based CBT is to learn to accept and tolerate these normal feeling states, despite the fact that they are unpleasant.

Subscribe to Reflections on Skin Picking and Hair Pulling

The first of two important factors to address in reducing the picking of “B’s” is to gradually learn to tolerate the urge to pick. If a “B” is left alone, it will either go away or become an “A,” sometimes overnight. So, start small and build on your successes. When you see or feel a “B,” acknowledge it and tell yourself you will wait at least 24 hours to look at it or touch it again. In 24 hours, if the bump or blemish is still there, you can then decide whether to pick it or not.

What? We’re giving you permission to pick? Yes, if you have waited at least 24 hours. By waiting, you teach yourself that you are able to resist the urge to pick immediately – that you can wait it out and see what happens. The more you practice doing this, the better you will become over time at resisting the urge to pick. Remember, picking is a choice – you don’t have to pick something just because you see it or touch it, or just because you have an urge to do so. This is what you teach yourself by mindfully acknowledging and accepting the urge to pick without automatically giving into that urge.

As you build up your tolerance for delaying the urge to pick, you will find that you can add on to your 24-hour wait time. Next, you might go for 36 hours, then 48, and so on. Over time, this practice will ensure that you are only picking “A’s,” the kinds of things almost anyone would pick.

Dermatillomania / Trichotillomania ebook

For most individuals with Dermatillomania, skin picking is a self-soothing technique that helps them to better modulate their feelings. The second factor to work with in reducing the urges to pick (and you can do this concurrently with having a “wait time” to pick) is to identify the feelings you have been “getting out” through skin picking. What is the metaphor for your skin picking? What are you trying to get out? Are you sad, bored, angry, lonely, or anxious? Do you constantly “pick on yourself” internally with a critical inner voice telling you all the ways that you aren’t perfect?

We’ve found that a very effective way to express these feelings is to write them out. You can journal and say anything you want. You can shred what you’ve written afterwards to protect your privacy and confidentiality. Once you get the feelings you’ve been suppressing out in this healthy way, you are likely to experience diminished urges to “get things out” by picking your skin. In other words, by allowing yourself to experience, acknowledge, and tolerate your uncomfortable feelings, you are less likely to need skin picking as a self-soothing technique.

When you teach yourself these two new techniques, the likelihood of getting to a place where you are relatively pick-free is significantly improved. Remember, turn off the perfectionist voice that tells you that you “must” change overnight. Success is a series of steps in the right direction, and building the practices of tolerating the urge and expressing your feelings in a constructive way can lead to success with conquering Dermatillomania.

To take our free, confidential, online test for Skin Picking Disorder / Dermatillomaniaclick here.

To read part one in our series of articles on Skin Picking Disorder / Dermatillomania, click here.

To read an excerpt of from our free special report “Skin Picking Disorder and Trichotillomania: Top Twelve Roadblocks to Recovery”, click here.

You can also click here to read our article “Excoriation (Skin Picking) Disorder, aka Dermatillomania”.

•The OCD Center of Los Angeles is a private, outpatient clinic specializing in Cognitive-Behavioral Therapy (CBT) for the treatment of Obsessive-Compulsive Disorder (OCD) and related conditions, including Skin Picking Disorder / Dermatillomania.  In addition to individual therapy, the center offers six weekly therapy groups, as well as online therapy, telephone therapy, and intensive outpatient treatment.  To contact the OCD Center of Los Angeles, click here.

164 Comments

    • What does one suggest for a category C who has moved on years ago from using fingernails to tweezers, nail clippers, sewing needles, etc.? I’ve had excisions and sutures because of this, and it’s cost me relationships, school, jobs, and most of all money.

      Reply
      • Gabby,

        You report dealing with this issue for years with no success, so my suggestion is simple – seek treatment with a therapist who specializes in treating Dermatillomania.

        Reply
        • Hello, Ive had this problem for quite some time and recently I was able to stop enough for the skin on my fingers to heal completely, the only problem I have is the skin in some areas is still callous like and tough and my ring finger still has a bump as if something is inside. There’s never any leakage or anything it’s fine I just want to get rid of the lump that made me feel like scratching in the first place. Any tips?

          Reply
          • Alece,

            My suggestion is simple – this is an issue for a dermatologist.

  • Great info! I’m forwarding it to my teenager as well. Unfortunately, I have passed on my OCD behavior to her. We commiserate with one another as we hide our picked cuticles.

    Reply
  • Dear Leigh and Debbie:

    Thank you for your comments. We’re so glad to hear that our article was helpful. It can take time to change picking behavior, but it can be done. We support each of you in becoming pick-free!

    Reply
  • Thank you. Very helpful and will pass on the family who have this problem as well. I am scared I am going to go bald one day from forming so many scabs and can’t seem to control some days. I am looking for a psychotherapist in the DC, Virginia area if yow know anyone here.

    Reply
    • Sarah,

      Thank you for your comments. We encourage you to contact the Trichotillomania Learning Center. They maintain a nationwide list of therapists who specialize in treating individuals with Dermatillomania / Skin Picking Disorder. You can also try the International Obsessive-Compulsive Foundation for referrals near you.

      Reply
  • Thank you for your helpful articles. I’m a “B” picker, borderline C. Something I do that you don’t mention is I have the desire to pick others, too! If my kid has a big pimple, I just want to pick it and I wonder how they can stand it for so long without picking at it. My dog had a bug bite on her neck and I picked it (she can’t argue with me). I felt so bad afterwards, but I couldn’t stand seeing it. Is this common?

    Reply
    • Ugh, me too. My partner has mild adult acne so he often gets blackheads and whiteheads I just soooo want to squeeze and pick. I don’t but I can’t help pointing them out and occasionally asking if I can pick them for him. It’s so gross but I hate seeing them.

      I need to find someone in the UK to see about this as when I mentioned it to my GP, they brushed me off.

      Reply
      • Nessie,

        You would be surprised by how many people with Dermatillomania want to pick at the skin of other people (especially their significant others or their children). If you are open to online therapy with one of our 12 staff therapists, we can be reached via the contact page of our website at https://ocdla.com/contactus/.

        Reply
  • I’m 28 and I can remember having this since I was a child. I can still remember the tone in my mother’s voice when she would say “stop picking!”. I used to pick my face alot during my teen years… But now that my acne on my face has gone, I tend to resort to picking my upper back (where my hand can reach), shoulders and my right arm. I’ve never picked my left arm, just my right. But I’ve been picking obsessively for a couple weeks now, pretty much every hour of the day that I’m not sleeping. I do the whole stare off into nothingness and unconciously pick. I don’t know why and I’m so ashamed. I’m supposed to go to my girlfriends this weekend and I’m terrified. I know I will not be able to heal these by then and I won’t be able to change in front of her or feel comfortable being intimate. And stressing about this just makes me want to pick more! Gah! I just want it to go away. Your article was helpful, thank you. I usually use bandaids to keep from picking myself. But recently even that wouldn’t work and I resorted to trimming my nails down, but even then I find a way. I’m going to try the waiting thing… try to do it in small increments like 1 hour, then 2 hours, so on and so on. *Fingers crossed. I know I need help.

    Reply
  • Hi Barb,

    Thank you for your comments. You mention a component of skin picking which is commonly engaged in by some skin pickers – like you, some are drawn to pick at the skin of loved ones, including family members and pets.

    Noticing the urge to pick the skin of others allows you to be mindful of how your skin picking urges show up (in sneaky ways!) and to engage in choice: to pick or not to pick just as you do with yourself. We suggest that you allow yourself to ride out the urge to pick the skin of others, as well as yourself. In addition to other positive outcomes, you reinforce that you do not have to give into the urge and therefore, not be left with the regretful feelings afterwards – feelings that possibly increase the desire for additional picking.

    Reply
  • Hi Sourire,

    Many skin pickers tell a similar tale of their desire to stop picking and their feelings of disappointment when, despite best efforts, their skin picking continues.

    Have you tried wearing thin cotton gloves. Many of our clients find that they are quite wearable and are effective habit blockers. Of course, you have to put the gloves on and keep them on. Gloves can help you ride out an urge. Doing so is foundational to demonstrating to yourself that you can tolerate the intensity of the urge without picking. Having gloves on your hands may help prevent picking as they are physically in the way of your fingers going right to your skin.

    Further, wearing gloves is also helpful to prevent picking during “zone out” times when your fingers are exploring your skin. During these times, as you mentioned, a picker can spend much time picking without being fully aware that she is doing so. Again, gloves touching your skin feels quite different than your fingers do, and a picker wearing gloves tends to “wake up” and come out of the unawareness zone.

    You sound like you are taking good steps to help yourself, Sourire. Keep going, as success is a process not a singular event.

    Reply
  • Thank you for this beautiful article. I thought I was the only person with this issue. I pick on my poor husband and dog too! I’ve been on antidepressants and am now weaning off while working on cbt. The “wait” game has worked for me. It is great when I forget to pick after starting to wait! Day by day.

    Reply
  • I am a full on C… I noticed while reading this article, I started getting anxious and nervous and doing weird things with my hands and feet. ? I believe from being nervous and ashamed of this awful “addiction” if you will.

    My family is full of alcoholics and I know I have it in my blood.. I have never touched a drug or a drink but I know that if I ever did I’d be gone. This is my fall back. I am so glad to know that I’m not alone in this.. I now need to follow what my mom says “One day at a time”. This really freaks me out knowing I have something like this but I need to start today with stopping this horrible habit that has left my back and shoulders scarred.

    Thank you so so much for this article, it has changed my perception on my shameful habit! 🙂

    Reply
  • I’m most definitely a B and bordering on a C. I’ve been picking since I was a pre-teen despite having what could have been mostly blemish free skin. The thought of having a pimple and leaving it alone is unfathomable…if I feel a bump on my face I literally obsess over it and feel extremely anxious until I can get to a mirror or scratch it. I never knew this was an actual disorder- I thought I was just nuts. I also obsess over previous pickings- I think of pimples I’ve picked over and over and over. I had a legitimate pimple that produced a lot of pus over a year ago and I still think about it daily and pick at the spot. Sometimes I wish for something to pick and am always happy to see a spot. As I write this I am shaking my head- this is crazy but I can’t stop!!! I don’t think gloves can help me…

    Reply
  • Hi Emily,

    Thank you for your post. You are not alone – far from it! You seem to be taking the right steps for you to continue making progress in letting the urge to pick pass you by. Well done and all the best ahead!

    Reply
    • So, I have now self-diagnosed that I am a C, I pick and pick at my scalp in a nervous fit and do it until it bleeds or becomes raw and sore. Then it scabs and I want to pick the scab. I often do and look at the red scab trying to figure out more. I feel I have had this since I was young as I used to do it to the top of my head.. One time I had to go to the nurse because my head was bleeding to badly. Are there any..safer ways to scratch without picking?

      Reply
      • Noma,

        I think looking for a “safer was to scratch without picking” is looking for trouble. It’s like an alcoholic asking if there is a safe way to spend time in a bar with people getting loaded. I think a better option would be to see treatment so that you no longer feel the need to pick. I encourage you to find a therapist who specializes in Dermatillomania treatment.

        Reply
  • Dear Whitney,

    It’s great to see your willingness to take personal responsibility for facing your skin picking.

    The “One Day at a Time” strategy is certainly one that we advocate because who can really do anything else? It also works when someone does pick to realize that the “new day” can start immediately after picking.

    It’s not about an overnight cure but consistency in your dedication to yourself and changing the ways you deal with stress and anxiety or boredom. You’re on the right track — keep going.

