Picking at Skin (Dermatillomania)

Archived Q&A and Reviews


Dermatillomania, skin picking, in 6-year-old

June 2009

Hi BPN community, Anyone out there with Dermatillomania, a skin picking disorder. I would love to get in touch with someone that has a friend or family member that has a skin picking disorder. I have done a ton of research and testing and have tried many diet changes for my 6 year old but we are not having as much luck as we would like. Thank you very much, Wanting clear skin for my 6 year old

SHORT VERSION: Check out trich.org.

LONG VERSION: I have struggled with skin-picking (and other BFRBs or Body Focused Repetitive Behaviors) my whole life. Thanks in large part to TLC, the Trichotillomania Research Center, in recent years BFRB resources, awareness, and research have exponentially increased.

Check out TLC's website www.trich.org, for more info. They've got stuff for both individuals and families, kids and adults. If you become a member, you'll get a welcome packet with tons of info and you'll get quarterly newsletters. Also, this year their annual retreat is being held near Santa Cruz August 9-12. I've seen kids, families, and adults transformed by this retreat - if there's ANY way you can get your family there, you'll certainly come away with a lot more understanding and information.

One thing to keep in mind - as a skin-picker, sometimes I find I need to substitute the word ''skin'' for ''hair'' in the literature, not only at TLC but also elsewhere. There seem to be more resources for hair-pulling than other BFRBs like skin-picking, but believe me, as someone who does both, skin picking and hair pulling are very similar in some ways. So you might also want to look for resources for hair-pullers.

It's great that you're reaching out for support. And I think diet changes are probably a great direction even though there isn't (yet) scientific evidence. I've found they've been helpful but not a magic or complete solution. Good luck, and remember to be compassionate and kind to both yourself and your child.

7-year-old picking at his fingernails

July 2008

For the past year or so, my 7 year old son has been picking at his fingernails (toenails sometimes, too) and peeling them off. They're down to little crescents that cover maybe 1/3 of his nail bed. If he accidentally hits his fingers on something, they'll sometimes bleed because they're so exposed. He seems to pick when he's nervous (i.e., waiting for his turn to play during a soccer game), but also when he's not (i.e., while we're reading in bed). So far, we've tried giving him fidget toys, bandaging up all his fingers, bribing him with toys, trying to keep the nails very smooth with a nailfile (so he can't get a piece to pull off) and teaching him to do deep breathing exercises to relax. We've had some limited success (a day or two) with some of these strategies, but then he's right back at it. He's definitely got perfectionist tendencies, and can be high-strung sometimes, but for the most part, he's a happy, normal kid, and there's nothing majorly stressful happening in the family. When I ask him why he does it, sometimes he'll say he's nervous about something like ''diving at the swimming pool during lessons'' - which he otherwise seems to enjoy and is good at. Therapy seems a little extreme at this point - doesn't it? I'd be very grateful for advice from anyone who has dealt with this before, or anything similar. . . getting anxious myself

I was a finger picker as a child, similar to your son. Sometimes I could relate the behavior to a particular stressor, other times I did it out of physical boredom (even if and sometimes especially if my mind was interested--reading and being in school were key picking times for me). I wish I could say I have grown out of it, but I haven't. There have been years when I quit, but if life gets tough, I start up again.

Looking back, I can say that I was a pretty stressed out kid. I wonder if some kind of therapy may have helped me at that time. I think I can point to the key stressors for me now, but I can't imagine having been able to articulate them as a kid. I wouldn't rule it out as an option for your son.

Physical activity helps a lot--daily exercise lowers my stress and anxiety, and makes me less likely to pick. All of the other distractions you described work for a while (having acrylic nails for a few years worked really well for me as an adult), but ultimately they are superficial answers to a deeper problem.

I encourage you not to make a big deal out of the behavior itself--the bigger the fuss, the more the stress, the more likely he is to do it! Explore underlying issues if you can.