    Reply
  • Dear ccp,

    Your post is so honest and it inspires us to write about Acceptance and Commitment Therapy (ACT) which is a Behavioral Therapy approach that includes the practice of mindfulness. Mindfulness can be described as being conscious of your thoughts and physical sensations without judging them or acting on them. It focuses on developing your ability to observe yourself. You can learn more about mindfulness at https://ocdla.com/mindfulness-cbt-ocd-anxiety/.

    You mention that the thought of leaving a pimple alone is unfathomable. Observe that thought without judging it, recognizing that it is simply a thought, a string of words that you mind put together. Acting on your thoughts is where you have choice. As you observe your thoughts and urges, you also give yourself a little space of time to decide what action, if any, you want to take. It may be writing about your feelings, delaying picking the pimple for 24 hours to see if it goes away, putting on gloves to help you ride out the urge to touch or pick, or all of these.

    The more a person can observe their thoughts and urges without judgement, the more likely that the anxiety, shame and urges to pick will fade over time. Also, when you prevent yourself from immediately responding to an urge to pick, you are practicing the habit-reversal component of effective treatment for compulsive skin picking.

    Know that you have our support and that there is much of value you may learn from your journey along the path to healing skin picking.

    Reply
    • Thank you very much for this article. I have been struggling with this disorder since I was 10 maybe 11. However, I only found out it was a disorder about two years ago. It all began with biting my nails obsessively, I used to do it whenever I felt anxious, worried, sad, lonely or angry.. My mother also does it so maybe I got it from her. Eventually I convinced myself to stop and I did.. only to replace it with skin picking which is really worse. I now have scars all over my back and face and when I can’t find anything to pick, I pick old ones and make the scars worse. Every time I realize what I am doing I feel shame and I say it won’t happen again but I still can’t stop. I’ve had some non picking periods of time and usually setting a target helped – for example, I succeeded in not picking my skin for about a month because I was getting married (I wanted to have clear skin for my wedding). It was very hard, but I did it!That gives me hope that I could do it again.Sadly, immediately after the wedding I started again.. I noticed that not looking in the mirror too often or constantly keeping myself occupied helps. I will follow your advice with writing things down.

      Reply
      • Sylvia,

        Both Dermatillomania (aka, Skin Picking Disorder) and Onychophagia (aka, Compulsive Nail Biting) are classified as Body Focused Repetitive Behaviors (BFRBs), along with other similar conditions such as Trichotillomania. And and both respond quite well to Cognitive Behavioral Therapy (CBT).

        It’s great that you learned you could stop picking when you had a “target”. Now you just need to learn how to apply the skills you previously developed around the time of your wedding to the rest of your life. Encourage you to seek CBT with a qualified treatment specialist.

        Reply
  • I pick my upper back left arm and face. I pick the same wounds over and over for months not letting the them heal by ripping off the scabs. Sometimes I have the same wound for 6 months. This leaves a terrible scars. I do not have acne on my back I will just find a pore and pick at it until it becomes a wound. I need help because this makes my self-esteem plummet. When I go to the gym I think about the scabs on my back and if they are covered. I also am always putting Mederma on the scars to help get rid of them. I also put Neosporin on the wounds to help them heal just to pull the scabs off again. It’s a vicious cycle and I notice it is real bad right now because I am stressed out and I have a lot of free time. It also runs in my family my mom, brothers and even my daughter all do it. I also suffer from depression and addiction. So sad.

    Reply
  • Hi JoDee,

    You are so right that skin picking can be a vicious cycle: feeling bad about previous picking or feeling stressed can lead to more picking, which creates more wounds and scabs, therefore, more to “feel bad” about, which leads to more picking, and so on.

    It sounds like you are being proactive with Mederma and Neosporin. Have you tried wearing bandaids over scabs or any other Habit Blockers like wearing gloves?

    We also recommend using a mindfulness technique in which you observe your urge to pick without acting on it. Observe the urge rising and falling without responding to it by picking. Then ask yourself: do I really want to pick or am I willing to tolerate the short-term discomfort of not picking? You might take that time to focus on long-term goals of allowing your skin to heal, to finding healthier outlets for stress and to stop injurious skin picking.

    Reply
  • I am a “B” progressing to a “C”. I am very distressed about my skin picking. I am full of open infected raw sores, scabs that have had no time to heal and scars. My skin is very thin. I had to have steroid injections put directly into the wound to help heal faster and have had to have a “cyst” cut, scraped and coderized that was the result of my picking and caused abnormal cell growth. To no avail I am still picking. I am in constant pain from the open sores. My skin always feels like it is burning. I don’t want to hurt myself, I just want to have smooth skin. I am unable to be intimate with my husband as I am way to embarrassed for him to touch my body. There is no area unscathed. I will try the wait game to overcome the urge and I have been keeping a log, so hopefully something will change. At this present moment I am a total mess. I’m praying I can stop this. Prayers to all out there suffering from this terrible disorder.

    Reply
  • Dear Tawnya,

    It’s great that you are practicing tolerating the urge without picking (the wait game) and keeping a log. These are useful tools to help reduce picking when used consistently over time.

    The key word here is “consistently.” This means using the tools as often as possible and not judging or berating yourself when you sometimes pick instead of using these tools (or any other tools mentioned in this blog and related comments). Being kind to yourself as you gradually use the tools more frequently will absolutely produce the best outcome.

    Why?

    Because mentally beating yourself up only leads to feeling worse about yourself, which leads to more picking, which leads to feeling worse about yourself, and so on, in a downward cycle.

    Alternatively, acknowledging yourself when you remember to use your tools leads to more positive feelings about yourself, which leads to less picking, which leads to feeling better about yourself, and so on, in a positive, upward cycle.

    Question any beliefs you may have about not deserving to be kind to yourself. There is nothing bad or selfish about being nice to yourself.

    Reply
  • I am 29 years old and have picked at my skin since I was about 12 and started to get some acne. I pick my face, upper arms, back and legs, which have the most sores on them. I am very hard on myself and a perfectionist, the desire to pick is partially to want to make the skin smooth and perfect, although of course it doesn’t work! I also have negative self talk and have had from a young age. I am stressed about a lot of things at the moment and this has led me to pick more! I pick without realising it when I am talking to people, when I am speaking on the phone, when I am reading, when I am driving. I pick with partial awareness when I am stressed as a way of relieving tension. I also pick consciously in front of the mirror as a way of distracting myself from negative thoughts. I have just started CBT with my psychologist but I have not told her about my skin picking, only my mental picking! This website has been very helpful, and I am going to try the techniques. Thankyou!

    Reply
  • Hello. I’ve been picking for at least seven years and it’s a real nightmare. I do it unconsciously and I barely let my skin heal. It’s got to the point where I don’t want to get out of my house or meet my friends for the fear of being judged. I get unconfortable even knowing that someone could be looking at my face and I always tend to avoid contact with everyone. I just want to have the skin I had before all this picking and I know somehow it’s possible, but it’s hard to stop once you’ve started. I’m very sick of it and I found this very inspiring. I’m totally going to try the waiting game. Thank you very muck for this article! 🙂

    Reply
  • Dear Emma,

    You sound very aware of your picking patterns, and awareness is always the important first step to change. It’s great that you have found a psychologist who uses CBT, and we encourage you to share about your skin picking. Most skin pickers tell us that the shame of hiding is worse than the shame of what other people might think. Plus, your psychologist can be an important partner to you in stopping your skin picking.

    Glad you found this article helpful, and like your phrase “mental picking.” Keep going — you’re on the right track!

    Reply
  • I’ve passed through a host of anxiety disorders- anorexia and ocd- and finally “settled” on dermatillomania because it seems to be the least destructive. I want to stop picking my skin, but I’m afraid that if I try this energy I have may take the form of something worse. Alcoholism runs in my family, and I am terrified of the pain I would cause my family and loved ones if I developed that sort of addiction. I’ve tried SSRIs, but they weren’t enough. Is there any way to address the root cause, or any reason to think that if I stopped picking my skin I would take up another destructive behavior?

    Reply
  • I pick my skin and feet i have damaged 25 percent of my body by constantly pickingI can’t wear shorts or let anyone see my feet. I am so ashamed I need help.

    Reply
  • Dear Laura,

    Thank you for sharing about your history and current concerns. Your choice of engaging in skin picking as a “lesser” destructive behavior is understandable, but there are other options for you.

    The use of Acceptance and Commitment Therapy (ACT) techniques for stopping or greatly reducing skin picking is effective, and those same tools and techniques can be applied to stopping or preventing any other destructive behaviors.

    We recommend reading the articles on our website about Mindfulness and also reading the book The Happiness Trap by Russ Harris which should help you to learn and apply ACT techniques.

    Reply
    • Ashley,

      Thank you for your comment.

      Lip picking is a common form of Dermatillomania (Skin Picking Disorder). Your best approach to this is to seek treatment with a therapist who specializes in Cognitive Behavioral Therapy (CBT) specifically for Dermatillomania. As an alternative, you may want to search the therapist listings of the Trichotillomania Learning Center (TLC) at https://www.bfrb.org. TLC maintains a database of therapists around the country who specialize in Trichotillomania and Dermatillomania. Take care.

      Reply
  • I am a B and C picker. I will pick at a “bump” until it bleeds. I feel like there is something to get out of it even if there is not. I have callouses between all of my fingers and most toes. I pick to the point that they bleed and it looks bad. I also catch myself picking at the corners of my lips, my inner elbows, back of my knees, and base of my hairline on my neck, and sometimes my gums. Those areas aren’t as bad. I used to bite my cuticles so badly that I would also pull the skin off of my fingertips. I have finally gotten away from that, but then I began picking between my fingers. It looks terrible, and I do it without even realizing I am until the areas start hurting more. I have been picking since I can remember, and have just now been diagnosed with depression and anxiety. My doctor wrote my picking off as a habit that might lessen with my meds. I’ve tried gloves, socks, and long sleeves and just tend to irritate my skin through those. Oh and I will cut the callouses off with clippers if I can’t pull or bite them off, and continue to pick

    Reply
  • This is definitely something that I do. Since I was very little I’ve had what my dermatologists call “chicken skin” on my arms, and the bumps bug me so much that I pick at them, sometimes until they bleed. I also find myself biting off the skin by my fingernails. But the most disturbing thing I do is when I pick at my scalp. I do this several times throughout the day, and a lot of the time it is unconsciously done. Worst of all, I eat the dead skin. Most of the time I try not to think about it and tell myself it’s fine and pretty normal, but if it was then I wouldn’t want to hide it.

    Reply
  • I was just reading through the comments and started crying because I see that I’m not alone. I have been picking since I was 14, now almost ten years later it has gotten worse. I wouldn’t just pop a pimple or zit, I would do destroy it,which left scabs that I would pick at. So a simple pimple that would go away in a day or two would last almost a month. I have Keratosis Pilaris on my arms and legs. I pick at those as well. Like the other comments I too like to pick at loved ones. I think to myself how can they just let that be on there without picking? I noticed that when I’m angry or stressed I pick more. I have done the 24 hour test ,and it has worked until something stressful happens and I pick again. When I have gone without picking I feel great and look so much better. When I pick though I feel like people look at me and think I’m some sorta drug addict because of my scars and scabs. I hate myself after I pick. I want to stop. I know that my Keratosis Pilaris or my acne wouldn’t be as bad if I didn’t pick. I’m getting married soon and I don’t even want to try on dresses I’m so ashamed of my picking. I want to stop. This article helps me see that others have gotten through this and I’m not alone.Thank You!

    Reply
  • Hi Whitney,

    In our experience, appropriate medications may be helpful if you tend to pick when you are anxious and if the medications help reduce your anxiety. You should address any questions you have about medication to your physician.

    Your doctor was partly correct in that treatment for skin picking includes stopping the habitual part of the picking. You may find that wearing thin cotton gloves doesn’t irritate your skin, for example. Or, you might work on identifying and changing routines that are associated with your picking. For instance, if you pick while watching TV and you usually sit on the sofa to do so, you could move to a chair to watch TV instead.

    Continue to take strides forward to assist yourself in stopping your skin picking.

    Reply
  • Hi Katherine,

    Some skin pickers report that they eat the skin or scabs that are picked off, so you are not alone in doing so. Your insight about trying to tell yourself that it’s “fine and normal” but still wanting to hide it is right on target. In fact, we know that trying not to think about something only makes a person think about the “something” even more. It’s called thought suppression, and it doesn’t work, as you have found. To read more about thought suppression, click here.

    More helpful is the awareness and acknowledgment of “what is” – also called Mindfulness. Noticing what is so with openness and acceptance puts you in a good frame of mind to choose how you want to respond or decide if you want to respond at all. Awareness leads to choice, and empowered choice based on what your long term goals are for yourself is the key to recovering from skin picking.

    Reply
  • I’m 37 and have been a picker for as long as I can remember. A year ago, the picking became “C.” In fact, I have a place on my hand that has been an open wound for almost that same length of time. About seven months ago, I decided to see a counselor and talk with my doctor about it. My doc put me on anti-depressants and anti-anxiety meds, and my counselor diagnosed me as a cutter. I feel like I’m not getting any better; in fact in a lot of ways it’s getting worse. A few days ago I read the article on Scrupulosity (from this same website) and I felt like I was reading a story about myself. Neither my doctor nor my counselor has said anything about OCD. I guess my question is this: is there a difference in treatment for self-harm (cutting) and CSP (as an OC spectrum disorder)?

    Reply
  • Hi Marci,

    Thank you for writing. You ask a very important question. Many people put skin picking and cutting in the same category because they both appear to be “self-harm.” In some ways, that is true, but there are important differences between people who cut and those who engage in skin picking. They are not the same and the treatments for them are not the same either.

    Since you relate to the OCD-like qualities of the article you read, I encourage you to either ask your counselor to educate herself about the treatment of skin picking or find a treatment provider who specializes in Skin Picking Disorder. Two websites that list treatment providers nearest to you are those of the International OCD Foundation at http://www.ocfoundation.org/ and the Trichotillomania Learning Center at http://www.trich.org/.

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  • Reading this was really reassuring to the fact that I do have a problem and it has a name. I have a serious problem with picking my face or any where that I feel has a bump or pimple like feeling. It has caused me stress and anxiety. I am going to try everything that was mentioned on this page in hope for change. I am a handsome 28 year old man but I feel hideous when I see all the scabs, marks/spots on my face. Thank you so much for putting a light to this condition. God bless!!!

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  • I’m 17 n just finish picking my face for 4 1/2 hours and I’m really tired of doing this to myself but I don’t think my family will take it seriously. For several years I’d wear long sleeves and pants to hide what I did to my body. Now I can fight doing it to my arms and legs but not my face, neck, shoulders, back or chest. I’m trying to look into this more and I’m glad I’m not the only one atleast, I feel so discusting and insane.

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  • Thank you so much for this very insightful article! I always thought I was alone in this, because everyone around me told me it was “just a bad habit” that I “just need to stop.” Of course, I’ve always wanted to stop, but the sense of relief and satisfaction it gives me in the heat of the moment is hard to overpower. I showed this article to my family and friends, and they are being a lot more understanding and sympathetic to my plight, and want to help me work on overcoming this disorder. Thank you again!

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  • So glad I’m not alone, honestly. I’ve had to spend the last few years around my friends with perfect skin, whereas I’ve been wearing long sleeved shirts in summer weather to hide my marks on my chest, back and arms.

    Every night literally i stand in front of the mirror before I go to bed an pick.. Sometimes for almost an hour. Then I put a million skin care products on my face.. As if it reverses what I’ve just done to make myself sleep better.. And then I pick my outfit for the next day just to know that I have something to wear that will hide everything.

    I find motivation helps.. Like, a very special event where I want to wear a strapless dress.. Then ill stop picking a few weeks in advance. And boom! When the day of the occasion arrives my skin is good enough to wear whatever I please! My skin has many imperfections but if I were to stop picking my skin would be just fine. But I can’t. I don’t know what’s up with me but I’m glad I’m not the only one who’s like me. Makes me feel a little more normal after my hour long trance I just had.

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  • I am 48 and I rotate picking spots between my face, scalp and lips. I never stop! When my scalp is on fire from picking so many new open sores (level c), then I move on to another site until that is completely raw. I do not understand what the anxiety is that is causing me to always keep picking! I am extremely accomplished and in spite of being a massive procrastinator, I have degrees up the wazoo and am currently working on another. I am on SSRI’s but I don’t see any change! I like the glove idea and I thank you for this frank discussion opportunity! It’s so embarrassing!

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  • Dear MC,

    Glad you found out you are not alone — far from it! The description of your skin picking is one we hear often.

    Consider saying “I am doing my best to stop” instead of “I can’t stop.” It is possible to greatly reduce or stop skin picking. You can do it when you are using tools that help. You may not have been aware of many of those tools until now.

    If you haven’t already downloaded our free ebook on skin picking, you can do so at https://ocdla.com/skin_picking_ebook_signup/.

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  • I am 29 years old and I have been picking and eating for as long as I can remember. I pick my face,neck,,back,shoulders,chest, scalp the crust in my eyes and even my butt. I have the urge to pick others, my husband and kids, every time I want to look at something on them they automatically tell me not to pop or pick it. Lately my skin has been getting more imperfections so I’ve been picking and eating more and my husband has been telling me I pick my self and its gross he doesn’t no I eat it. This makes me feel more yucky about myself. I started out picking and eating scabs and boogers. Then I started getting pimples on my face and then it was all down hill. I made my face have scabs from picking pimples. I have always kept it secret. But the past few years I haven’t been able to fight the urges so my family has “caught” me picking I didn’t know that lots of people did this. I thought I was a weird person who never grew out of it. I also had an obsession about scrubbing my skin on my face and back raw to get rid of the pimples. I hate that I pick but didn’t know it was a real problem.glad I found this site I feel a little better

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  • I am 53 and I started picking at my chin “whiskers” for 3 years. As soon as I started menopause and started getting those little hairs on my chin, I started picking at them. They are so little that I can not see them in the mirror but they feel huge to me. I also pull them out with twizers. I have noticed that I never pick in the mornings. It is worse in the late afternoon and evening. I pick while I watch TV, am reading something on the computer or talking on the phone. I have tried putting salve on my chin so I won’t touch it, but as soon as it wears off I pick. Has anyone tried getting fake nails. I wonder if they would make it harder to pick.

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  • I have been picking ever since I first started getting acne, which was about 6 years ago. I can’t stand it if I have any bumps on my skin, I am a type B. I want my skin to be incredibly smooth when I feel it. But this causes scarring, and it’s harder to get rid of. During summer it gets bad because I have to wear more revealing clothing, but most of the scarring, acne and oiliness which is the cause of acne, stops when I start tanning and swimming in the sea. I think it’s because the sun helps dry the skin, get rid of the scars and the sea water helps with the acne.
    My mother used to be angry with me because I could not stop my urge to pick. Only this year I found out that it was not solely my problem, but a problem that a lot of people face, and most importantly, it’s a disorder. I can’t just stop by telling myself to stop. I’ve been trying to tell this to everyone who knows about my condition, but they never believe me. They think that it’s my fault that I am like this, and it makes me incredibly depressed. Unfortunately, almost no one in my country, including psychotherapists, knows about this disorder. Even if they know it, they wouldn’t think that it is considered as a disorder. Which makes it even harder for me to stop, because there is nobody who can understand me. At least now I know that I am truly not alone, and hopefully some point in the future I will be able to get help. Thank you so much for this article, I wish I lived in Los Angeles so that I could come to your center and get help.

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  • Thank you for this article. It definitely gives me the tools to try to stop… It’s very hard to get control. Currently I suffer alcoholism, an eating disorder and dermatillomania… I’m working on all three and AA meetings are the only common “meetings” for disorders. It’s hard to even find ANAND groups. I will try the writing log and start to not down my feelings and the glove idea is great! I used to get fake nails when I get too bad but it becomes a really expensive disorder… Thanks again.

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  • Hi Crystal,

    So glad you found us, too, and that you now realize that you are definitely not alone.

    Help is available. We encourage you seek treatment with a therapist who specializes in Cognitive Behavioral Therapy (CBT) for Dermatillomania. Also, you can click here to download our free ebook on Skin Picking if you haven’t already done so.

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  • Hi Bonnie: Thanks for sharing and asking about what we call “habit blockers,” i.e., those things that physically provide a barrier to directly touching and picking or pulling.

    Many of our clients have reported that having acrylic nails provides a deterrent to touching and picking. However, some report that the nails give them an extra “tool” to dig more deeply into their skin. Our suggestion: give them a try and see what your experience is with them.

    You might also want to try wearing soft, thin cotton gloves during the times you’ve identified as the main times you touch, pick and pull (watching TV, at your computer and talking on the phone). Gloves are a popular habit blocker because when you wear them, there is no way to directly access your chin. You might want to try them, too.

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  • Hi Oben: Glad that our information is helpful to you, especially in helping you learn that there is something called Skin Picking Disorder, and that you are not alone. Feel free to show this information to others so that they can be better informed and possibly offer you their support.

    Depending on where you live, we may be able to provide you with online therapy via webcam. You can click here to learn about online therapy. If you would like to further discuss this option, we can be reached via our website at https://ocdla.com/.

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  • Its crazy.. I think i have this. I do it without thinking about it. I catch myself. My mom used to do it. I used to tell her to sit on her hands.. I dont know if she ever found a way to stop… its hard to break the habit once youve been doing it for so long. Although, it is possible. I had to go somewhere where i was around people all the time. Only alone when i went under my blanket. But if ppl seen you picking your head they would say you had lice. And you dont want ppl to think you have lice there. So i was forced to stop. I would do it a lil under the.covers at night tho.. But def not.constantly. .. A week after i came home i started doing it again. I faught the urge but once i started i dont want to stop. It makes my hair oily and causes flakes. It sucks. I will try the bct one day.. Its good for more than just picking.. I here…

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  • I’m a C.
    No one listens and no one gets it.
    I’m 17.
    I’ve been hurting and mutalating my whole entire bod for atleast 9 years.Its getting worse.Please fix me.

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  • Hi cantstop,

    You share a common story, one we hear over and over again, so please know that you are definitely not alone.

    One of the reasons Skin Picking Disorder is so challenging and shame-inducing is that a picker can stop sometimes when a vacation or other event happens and then go right back to picking when the event is over. It can be hard for people to understand.

    The good news about what you share is that you can stop picking even if, for now, it’s only under certain circumstances. If you practice the tools and techniques we discuss in our articles, on our website, and in our free ebook “Skin Picking Disorder and Trichotillomania: Top Twelve Roadblocks to Recovery”, then you will be more likely to find yourself making progress towards doing far less or even no skin picking.

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  • Dear Kate: It is tough to feel so misunderstood. Please know that there is nothing wrong with you as a person. You have a condition called Skin Picking Disorder. We encourage you to seek psychotherapy with a therapist who specializes in Skin Picking Disorder in order to to deal with it. You can find resources on the links page of our website at https://ocdla.com, or at http://www.trich.org.