If it helps, I'm a pretty normal person generally. It's an annoying habit, and signals to me that something is stressing me out. It might help your son to look at it that way, too. Picker

You are not alone, my friend. We have been struggling with our son's finger preoccupation for the last couple of years. The nail biting didn't start until he quit sucking his thumb last year, which he did under the exact same circumstances you observe in your son (sometimes nervousness & anxiety, other times just daydreaming & sleepy). We successfully kicked that habit, but didn't expect the ensuing biting & chewing that borders on self-mutilation sometimes. (He doesn't bite them to the level your son does, but will rip of skin from his fingertip; last week, he ended up with a large, exposed area of pink flesh that of course would sting when it came in contact with anything.) We've tried reasoning, relaxation, incentives - all of which will work for a while...but after last week, I've resorted to using ''Mavala Stop'' again - a solution you paint on to fingers that has a very bitter taste to discourage nail biting/sucking. It smells awful too - like a nail salon, but it literally worked in 3 days w/ the thumb sucking (my son said, ''it's like there's an invisible barrier on my thumb!'') and while I hesitated using it again, it appears to be working: I haven't seen him biting his nails this entire week, and we even clipped them the other night. I found it online, and I'm sure there are other products too that can be used. Mom of a Nail biter

You know, this sounds a lot like another compulsive habit called trichotillomania (urge to pull out hair). There is some advice about this on the BPN website here: http://parents.berkeley.edu/advice/worries/hairplucking.html

I found information about compulsive nail biting on www.trich.org and at Wikipedia: http://en.wikipedia.org/wiki/Nail_biting

It's called onychophagia, so you might try googling for that. Good luck! Anon

4-year-old is picking at her nails

Sept 2007

My daughter has begun to compulsively pick at --not bite-- the ends of her fingernails. I've tried to keep them very short and constantly trim them; however, this just exposes hangnails that she then picks at as well. It has gotten to the point that even if her nails are down to the nubbins, she will actually lift up the remaining nail. If she is in gymnastics, she will do her rolls, exercises, etc...then immediately start picking once her hands are unoccupied. To my dismay, I have now noticed she has started picking the nails on her feet! Has anyone dealt with this before? How can I dissuade her from continuing this? I know it is just a nervous habit, and she is doing it unconsiously, but it is driving me nuts. Tina

i did this as a child. it is a nervous habit, exacerbated by anxiety/stress. farther out on the spectrum, but related is picking at other skin (Dermatillomania), hair pulling, etc. some links:
http://en.wikipedia.org/wiki/Nail_biting http://www.wikihow.com/Stop-Biting-Your-Nails http://en.wikipedia.org/wiki/Dermatillomania http://www.homestead.com/westsuffolkpsych/SkinPicking.html http://www.ocdla.com/compulsiveskinpicking.html 
anything you can do to help lessen stress will help. i quit at 13 when my stepmother buffed my nails and they felt so wonderfully smooth, that every time i put them in my mouth, i felt that smoothness, and didn't bite. so they grew out, and look fine, but i still pick at the skin, the habit is still there, just less obvious. and coincidentally, that's when i started picking at skin... former biter, now a picker. sigh.

3-year-old is picking at her face and fingers

June 2007

My daughter seems to have an obsession with picking at her face and fingernails. Whenever she gets a tiny little sore on her face, she picks and scratches at it until it bleeds. She does this when she is tired or bored, mostly when she is in bed. It happens night after night until the little sores become larger and infected. Lately she has been bleeding on her clothes every morning when I get her from her crib.

The last time this happened I put a bandaid on her face to protect the sore from scratching. The sore healed, but she had an allergic reaction to the bandaid and developed little bumps under where the bandaid had been. Now she is scratching at those bumps too, so she is up from one to three big sores on her face!

She also picks at her nails until she gets little hangnails and then cries until she gets a bandaid. Is this normal toddler behavior? She is almost three years old, and besides the usual bossiness and stubborness that comes with the age, is a very normal, bright, loving child. Everything I look up on the Internet suggests obessive-compulsive disorder or dermatillomania, which worries me immensely. Has anyone else had any experience with this type of behavior? Worried Mother

My daughter, now 5 years old, has picked at her face since she was about 6 months old exactly the same way as your daughter does. You should see the many photos we have with the bandaid across my daughters nose or cheeks. My husband has allergies to everything, has excema and has been diagnosed with Obsessive Compulsive Disorder. My therapist suggested my daughter is just ''anxiety wired'' (thus her picking behavior at 6 months old) and this is her self soothing, calming technique. Nevertheless, I was/am concerned about the scarring that happened on her face. I used Aveeno lotion on her face whenever I thought about it (at least once a day), bought the latex free bandaids, and found that the little round bandaids worked the best for minimizing her skin reaction to the glue. I also put her to bed with plenty of antibiotic cream on the sores and bandaids, and washed her hands as much as possible (again, remembering!). I CONSTANTLY said, ''don't pick'' and tried to replace that comforting picking motion for her with a stuffed animal or a blanket. Didn't work for her, and she eventually stopped picking when she was about 4. Just this week, and she is now almost 6, I found her picking again on her face causing the bleeding, etc. Now, I just have to suggest/threaten the bandaid on her face, and she stops. Of course, she's older than your child and has more self control at this age.