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  • A counselor who helped me immensely with this disease wrote and told me today that this is now a recognized diagnosis… Is that what you know as well?

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    • Hi Paige,

      Yes, it’s true. The American Psychiatric Association recently (finally!) recognized Dermatillomania as a real condition and have given it the formal title of “Excoriation”, or “Skin Picking Disorder”.

      Reply
  • I am a full on C. Been picking at my skin for the past 14 years. I’m 30 years old now and this is still going on. I have a fully scarred back and breasts. Reading about this condition and knowing that there are others out there who also suffer from it is strengthening my will to beat it! And I have strong faith in myself that I will!

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  • Hi I’ve been picking my face for 17 years now. It is sickening for me to even write that because it makes it real. I’m a “B” and it has always been a way for me to deal with stress and anxiety. I can relate to everything other people are saying which feels good, but making myself look ugly gives me such a feeling of worthlessness. Always the question : why can’t I stop? It’s gonna make me feel worse after I’m done, but that voice suddenly hides during the picking. I want control back over myself. I want to feel good about my skin, that I didn’t damage myself.

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  • Hi Diana,

    You are moving in the right direction. Once a skin picker is in touch with the fact that she doesn’t like the results of picking, it’s an important turning point. How can you remind yourself that the consequences of picking aren’t worth any momentary pleasure, relief or gratification? Maybe covering your mirrors and posting a big note on the cover? Keep going – you can do it!

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  • I just wanted to check if maybe this is related to what I do. I frequently find my self scratching my scalp. My scalp is quite dry and flaky but I’m not sure if it was like that before I started scratching. I find that I get some sort of satisfaction out of removing the skin from my scalp from under my nails. But of late I’ve noticed little scabs forming visibly in my hair line and I’m worried people will notices. I’ve also notice that the skin under my nails is red as if I’ve picked until it bled. Finally I have been diagnosed with Depression and Generalised Anxiety and currently take an SSRI. What do you think?

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  • Hi Sophie: Thanks for your inquiry. We can’t make a diagnosis via this blog but it does sound like you may have some behaviors that are common in Skin Picking Disorder. You may also have a skin condition that is showing up on your scalp. It would be best to see a dermatologist for an evaluation.

    Using habit blockers like gloves may also help you reduce the amount of time you spend scratching. We also encourage you to journal to express your feelings and anxiety. Finally, getting sufficient sleep and exercise is a basic for all who engage in skin picking and experience anxiety and depression. Sounds like you are taking appropriate steps forward in getting on an SSRI. Good for doing what you need to do to take care of yourself – keep going.

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  • It is extremely comforting to learn that other people are plagued by this, and motivating to see that so many have become better. I think it is important to know that each person’s situation is different. I became aware almost immediately that my dermatillomania was a direct side effect of dealing with and recovering from anorexia nervosa – to avoid thinking about food I would ‘purge’ my skin, often directly after eating. While it provided some relief (and I’ve knocked the first disorder), I hate the idea that I am just pushing my compulsions around… and I’ve been fighting with this one for almost four years now.

    I just wanted to put this out there in case anyone else has experienced a similar transition.

    I also wanted to share a trick I invented that sometimes, though not always, helps me push away an urge. Basically, I made up an imaginary friend (named Ike) who is the little imp who causes me to lose my will power. Now every time I get an impulse to pick I remember that Ike is just being mischievous again and tell him to go away. This also helps me take the blame off myself and not feel ashamed about the problem.

    Thank you to this forum for teaching me about picking, and good luck to everyone… let’s overcome this.

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  • Hi Lena: Thanks so much for posting about your experiences and about Ike! That’s very creative and you sound determined to continue to progress personally and overcome skin picking. We are so glad you are part of our community.

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  • Thanks so much for this. I am glad that this has a name and can be dealt with as I have had many of these symptoms consciously and unconsciously for years and I always thought it was just me and I was so embarassed. Its the worst feeling to continually unconsciouly pick, it such a bad habit, most of the time I dont mean to. I’m so relieved that I can follow this advice and try to be better. Thank you

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  • This was so helpful to read, I felt crazy. Absolutely crazy. Still kind of do, but its nice to know I am not alone in this. I vacillate between feeling ashamed and healing and then after my skin has cleared some, feeling like all of the sudden I have the right to do it again because I am not as bad as I was before. Any progress I make I feel is obliterated because I feel like I can freely pick because my face looks better. Utterly absurd, but I can’t conquer it. I’m relying on God to heal me, fix my brokenness so that I can move on. Thank you so much for this post, it really will help me.

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  • Hi Abbi: Thank you for letting us know that our article was helpful to you. You are definitely not alone as it is estimated that up to 5% of the population has Skin Picking Disorder. You can help yourself and there are many great ideas here as well as resources on our the “Links” page of our website at https://ocdla.com/. Also, you can download our free ebook to receive additional information and suggestions.

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  • I’ve been picking for 11 years. My face is now so badly scarred I must always wear makeup, and I still develop more acne. I also sometimes pick at my back and chest, which are also scarred. It’s sickening… I go without picking for a few days, my face starts to heal, I’m pleased about it, but then I find myself in front of the mirror and walk out an hour or more later, with my face destroyed again. I squeeze pimples/cysts and all pores that seem blocked, which just causes infections and bumps. I fear that my skin will never heal and that it will always be red and ugly and rough from the scarring. I’m in my 20’s and I can’t even go swimming anymore because of my bad skin. I also avoid relationships or being seen with little clothing for this reason. My life is so f**ked and I’m severely depressed (not just for this reason). I don’t know what to do anymore and I look so ugly now (makeup helps, but it doesn’t hide the roughness of my skin).

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  • Hi Jada: Believe it or not, your story sounds very typical of someone with Skin Picking Disorder. The good news is that there is help available! You may want to read the Skin Picking section of our website, as well as our other articles about Skin Picking, as there are many great questions, answers and resources mentioned that may be helpful to you. You are not alone and recovery is possible. You simply must be willing to take the necessary steps.

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  • Hi all
    It is comforting to know that I am not alone in my skin picking habits. I thought I could help other sufferers of this OCD by sharing my experience so far. I started squeezing spots when I first developed acne aged 15 off the back of a fledging never-was modelling career. The self-deprecation and failure to be “perfectly” flawless and beautiful lead me go try and correct the ‘mess’ and ‘imperfections’ on my face by eliminating them through picking. At the time I went onto a starter pill to ease my mild facial acne but a side effect was depression if used longer then three months. They mistakenly kept me on it for 8 months and I did get very depressed. It is only ten years later that I have made this link.

    Stress from arguing parents at home, growing pains, peer pressure, academic pressure of straight As lead to a sort of nervous breakdown which at that time manifested itself in what would appear to the naked eye as depression/ M.E./ burnout / exhaustion…

    Maybe it was all those things. I became an expert make up artist and a super depressive that was very hard on myself. Very recently I noticed that my parents are very good at remembering all failings or mishaps of each other and of me even though I couldn’t try to be a more perfect child. I’veived on from this a bit now but I’m still an avid skin picker.

    The only time my skin healed was when I took a high vitamin B dose (3000mg) daily – which aided skin reparation and boosted my mood.

    And the other time being when I was injured and was unable to wash/stand/use a mirror for four days in a French hospital. This worked wonders. My skin healed and combined with once daily hot flannel wiping of my face , my skin reverted back to a normal pH balance. No products and grease. Also I just slept and slept which do really alleviated any stress over following 8 weeks recovery on strong painkillers.

    Just leave to fix itself. The unconscious picking frenzies are my usual again but I want it to stop.

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  • Hi Geraldine,

    Thank you for sharing your experiences with Skin Picking Disorder. You touch on some excellent points, including that stress tends to increase skin picking for most pickers and that not touching or looking/scanning the skin is very effective at reducing skin picking.

    Of course, many things go into reducing or eliminating skin picking over time, including those discussed in these articles and in our free skin picking ebook (which you may download here if you haven’t already).

    You are aware of your patterns and the things that lead to picking, and that is wonderful self-awareness. Keep going with your awareness, being mindful of where your hands and fingers are at all times so that you can more frequently stop yourself before you pick or when you start to pick. You can do it!

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  • Thank you. I’ve always picked, but it got bad enough to be the focus of my life 18 years ago after a traumatic dating experience. There was no name for it then, or at least none that I could find. My first visit was to a Horrible dermatologist who told me to find something other than my face to pick. He was borderline inappropriate and said my face was too pretty to destroy and I should just stop. A later dermatologist called it neurotic excoriation, and he was more helpful and a lot more professional, but he and therapists since could give me only general advice and meds (meds help many things, including some of the underlying anxiety and OCD and depression, but not the picking). Over time, I learned to live with it, and accepting it and removing some of the self-loathing part of the cycle is the only thing that has really helped.

    Acceptance is the key for so many anxiety issues for me. Removing the fear and shame takes away much of what fuels these conditions.

    Even though it’s no longer the focus of my life, knowing that this condition is now so much better understood and has made it into the damn book the medical practioners read from Is a great comfort to me. I always felt like I had to explain it to the docs, knowing they’d never heard of such a thing. People around you can be very cruel. The more we talk about it the less stigma it will have. I’ll never fully get over hearing my now-ex husband exclaim in anger after a relapse, “I thought we were DONE with that!” Jerk 🙂

    I can tell you guys who are really, really in the worst of it, where it eats up all your energy and forms the center of all your thoughts… it won’t always be that way. It will get better. The more you simply refuse to let it rule your life the better. As with all “disorders,” our greatest power to end the cycle is to step away from the mirror and just say, “yeah, I did it again, and that kind of sucks. Okay. so what? Life goes on. I didn’t mirder anyone. I’m going to go out in public anyway and not let this control my life.” The more you do that, the quicker you get back to learning to ignore the urges to pick and learning that life is better when you don’t do it.

    Best of luck to all of you.

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  • Everything has to be smooth. No bumps, no rough spots, just smooth.
    I don’t believe I pick to reduce any emotional feelings. It just feels like a completely irresistible compulsion.
    It feels like something is very wrong with me.

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  • Hi Alejandra: What you describe is actually something we hear quite frequently from our clients with Skin Picking Disorder. The desire to want the skin to be “perfect” is a common thought associated with picking. We encourage you to investigate your desire for perfection and ask yourself if it is truly realistic.

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  • This is the first information I have come across that actually breaks down the compulsion of skin-picking into something I can identify with.

    I am African-American and have frequently experienced chemical burns created by relaxers to straighten my tightly coiled hair. The burns create scabs on my scalp and I have always picked them. But once satisfied, I would stop after freeing the scab from my scalp. Once stressors entered my life upon entering college over twenty years ago, I began to constantly pick to the point in which the sores would sometimes scar and keloid. When things got especially stressful, I would return to the overly healed scar and begin a new sore from which to pick. Over the last 6 months, it has become an everyday activity. I had come out on the other side of what could have been a forever life-changing event and had hit rock bottom (I was the cause). While staring into space paralyzed with thoughts of my actions, I created sores to pick. To further illustrate the compulsion, I have since begun to forego bedtime at a reasonable hour so I can stay up and pick to my heart’s desire. And because it’s with more intensity, I have not been to the hair salon to have a relaxer retouched. The conditions of mental health among laypeople is not widely understood and hence, stigmatized. So as a result, my hair has reverted to it’s natural state and I cover it with a scarf everyday so no one (not even my husband) can see the sores I have dug into my scalp. When I woke up this morning I decided enough was enough. I have caused myself pain and infections which have occasionally presented themselves in my body as flu-like symptoms or worse- migraines that require a doctor’s visit. But I don’t mention the migraines are a result of picking because I don’t want to take the time to explain the behavior. I have, however, brought it up with my brilliant therapist who familiar with the condition and has some pickers and hair pullers in her clientele.

    I never thought of wearing gloves during idle time or the incentive to play mind tricks to resist the urge to pick for 24 hours. These are solutions I can put to use to finally stop. Coupled with weekly sessions with my therapist, I can finally get on the road toward better health and happiness, all while wearing a fabulous updated version of the Afro!

    Thank you!

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  • Dear Kim:

    Thank you for your message of hope and recovery. It’s great that you have a therapist who understands skin picking and can assist you in your recovery goals. Your determination rings clear as a bell!

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  • I believe my mother suffers from dermatillomania. She’s picked at the skin on her face since I was a child and I always thought she had adult acne until I was in college and I noticed that she was spending hours in front of the mirror picking at freckles and scabs. Recently things have been difficult between my parents and in the stress of it all she has given herself massive scars and discoloration on her face. It’s been really difficult to watch but no one knows how to approach her about it or what to do. My father and grandmother tried bringing the subject up a few times but she completely shuts down. She’s also dealing with depression and stopped talking to a therapist awhile ago. From what I’ve read I’m sure she’s feeling embarrassment and shame in addition to the depression. I don’t want to exacerbate those feelings or make her feel any worse but I think she needs help and I don’t know how to bring it up to her. Is there a list of therapists by state or region who are aware of dermatillomania and have experience treating it that you’re aware of? (We unfortunately are east coasters and your CA clinic isn’t feasible) I think I could have a conversation with her about going to see someone and it would be great if I could find someone in our local area with experience in treating this condition. If there is no such list, should I just look for someone with experience in CBT and OCD?
    Thanks

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  • Great article. I have had skin picking disorder for quite long and a few years ago after reading a lot of the same situations on the Internet and crying my eyes out about it , I managed to stop. I stuck post its on my mirrors saying “don’t even think about it” etc. now i find myself doing it all over again and i cant stop. My fiance shouts at me and slaps me to stop sometimes and i might just carry on. I like to pick on my face and especially under my lip. I don’t even have normal pimples. I just squeeze any small bump and black head then they turn into scars and I pick them all the time.. So I have the marks for weeks!! Then I just cover everything up with make up. But then when i bath or take make up off i look at the mirror and start again. I feel so sad about this problem. I just feel my face and can’t stand the feeling of the scabs so I scratch them all off. But of course they appear again. I don’t have stress I just do it because i am addicted to doing it. I am going to try and write a diary so I can stop. Do you have any good cleaning products or cream to recommend that is good for me? Is it good to keep my face moisture? Because I usually tend to try to keep it dry so that I can stop the picking. I often put baby powder on.

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  • Dear Ashley:

    Your mom is lucky to have you as a daughter! You are compassionate and caring!

    We’ve found that a good way to approach family members is to simply offer them information on Skin Picking Disorder (you could refer her to our website, for instance). This information could also include a list of therapists who specialize in treating skin picking.

    One excellent resource is the Trichotillomania Learning Center. While they were originally founded to help hair pullers, in recent years they have expanded to include information for skin pickers, too, including lists of resources by geographical area. Their website is http://www.trich.org.

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  • Hi Stella: Your plight sounds very familiar – you are not alone! You appear to be subject to the two main triggers for picking: touching and looking in a mirror. Perhaps you can use some Habit Blockers (gloves, covering mirrors, etc.) to help you reverse the habit part of Dermatillomania.

    Your idea to write a diary of log of your picking is also great, as long as you use it to inform you and encourage yourself, and not to condemn yourself for each time you pick.

    As far as what products to use on your face, we encourage you to ask a dermatologist as they are experts in skin and can examine you and make a recommendation.

    You can stop again. Love your “Don’t even think about it” post-its!

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  • Hey,
    I recently stumbled across your articles. I believe I have trichotillomania and dermatillomania but I’m unsure as a lot of the more specific things that make me doubt it aren’t usually mentioned in articles or discussions talking about the disorders.

    I like this idea of a basic guideline for what could be considered normal and dermatillomaniac skin-picking.

    I’ve been picking my skin since I was a toddler, I think around 2, 3, 4. Your description of ‘B’ areas is on-par with what I pick – those little raised bits of skin, sunburnt, peeled skin, etc, and the skin on my heels recently started “cracking” (for lack of a better term) too, which I’ve attacked with the pins and tweezers. I also pick at the layers of skin in the sides of my toenails and the skin on my nipples. I also have urges to pick other people’s skin too. I’m so glad that someone has finally given me some explanation as to wether this could be considered dermatillomaniac behavior or not.

    Thank you for writing this article, once again.

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  • I’ve been picking (and biting) my skin since I can remember. Even when I was 3-4 years old I remember chewing and picking the skin off my thumbs and forefinger on a regular basis.
    Once I got acne on my face at around 12, it became the main target. Every morning and night when I brush my teeth and do the rest of my routines, I end up leaning forward to look at the mirror and analyzing everything. Then everything that’s too dark or too bright ends up picked at. I end up with scabs that, while healing, I pick the dead skin off of so they get re-irritated and back to a wound.
    The waiting thing I’ve found to be a good help. I gave myself one day a week to pick, and while I’d still overanalyze my face throughout the week, I would stop myself and go “If it’s still there on Saturday, I’ll pick it”. To prevent a massacre on Saturday, though, I’d give myself a limit of let’s say, 10 spots to poke at, but if anything bleeds, I have to stop before I reach 10. This works fairly well.
    Unfortunately, I keep falling off of the “plan” I made up. I somehow space out and end up doing it some random day I’m anxious and and then giving up. I’m hoping maybe putting some kind of reminder around my bathroom to keep me from “zoning out” might help.
    I also can’t stop eating the inside of my lips, which only stopped after I got my wisdom teeth taken out, and my jaw hurt so bad I couldn’t do it. I was so happy I’d stopped for three months, then one day I suddenly noticed I was doing it again. That was the only time I remember not biting my lips in my entire life. What an awful feeling after I realized I’d suddenly just done it without thinking.

    Reply
  • Thanks for these articles. I’m sixteen and I’ve recently discovered this disorder when looking into my skin picking habit. I’ve had eczema since I was born and usually pick at any bumps or pores from that. Hence, I’m definitely a ‘B’ picker, and I often pick these so much I affect surrounding skin and so become a ‘C’ picker too. I don’t really feel embarrassed or ashamed of my scars, more disappointed in myself that I can continue picking when I’m physically harming myself. I was wondering if picking my nails and cuticles, as well as biting and picking the skin on my lips, is common or whether it even comes under this disorder? I know I’m only young, but I think I’ve suffered with this disorder as long as I can remember, with it gradually getting worse over the past year. Is this normal at my age? I’d really appreciate advice with this, your article really made me realise the extent of my own habit. Thanks for reading my comment if you’ve made it this far! 🙂

    Reply
  • Hi, thanks so much for the information provided!

    I have a few questions:
    I’ve been picking “A”s forever. But I often pick the horny skin on my feet (on toes and heels).
    And that really got worse in the past few weeks: both my heels are almost completely “horny skin free”, but I keep picking even further up the foot. Of course it hurts at times and it bleeds at some points, but I can’t stop. How can I stop this, and how can I let it heal without interrupting the process all the time? I’m desperate.
    (I’m female and 16 years old)

    Reply
  • Hi Kaysteena: It sounds like you have been using some Habit Reversal Training (HRT) strategies with success, for instance, delaying and limiting picking. We encourage you to keep going with your “plan” and possibly add to it. For example, you mention “leaning into the mirror” as a precursor to picking. One thing you can do is have indirect lighting on in your bathroom – just enough to see what you are doing but not enough to see well enough to pick. As for biting inside your mouth, perhaps chewing gum could help.

    Please remember two things: reducing skin picking is a process that takes time. You just have to keep going (and, you have a great start). Also, nothing beats awareness. When you are aware of what you are doing (e.g., biting inside your mouth), you can choose to stop doing it.

    Reply
  • Hi Becky: Thank you for your comment. We are glad to hear these blogs have been helpful. Yes, picking nails and cuticles and lip biting fall under the category of Skin Picking Disorder.

    Having a skin condition complicates your situation because your skin constantly produces things you might pick. However, that doesn’t mean you have to pick! We encourage you to find a therapist who is trained in working with people with Skin Picking Disorder to assist you. You can find resources on the links page of our website at https://ocdla.com/, or at http://www.trich.org.

    Reply
  • I do not pick my own skin, but everyday i have tge strongest urge to pick at my dogs scabs (she has a lot because of sensitive skin that is prone to problems, and because of allergies) i’ve been doing this for about 2 years (almost everyday) and i feel really bad about it after but this anxiety builds if i dont do it. I want to stop but the urge is too strong. I love my dog and i dont want to hurt her anymore.

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  • I have mrse (a variant of mrsa). If I don’t stop picking at these lesions I could die. I have already had 4 surgeries for this, which don’t heal properly because I pick at the sutures/ surgical sites. I will be put on a very dangerous drug for this (thalidomide) if it doesn’t get better. The dermatologist thinks people only pick if things itch. Unfortunately, most of the medical community is clueless about this.

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  • I’ve been destroying my skin since I was a toddler. Usually my legs and over time I’ve moved to my entire body save the palms of my hands and the soles of my feet.

    I’ve long ago given up worrying about scars, though I do sometimes worry about infections and nerve/tendon damage (I go deep sometimes). But a big part of what really worries me is the feelings behind it. I feel like there’s something under my skin. I know there’s nothing there. I can look and touch and tell myself cognitively there’s nothing under my skin. I don’t feel any pressure, itching, or tickling. But something in the back of my mind -insists- there’s something in there and the moment I turn my back my fingertips are bloody again.

    When I was little I had difficulty putting that feeling into words. I knew that once I could feel a significant empty pit in my skin I could easily leave it alone, even if it had a scab. I was actually very glad when I was old enough to have acne and there really was something in my skin to remove. I didn’t care about ‘popping zits’, whatever I’m after was solid. I sought out blackheads and cysts. I would even take steps to create these in my skin so I would have something to remove. The shame of scars and scabs was nothing compared to the need to get something out of my skin.

    I could liken it to the visceral pleasure I might get from peeling something. Like the pleasant feeling of peeling off your sunburnt skin times a million. But while a painted wall or a glue on my hand might be an workable replacement for a sunburn there was -nothing- to replace the feeling of opening my skin and taking something out. I can refrain from picking for days just from the satisfaction of running my fingertips over the hole I’ve left.

    Normally it doesn’t hurt, not one little bit. Some of the deeper excisions may hurt somewhat but that wont stop me from using fingernails and a scalpel to remove, intact, anything that feels like it doesn’t belong. I once removed a salivary glad on accident. I even have dreams about small things like ants crawling under my skin and living there, like my veins are their tunnels.(I’m not afraid of ants or any insect and I can handle them without qualm, its just the dreams). To this day I still scratch holes and pull up scabs on my legs arms and body, looking underneath for some sign of something I can remove. But usually I have to content myself with removing the hard skin and leave it at that.

    I’ve been trying different ways to stop for a very long time. Anxious and depressive thoughts induce the scratching, but its hard to use something like ‘mindfulness’ to deal with them. (Is it really anxiety if the bad thoughts are justified?) My attempts at physically stopping myself have had some unfortunate results. When I put on gloves and tape on my fingernails I ended up so desperate I used a hairbrush to take a third of the skin off my shins before I could get the gloves off. When I put on thick acrylic fingernails I lasted almost a week before I had to remove them. I ended up using a pocketknife to carve my fingernails completely off my fingers and scraped the blade on my face until I was satisfied (luckily they did grow back).

    Dermotillomania is one thing, but can it really be this extreme? I haven’t heard many stories of people going to such lengths to open up holes in their skin. And I especially haven’t heard many people able to describe anything they are trying to get out. Saying I’m trying to remove something I know isn’t there sounds pretty crazy. And intentionally putting things in just so I have something to remove seems like a recipe for trouble. I have a history of schizophrenia in my family and it makes me worry.

    Am I quacking up the wrong tree here? Is it still Excoriation if you want something out? Is it delusional parasitosis if you aren’t deluded into thinking there are any parasites? Or maybe this is a flavor of schizophrenia I haven’t learned about yet? Hell maybe I’m trying to invent some perfect perpetual motion machine powered by hypochondria and anxiety. If I solve the world power crisis with a neurosis cocktail I’ll let you know, in the meantime I’ll be shopping for therapists who know what to do with this.

    Reply
  • I’m and avid B & C picker and have been since I was about 12 (got my first spot). Now 23 I have picked my whole body and my face is totally jacked up. I stay inside for weeks at a time depending on the condition of my face. I pick every single day and can’t help it, I hate myself for it and just want to get better. I don’t start new relationships because I literally would rather die than be seen without makeup and I am so scared for anyone to see the scars on my body that I would rather just seclude myself than deal with the rejection.
    I have missed countless dates, interviews, holidays, nights out, birthdays, family occasions due to my picking and my scars.
    Whenever I feel stressed or sad I go and pick because I am obsessed with perfection and feel that this will make me better (even though it makes it ten times worse)
    I hate myself and right now my face is a mess my body is a mess and I am using Retinol and Hydroquinone to reduce scars and heal my skin but as soon as its ‘on its way’ I just pick again out of feeling stressed that its not perfect. Also, I have brown skin which you only have to look at and I get a scar, its a nightmare and my scars are all really dark brown and look awful.
    Up until a couple of weeks ago I thought I was the only person with this as I constantly look at people with perfect skin and think ‘why can’t I be like that?’
    Obviously asking Google ‘why can’t I stop picking my skin?’ Revealed that, I am not alone and this is a disorder.

    I really want to change, I want to see my friends, go to work, have a boyfriend, go out without makeup, go swimming, not keep letting my family down and making up lies to not go out, not have to spend excess of an hour putting foundation on before I
    go out and not want to die.. all because of my skin.

    If this makes just ONE person feel a little bit better knowing they can relate then I will happy that someone doesn’t feel alone and there is hope that this horrible disorder can be overcome.

    As of tomorrow I will start my journey to recovery, I hope you can too.

    Reply
  • My experience seems a bit different. I began scalp picking as a teenager (C) level and will go through these stages for variable periods and then just stop – doesn’t seem like anything I’ve done to stop, just lose the urge. I will then go through variable stages where I don’t pick or really even think about it – these are periods of several years usually and suddenly I’ll find myself doing it again obsessively as I’ve been doing for a month or so now. I feel so disgusted both to be doing it and unable to stop plus having started again.
    Good article with some things I’ll try though usually I just suffer through until I suddenly lose interest – hard to understand.

    Reply
  • I’m 15, and I’ve had this for as long as I can remember. Even when I was really, really little. I remember how my mom and dad would always yell at me to just stop, but they never understood that it just wasn’t that easy.

    I pick at my fingers, cuticles and toes. I hate it, and I wish I could just stop. Sometimes I’ll eat the skin.

    Up until about last year, it had always been those three- fingers, cuticles and toes. But I’ve began picking at my scalp now. I’ve been doing it so much that it’s at the point that my scalp is bleeding and it’s all red.

    I hate this, I hate this so much! I want to stop. This is a horrible disorder to have, and I feel sorry for anyone else who has to suffer with this. It’s truly awful.

    I’ve tried to stop in the past, but it never seems to work. I’ve tried everything, from gloves, to that whole ‘dipping your fingers in lemon juice’ thing… I’ve tried everything!

    I used to be afraid of walking around showing my hands back when I was like 7. I’d always have my hands balled into fists to hide my fingers. Over the years though, I’ve sort of gotten to the point I don’t care anymore about that. But I still hate this, and I want to stop.

    Reply
  • Hi Em: It sounds like you are describing Skin Picking Disorder which sometimes manifests as picking on the skin of a pet. You say that you love your dog and it sounds like your dog is very important to you. Before you pick at your dog’s scabs, ask yourself if picking them matches your desired actions. It doesn’t sound like it does match.

    Instead of picking at your dog’s skin, there are other things you can do, including: using a squish ball, clenching your fists for one minute, popping bubble wrap and journalling about your anxiety. In other words, do something else with your hands when the urge to pick your dog’s skin strikes.

    Reply
  • Dear Teri: So sorry to hear about your intense circumstances. To help yourself and the doctors who are treating you, it would be best to share information about Skin Picking Disorder with your doctors. We also encourage you to find a therapist who can help you with stopping the picking. You can find a list of providers by geographical location at http://www.trich.org.

    Reply
  • Hi Roxy:

    Thank you for sharing your history and thoughts about your skin picking.

    It’s not unusual for skin pickers to have a desire to “get something out.” The part of you that wants to pick is very clever at finding ways to make sure you follow its orders. You have to outsmart it. Sure, nothing will ever give you the same satisfaction as getting something out of your skin, but you can put a higher value on finding other ways of experiencing satisfaction without picking.

    Reply
  • Hi Catherine,

    Thanks for sharing your experience.

    One thought is for you to log to keep track of what is going on in your life when you start picking at your scalp. Is it a stressful or boring time in your life? Is it dry weather? Are there other variables you notice that might help you see a pattern. If you are aware a picking episode might be about to start, you can have tools (habit reversal techniques) ready to possibly stop the picking before it starts.

    Reply
  • I have been picking my lip since before I was in kindergarden… I’m not entirely sure ‘why’ it started; but I imagine it was probably a way for my younger self to cope with my mother’s drinking problem and despression. Now, at the age of 21, I’ve noticed distinct patterns between when I’m stressed/anxious and when I pick. It’s the worst when I lay in bed with something weighing on my mind… my hands just seem to take on a life of their own. Before I know it my entire bottom lip is covered in red marks and blood. Even though I often become aware of what I’m doing, I feel reluctent to stop because it seems to make things better. I can confidently say I’m a level ‘B’… it gets about 1000 times worse when my lips are chapped. The feeling of a rough patch of skin on my lips just drives me crazy. I always have at least 3 lip balms kicking around the house to try to combat it. When It’s at it’s worst and know I have to go out, I’ll resort to taping the tips of all my fingers for a few days in advance to try and make them heal. I tried gloves, but they were too easy to remove… sometimes I manage to stop long enough for them to actually be healthy, but the second I get stressed again; boom! Back to square one. It’s an ongoing battle, that’s for sure. Glad to see I’m not the only one, and that more help is out there for people with this socially crippling disorder. Someday I hope I can stop for good…

    Reply
  • Hi Renae,

    Thank you for writing to share your experiences. You can stop or get to a level of picking that is barely there. In other words, you can stop as soon as you start. It is possible and you have used Habit Reversal Training (HRT) strategies to help yourself in the past. Keep going with them!

    Also, you can find other ways to release and process the things that weigh on your mind. Exercise, meditation, journaling and seeing a counselor are other, healthier ways to deal with stress. Don’t give up – every time you don’t pick when you want to, you have given yourself a gift you will always have with you.

    Reply
  • Hi,
    I was wondering how to get rid of dermatillomania scars!
    I see people who have this disorder overcome their scars really fast, like in months but mine are taking years to heal even though I have stopped picking, and they are still very noticeable. I have heard testimonies and the things doctors prescribe don’t work and I am very convinced they are right from my previous experience. I really want my scars gone by this summer but it’s not looking to good. I know there is laser treatment and other treatments that cost so much money there is no way I could afford it! Do you know of any ways I can get them to go away. My problem is no longer picking really, it’s how to get the scars that I had created to go away! Please help.

    Reply
    • Hi Lia,

      Our treatment center focuses on treatment of Dermatillomania, not on the scars left by this condition. We encourage you to speak with your dermatologist about your concerns with your scarring.

      Reply
  • I can’t do the ABC! Once I feel a “B”, I can’t stop thinking about it. I have stayed up tossing and turning at night because it is on my mind. I have even found myself picking at it in the middle of the night. I have tried, time and time again to wait to see if it worth picking but it is always on my mind. Going and doing something to keep my mind off of it only makes it worse because I then feel like everyone is looking at my skin. I don’t enjoy myself, I get upset and want to leave. I understand I am not the only one in the world that feels this way but I am the only one around ME that knows this isn’t an easy fix. All I ever hear is, “stop picking, stop picking!” News flash friends and family, the more you do that the more it creates anxiety and pushes me to become a closet picker.

    My spouse thinks I am crazy because I pick my face until there are sores and pick my lip until it bleeds and swells up. I have an obsession with wanting to have perfectly smooth skin. I wanted to laser my face because it bothers me so much (it cost too much).
    So the ABC method is a good idea… but not realistic.

    Reply
  • Hi Rikki,

    You’re right – overcoming the urges and not giving in to thoughts about picking is not an easy path. The ABC Model is not a treatment protocol – it is just one way of conceptualizing Skin Picking Disorder. If it isn’t helping you, that’s okay – there are many other tools and techniques to help yourself. If you read our articles here, you will see many of them mentioned. There is also a wealth of information on a website called http://www.trich.org, including a list of treatment providers that may be able to help you. Many people share your struggle and frustrations; the important thing is to keep moving forward on a path to healing, as it is possible to significantly reduce or stop picking.

    Reply
  • I thought I was through with picking my scars, I hadn’t picked my skin in two weeks but then all the sudden it started up again. I wasn’t stressed really, I was actually happy for a moment because I was so proud of myself for overcoming it (so I thought). It came back stronger than ever. I have HUGE cuts on my face and back now that are going to turn into terrible scabs that I’m sure I will pick and make the cut way worse even though I try so hard not to pick them. And even if I don’t somehow I will still have a stupid huge black scar ( I’m brown) to remind me of what I’ve done. They will be added to the hundreds of other scars I have all over me. I tried to figure out why I started picking my skin again and after talking it out with a dermatologist it’s because I have no hope that I will get rid of my scars. When I’m picking I always think to myself I already have hundreds so what’s one more, either way I’m never showing my real skin without makeup in public. I thinks it’s the weighing thought of always being covered in huge black dots that scars me because I really want my old skin back, the way it use to be. After doing some research and talking to professionals I found out that my scars could be permanent, no matter how many face masks or screams I try! It broke my heart and so now I pick like crazy and am always very depressed and seem to be always bleeding somewhere on my body. If there way some way I could get rid of the scars I would of course have more hope and I’m hoping would stop picking, but right now it looks hopeless. And I hate being so depressed when it’s so close to Christmas. All I’m asking for for Christmas are things that I think might help get rid of the scars instead of things a 16 year old girl would really want, but oh well. Do you think skin lightening cream would help? If I only put it on my scars? My dermatologist says it’s a risk but might work but honestly I’m kind of scared to try it since I have heard so many stories of it causing cancer! But I willing to try anything that would help.

    Thank you

    Reply
  • Oh my god I am so glad I found this, I didn’t even know it was a disorder! I have two scabs on my head about 5 inches (if that) apart and I’m always at them, I just want to feel the scan sliding off my hair, to look at it and see what’s underneath and then if any clear liquid comes out I slide it down my hair so when it dries I can slide that off my hair too.. I’ve had it before but I’ve cut the hair in that area off.. It’s so so embarrassing but it’s great to know I’m not alone in this and that it can go away so Thankyou all

    Reply
  • A friend of mine (in her early 60s) got athlete’s foot, and the treatment, over a very long period of time has turned into a 3-hr per day process with potassium permanganate, which turns her sole black, a razor or scissors to scrap away the “oxidation.” Something on her face made her think she had athlete’s foot on her face, so now she treats that as well. She recently had a couple of bruises, and thought that was athlete’s foot beginning to erupt. She was recently to a dermatologist who told her in no uncertain terms that she was not to treat her skin with scissors or razor. I’m wondering if all this is her way of treating a nerve disorder, as if maybe the scraping is releasing soothing endorphins or something. If I have some basis, I think I could get her to go to a psychologist. Is this like another form of dermatillomania that could be helped with CBT and maybe an anxiety med?

    Reply
    • Hi Grace,

      I have no idea if your friend has a nerve disorder, and I encourage you not to spend much time trying to figure this out. The bottom line is quite simple – people should not be scraping their faces with scissors or razors. Your friend should listen to her dermatologist. I also suggest that your friend seek a consultation with a therapist who specializes in the treatment of Dermatillomania so that she can determine if she has this condition.

      Reply
  • No idea why I do this but it scares me. I’m afraid of getting intimate for the Shame of being looked at like I’m crazy. I can stare at my arm and find nothing but when I squeeze something .. Something comes out and it gives me satisfaction… I also graze my hand over shoulder and find something… I started off on one arm only enough that a T-shirt would cover the scars. But it’s like an addiction. I moved into both arms and further down. So much that a T-shirt no longer covers it. I find myself buying long sleeves just to cover it. I seriously need help. I want to keep busy but my mind continues to search for that one more… And one more turns into another and another… Until long times pass and I continue lying to myself. This is awful, I don’t know how it came about. I am not one who cares about my appearance or I haven’t been emotionally hurt ( not that I can recognize) … But now that I’m talking about it, it helps.

    Reply
    • Hi Jenny,

      A few thoughts…

      1) I agree – Dermatillomania is very much like an addiction (the addiction is to the behavior of picking, rather than to a substance).

      2) Many people with Dermatillomania do not have a history of significant trauma.

      3) A fear of getting intimate due to concern about being judged about scars and scabs is a veryalways be able to squeeze something out of your skin. It will never become dried out. That moisture is a good thing that doesn’t need to be squeezed out.

      5) Grazing one’s hand over one’s skin is a common behavior for those with Dermatillomania, and frequently leads to picking. It is critical that you stop scanning your skin, as you will almost always find something that you think deserves to be picked.

      I encourage you to seek treatment with a therapist who specializes in treating skin picking with Cognitive Behavioral Therapy (CBT). Take care.

      Reply
  • I have been picking for as long as I can remember.It started with bug bites. I would pick and eat scabs until a scar formed. I am very self conscience of the scars I created and always try to cover them up. In later years I started picking at my feet and hand. I eat the skin that I have picked off. When I pick at my feet they sometime bleed. It is painful to walk after picking. But for some reason the pain comforts me. It’s something I can relate too. I don’t know why. As soon I begin to heal I start picking again.

    Reply
    • Hi Joan,

      Thanks for sharing your experience. I encourage your to seek out treatment with a therapist who specializes in the treatment of Dermatillomania (Skin Picking Disorder).

      Reply
  • Hello,
    I have been picking for as long as i can remember and it has not been an issue, that is until i got married and it drives my wife nuts. I then realized it was a problem when i was not able to stop. For me it is stress related, i am always scanning my shoulders and back looking for somthing i can pop. If there is a scab i will have it for months making it bigger and bigger until a new one(s) take more attention. I have even noticed that i will see a red spot or unlevel skin and pick or squeeze it until it bleeds and then becomes a scab. My shoulders are covered in scars from the picking. I really do not want to pick and especially eat it from time to time, but it happens without me even noticing. Most of the time i dont notice i am doing it until i catch someone staring at me. Then the guilt and shame sets in. I really hope that this is somthing i can learn to control. I am going to try the glove method when driving, that is when i tend to be at my worst. I have never really talked about this before because i never knew it was a thing. I assumed i just had a bad habit.

    Reply
    • Hi Brad,

      Your comment perfectly illustrates how the line between a “bad habit” and a problem that needs to be addressed therapeutically can at times be grey. Yes, you have a “bad habit”, and that habit is causing disruption to your life, your relationship, and your sense of self-worth. This suggests that it is time to address this issue. I encourage you to seek the assistance of a therapist who specializes in the treatment of Skin Picking Disorder with Cognitive Behavioral Therapy (CBT). Take care.

      Reply
  • I’m borderline “C” , I’ve been picking since I was kid and while I’ve never had any serious infection, they do leave sores, scabs, and eventual scars. For me, I feel like it’s a way of coping with my anxiety and stress, and I hate how my coping mechanism is self-damaging. For me, if I feel something rough, or something like a pimple or scab, “THIS THING IS WRONG” blares in my mind and all I can think of is how by getting rid of that “wrong” thing, everything will be alright. If I’m stressed out, then somehow by picking away those wrong things, everything else will be better. Logically, I know that picking will make things worse, make new scabs and marks to pick at and grow, but at the time, it seems like the solution to everything.
    I hate it when they say, “That’s just a habit, just stop picking”, b/c it’s much harder than that. I’ve managed to stop picking at times, maybe for a week at most before it starts again. I’m ashamed b/c my skin is much worse than my siblings and my mom constantly comments on how I could be pretty if I just stopped. I’ve tried gloves but ended up pulling my hair instead.

    Reply
    • HI Sammie,

      Your experience is textbook Dermatillomania. You notice something that feels “wrong” to you, you know it’s a bad idea to pick at it, yet picking feels like it will be the perfect solution to not just the “wrong” feeling, but to “everything else”.

      I encourage your to commit to treatment with a therapist who specializes in Cognitive Behavioral Therapy (CBT) for Dermatillomania, as this is the most effective long-term solution to this problem.

      Reply
  • This article was so helpful. I struggle with my boyfriend constantly picking at scabs and making new ones. He even picks at mine! I’m trying my best to keep him from picking, but while I’m at school and he’s at work, I can’t smack his hand away and hold them. Doctors need to help more, this is an unsanitary disease and the people with this condition are destroying their beautiful skin.

    Reply
    • Hi Gracie,

      Thanks for commenting. Based on what you write, it sounds like your boyfriend has Dermatillomania. It is actually fairly common for those with this condition to also pick (or try to pick) others’ skin.

      Unfortunately, most doctors and therapists are pretty much clueless about this condition. I encourage you to discuss with your boyfriend the option of treatment with a therapist who specializes in Dermatillomania treatment.

      Reply
  • Thank you so much for this article, I do believe I have ‘C’ because I pick at my lips, skin next to my nails, and the corners of my big toes. I do this when I get nervous or bored, or something like that. I REALLY want to stop but I just cant find out why I cant. Today I found out that I actually have this disease. It’s scary knowing that, I have a disorder that I can’t control. I often wake up in the middle of the night only to realize that I’ve been picking my “Nail Skin” and lips so much that I have blood all over my hand and face. I do this sometimes without even noticing. I’m self conscious of my nail skin and lips that I have to but on HEAVY chapstick and I have to put band aids around all the tips of my fingers. I’m only 11, (going to be 12 in December) and I get rude or confused comments about my nail skin and lips ALL the time. I don’t know how to reply to them because, I don’t want to tell some stranger that I have a disorder. I also have scars all over my body from picking scabs. I hope that one day I’ll be able to cure it because this is something I hate. I think I also do this out of stress.

    Reply
    • Hi Rebecca,

      You actually can control this disorder – you just haven’t yet learned how, which is not surprising when you consider that you just realized you have this problem.

      Because you are only 11, I strongly encourage you to discuss this matter with your parents, as they are your best resource for help. I encourage you to show them this article, which will give them a better idea of what you are experiencing. After that, your parents should seek out treatment for you with a therapist who specializes in treating Skin Picking Disorder.

      Take care.

      Reply
  • I am 6 months skin picking free! I have been reading reflections and it has really helped. Ive learned how to feel my feelings and not react to them. I have been a skin picker my whole life. However now I have scars and I look at them and feel guilty and ashamed. How do I get past this?

    Reply
    • Hi April,

      I am so glad to hear that our free online “Reflections” subscription series has been helpful for you!

      Your experience of feeling guilty and ashamed is extremely common for people who struggle with Dermatillomania and the scars it leaves behind. I encourage you to seek treatment with a therapist who can help you address these feelings.

      Take care.

      Reply
  • I really think I have Dermatillomania and like alot of other people my family and boyfriend slap my hands and yell at me to stop but they don’t understand that I cant. At night I stay up even if I’m super tired because I am picking and can’t just stop. I once had a large bump the size of a golf ball on the back of my head from picking so much and causing an infection. Even after that scary bump i still cant help but pick, recently i have been scrapping at my head even though nothing is there and i caused a large scab because of it; the scabs nevet there very long because the second it starts forming and i notice it i cant help but pick it.I will pick at a scab and dig in even if it really hurts and I find satisfaction when I finally get it. My mom once put a large bandage and first aid tape over this large scab I got from a horrible burn because I would continuously pick it and not let it heal…When she left I pull it off and continued to pick, the urge was to great and I couldn’t control myself.

    Reply
    • Ashley,

      While I cannot provide a diagnosis via a blog comment, I can say that there does not seem to be much doubt that you are struggling with Dermatillomania. You are picking at your skin repeatedly, which has on at least one occasion led to a significant infection. I strongly encourage you to seek treatment with a therapist who specializes in treating Dermatillomania with Cognitive Behavioral Therapy (CBT).

      Reply
  • Thank you for the article, I am so glad I came across it as there isn’t much about this out there. I have both, skin picking ‘b’ and ‘c’ and hair pulling too. Unsure how I can break this ‘habit’. For me it is a form of relax and getting a flaw out, physical flaw – pimple. Or I see something is healing so I try to ‘speed’ it up by pulling on the dried bits. I am going to try these, fingers crossed. I also think I have overeating problem. Cannot resist sweets and eat them until I feel almost sick.
    Do you think these can be cured by hypnotherapy?
    Thank you.

    Reply
    • Hi Maria,

      Everything you write sounds like classic Dermatillomania. Specifically, you note three of the more common reasons people with Dermatillomania report as “reasons” they pick:

      ~ trying to eliminate a “flaw” such as a pimple

      ~ the sense of relaxation they experience when picking

      ~ trying to improve an already healing scab

      Some people have found hypnotherapy to be helpful, but the most effective treatment for you is likely to be Cognitive Behavioral Therapy (CBT).

      Reply
  • This was really helpful- I have to remind myself that a small bump isn’t something to pick at. I would definitely be a ‘B’ picker. I just have to tell myself if it’s not really visible then there’s nothing really for me to be trying to pick away. All I want is smooth clear skin (especially on my arms) and rather than let it heal my fingers always wander and find bumps to try and get rid of. It’s like my brain won’t accept that removing a scab/bump, although feeling smoother, actually makes my skin look worse. There’s like a disconnect between my head and my hands. I find applying aloe vera gel when I have a picking urge gets rid of the tension that I feel sometimes (it’s nice and cool) and satisfies the need to at least address my arms in some way that isn’t harmful.

    Reply
    • Teresa,

      I’m happy to hear that you found our article helpful.

      Your comment illustrates one of the key cognitive distortions in skin picking, which is the idea that you can create “smooth clear skin” by picking. This is a distortion because no such thing as “smooth clear skin” exists in a permanent state, and picking will always find some – as you note, your “fingers always wander and find bumps to try and get rid of”.

      Trying to get perfect skin is a futile task, and picking in an effort to get perfect skin is bound to result in just the opposite. If you have, as you put it, a “disconnect” between your head and your hands, you need to find a strategy that addresses that disconnect. It sounds like aloe vera is at least partially successful in helping you with this disconnect, and I encourage you to continue with that strategy, and try others that might also help.

      Reply
  • Can you advise me, I have just found the term ‘dermatophagia’ and it applies to me. I am constantly either picking, chewing or tearing at the skin around my fingers. When I tried to stop, I started chewing my lips and the insides of my cheeks. I feel I could control the finger biting/picking but the mouth chewing is when I am most ‘trance like’.

    This website is so helpful. Its frightening to realise that something funny and habitual about you is a disorder. Its even more frightening when you think about the fact that you chew and eat your own flesh. There is comfort in numbers though.

    Reply
    • Georgina,

      My best advice is to seek treatment with a therapist who specializes in treating Body Focused Repetitive Behaviors (BFRBs) such as skin picking, skin eating, cheek biting, and hair pulling.

      Reply
  • Does consuming caffeine exacerbate Dermatillomania by creating more anxiety?

    Reply
    • Hi Sarah,

      While I do not know of any research specifically on the impact of caffeine on skin picking, many of our clients have reported that they feel an increase in the urge to pick after drinking coffee, tea, and certain soft drinks that have high levels of caffeine. If you have noticed this in yourself, I encourage you to reduce or eliminate your caffeine intake.

      Reply
  • I am only twelve and this is already ruining my life. I can’t even wear my swimsuit because of how hideous this has made me. I’m ugly, but I just can’t seem to make myself stop! I started picking at things that weren’t even there when I ran out of pimples and zits to pick all over my body. For some reason, I love the white stuff that comes out to the point where I am so obsessed I have been know to ask people if I can pop their zits for them, which is weird and disgusting, and I don’t know what to do! I have noticed that the majority of the responses end with seeing a therapist, but that won’t work for me because I am only 12 and my parents believe it is just a habit made stronger because of my anxiety medication, even though this isn’t a known symptom of the medication. Suggestions?

    Reply
    • Me,

      Thanks for your comment. My suggestion is actually pretty simple – discuss this issue with your parents and ask them to find you a therapist who specializes in treating Dermatillomania. Talk to them about this over and over until they wake up and realize this is a real problem. If/when your parents reject the idea of therapy, show them our articles on Dermatillomania, and show them your scabs and scars. They need to take this seriously and they need to find you effective treatment. Take care.

      Reply
  • I am fairly young and I belive I have dermatillomania. I pick at “pimples” and scabs on my arms, legs, and chest. I think that makes me a B and C. I hate wearing shorts and short-sleeved shirts because I’m afraid everyone will stare at me and judge me. No matter how awful it looks to me, I can’t stop picking. I don’t hang out with my friends or anything because I’m too afraid to show my terrible skin. Kids at school ask me what happened to my skin and I have to lie because I’m afraid to tell them the truth. My sister picks her arms too, and the rest of my family. I also do dance and so it’s very embarrassing for the teachers and my classmates to give my arms a side glance. It puts me in a very sad mood when I see my arms and legs. It prevents me from going out to the pool or hanging out with friends. I think I’m the only kid in the school with this disorder. I feel like everyone is always talking about my arms and legs. If you can help me at all in any way, I totally appreciate it. Thank you!

    Reply
    • Hi Macey,

      Thank you for commenting.

      The best advice I can give you is to openly discuss this with your parents. I know that will be difficult, especially if your parents also pick at their skin compulsively as you suggest. But because you are young, your parents are your best resource for finding treatment. If they resist the idea of treatment, let them know just how much this issue makes you suffer.

      There is help, you just need to access it. Take care.

      Reply
  • Does anyone else have family and friends who consistently say “just stop picking. Simple!”? If only it were that ‘simple’. If people with this disorder could actually stop picking, don’t you think we would have already stopped by now?!?! Every time someone tells me to stop picking, it just causes me to pick even more. I know people mean well, but it honestly does not help anything. I’ve expressed this. Anyway, the only thing that seems to have any sort of positive effect for me is blister bandaids (aka hydrocolloid bandage). I still pick……a lot……..but after I’m done picking, I wash my face, pat it dry and put on a blister bandaid. It absorbs the fluid and traps it from wounds in general, but I use them on freshly popped cystic zits. They’re like little cushions, greatly reduce pain and they seem to cut healing time in half. Now, they’re not invisible, but they do conceal the redness and are as close to being flesh colored as you’re going to get so if you can handle going out in public with them on, do it! I’d rather walk around with these bandaids on my face than walk around with a bright red, painful, unsightly oozing lump on my face any day.

    Reply
    • Erin,

      I certainly understand your frustration with people suggesting facile solutions to this complicated problem. That said, your current solution is not really helping – the bandages merely hide the severity of the problem from public notice. I encourage you to seek treatment with a therapist who specializes in treating Dermatillomania.

      Reply
  • I am a teenager who has been struggling with skin picking for a while. Every night I tell myself I won’t pick, but I end up giving in and an hour or more later find myself with an inflamed red face and a sore back from hunching over into the mirror. It makes me feel so angry and disappointed in myself, so I loose sleep. and I hide my face until the morning because I don’t want even my family to see me. It causes so many more skin problems like acne, scarring, and pain, which I desperately want to be without. In the mornings I put on lots of concealer to cover up what I’ve done, but It’s hard to cover pealing skin and wounds. It takes up so much of my day, and I end up loosing lots of sleep. Throughout the day I’ll scrunch my nose just to feel the pain, which just makes me upset again and doesn’t prevent me from picking at all. I have tried everything short of seeing a professional. I don’t want to tell my parents about it because whenever I have talked about something related to it with my mom she just says, “Don’t do that. It’s bad,” which just makes me feel more shame and doesn’t help at all.

    Reply
  • My husband picks at his skin EVERY morning before his shower, and EVERY night before bed. His routines are very long taking over an hour + to get ready in the morning. I knew it was habit, but what I didn’t notice until later was that he was picking at nothing. He creates his own zits/sores. He will squeeze his pores until something comes out and creates red marks all over his body. He’s convinced he has acne. I have never seen him with what we would call an “A”. His are all “C”. He is a very fit and attractive man, so he assures me that he’s just taking care of his skin. He will also pick his bald head in the evening when he’s relaxing. I have brought up his condition a couple times, but he gets extremely defensive and will show me his marked body and tell me that I’m crazy if I can’t see all the acne. My husband does have a lot of anxiety, which he doesn’t realize he has. He is a successful man, who is driven and motivated which is why he said he will never take medication, he doesn’t want it to effect who he is. I see a lot of anxiety, stress, and anger. How can I help him?

    Reply
    • Chris,

      Unfortunately, there is little you can do to help someone who denies they have a problem.

      Reply
  • Thank you for writing this! I’m crying right now at the thought that these techniques might help. I’ve been trying to stop picking at my face and other areas of my skin for maybe 25 years! I’ve recently had some progress, but I’m having a lot of setbacks. You’ve given me extra hope. Again, thank you!

    Reply
    • Kim,

      Thank you for commenting. It’s great to hear that our article has helped you feel more hopeful and motivated. Rest assured that many people learn how to effectively manage their urge to pick at their skin. Do the work and you will see progress.

      Reply
  • Thank you so much for writing this article. I am a type ‘C’ picker and have been so for the past 13 years. I am outwardly the cool, calm and collected type who would never dream of commenting on a blog like this. But inside, I am a mess of non-communication, and squeezing my face and arms (anything really) is my way of ‘getting it all out’. I almost zone out when I am squeezing, and it allows my mind to calm itself in what feels like a sea of emotions. I have known this for years, but knowing it and doing something about it are two very different thing. I will try the 24 hour waiting idea (I have tried everything else), but I am not giving up. Are there any skin picking disorder specialists in Zurich, Switzerland?

    Reply
    • Nicole,

      You note that you are “a mess inside” struggling with “a sea of emotions”, and that you are using skin picking as a coping mechanism. This strongly suggests that you should be in treatment for Dermatillomania. I know of no specialists in Switzerland, but if you are open to online therapy, we can be reached via our website.

      Reply
  • Thank you for the article. I have two questions though. What if you like to pick? And what do you do if you feel so anxious and nothing relieves it like picking or pain? Even picking doesn’t really relieve it I guess, it just puts me in a state where I don’t have to think. And pain helps distract. I’ve tried therapy, medication, mindfulness, bubble wrap, exercising, etc, but I can’t break the habit of picking every evening when I’m stressed about having a whole day tomorrow. What do I do?

    Reply
    • Erica,

      Everything you write is common for people struggling with Dermatillomania. As for what to do about it, my suggestion is that you seek treatment with a therapist who specializes in treating this condition.

      Reply

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  • Cy Young, Zack Greinke, and Social Anxiety
    Zack Greinke has overcome his Social Anxiety to become a superstar in major league baseball. […]
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  • Exposure Therapy for OCD and AnxietyExposure Therapy for OCD and Anxiety
    Exposure therapy for OCD and other anxiety conditions is discussed by Tom Corboy, MFT, of the OCD Center of Los Angeles. […]
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  • Social Anxiety Research
    Recent Social Anxiety research is discussed by Tom Corboy, MFT, executive director of the CD Center of Los Angeles. […]
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  • OCD Awareness Week
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  • CBT and Evidence Based Psychotherapy
    Unfortunately, many psychotherapists dismiss evidence-based treatments such as CBT, instead choosing to do what feels comfortable for them. […]
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  • OCD, Mental Health, and the National Health Care Debate
    A look at the national health care debate, especially as it pertains to OCD and related anxiety based conditions. […]
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  • Childhood OCD, Strep Infections, and PANDAS
    There is a growing body of research that indicates strep infections are related to rapid-onset OCD in children. […]
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  • OCD and the Swine Flu – Part 2
    Panic about the Swine Flu continues, despite facts that suggest there is no cause for increased concern. […]
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  • 2009 Obsessive-Compulsive Foundation Conference
    A review of the 2009 Obsessive Compulsive Foundation conference. […]
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  • New Trichotillomania Research
    A look at recent research related to Trichotillomania. From the OCD Center of Los Angeles. […]
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  • Parenting a Child With OCD
    Parenting any child is a full-time job. But parenting a child with OCD can be particularly challenging. From the OCD Center of Los Angeles. […]
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  • Social Anxiety in Baseball
    A look at the recent rash of pro baseball players struggling with Social Anxiety Disorder. […]
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  • Michael Jackson and Body Dysmorphic Disorder (BDD)
    A look at the sad tale of Michael Jackson and his mental health issues. […]
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  • OCD and the Swine Flu
    The past few months have seen an avalanche of news stories on the Swine Flu, despite its relatively low impact in the US. […]
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  • Meet the OCD Center of Los Angeles Staff
    Meet the OCD Center of Los Angeles Staff […]
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  • Welcome to the OCD Center of Los Angeles Blog
    Welcome to the OCD Center of Los Angeles Blog […]
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OCD Center of Los Angeles

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During the coronavirus emergency, our 12 staff therapists are available for telephone therapy or online, webcam-based therapy.