To be honest, my experience was to lube, bandaid and be sad for her self-soothing technique. Yes, I will probably have to take her to a dermatologist when she is a teenager to see what we can do about the mild scarring, and yes, I worry about the OCD symptom as well. But, I've learned I don't have a choice over either of those things, and do my best to stay calm about that, watch her, and teach her other more healthy self soothing techniques. Not sure if this post is helpful other than you are not alone. Try the small round bandaids! Good luck. Mom of a Picker Too

Skin-picking is a habit I'm more than familiar with. I'm an adult who struggles with that habit, and I attend a support group that includes folks who started picking at a very young age.

I didn't see your original post, but I caught the reply and wanted to add some additional info.

First, visit www.trich.org which is TLC, the Trichotillomania Learning Center. While TLC started with a focus on hair- pulling, in recent years it's become apparent that hair-pulling is only a subset of what are affectionately referred to as BFRB's: Body Focused Repetitive Behaviors. This includes hair- pulling, skin-picking, cheek-biting, nail-biting, hair- twirling, and other behaviors. (Note: don't be afraid to substitute ''skin-picking'' for ''hair-pulling'' in their literature. As someone who does both, I can attest to the fact that they're very similar. Also, call and ask to speak with Christina, who is very knowledgeable.)

Second, BFRBs are not the same as OCD. While there's not a ton of research yet, it's clear that at the very basic level, BFRBs don't respond to OCD medications effectively (for most people). BFRBs are their own thing - related to but not the same as: OCD, impulse control disoredrs (like Touretteb

s), body dismorphic disorder, addicitions.

Third, be compassionate with yourselves and your children. It's extremely difficult to see a child, or any loved one, suffering from this. It's hard for the child too, so remember that if they could stop, they would. This may be a life-long journey for your young one and you can't fight the battle for them.

Fourth, unfortunately many professionals (doctors, therapists, dermatologists, etc) will not know how to handle hair-pulling and skin-picking. Just because they've got a degree doesn't mean they know anything about this. TLC may be able to help you find someone who *is* familiar with the disorder. But you and your child should prepared for dermatologists to say ''just stop'' and for therapists/psychiatrists to offer medications or treatments that will not help.

There are a lot of parents' resources out there for those with BFRB's. I would start with TLC - if you join for $45 (or less if it's a financial hardship for you) they can give you a list of local resources in your area. Also, this August their annual retreat is in Santa Cruz, which you may want to attend with your child, if that's the kind of thing your family would do.

Hope this was helpful. Good luck, and take care! An Adult Skin-Picker

11-year-old is picking at and poking himself

May 2007

HELP!!!! My 11 yo son has been poking himself at school. He has other anxiety issues and now we are having him tested for a possible learning disorder. I've noticed that his sores never heal....he keeps picking, but today his teacher called and said that there was an ''incident'' in class (5th grade) and one of the kids freaked that he was poking himself with a pencil. My son was humiliated and was given permission to leave the room to chill,which he did.

The teacher explained to the class that this was a nervous habit and that he doesn't really realize he's doing it so it's best for the kids to not freak out but to be kind and bring it to his attention.

He's well liked and has lots of friends so it's not like he's an outcast, but still this is very disturbing to me. He has a therapist, dr, etc./.....so I dont' need medical/therapy recommendations. I want to hear from other parents who's kids have had this issue. Thanks in advance....OY!!! What else???? concerned mom

Hi there- I know you didn't want any medical advice but you didn't mention OCD, so I wanted to be sure you know that poking and picking are symptoms of this. It is not just from anxiety. I KNOW, I have lived and am still living it. I am also a picker and have suffered tremendously from this. I used to be much worse but have managed to mostly stop by employing many different means and the support of my husband. BUT I have scarred my skin and have self esteem issues because of this. Please consider medication for this for your son, it literally saved my life when I finally got some in my adulthood. I no longer need medication because I have found ways to control and manage my anxiety which kicks in my OCD, but it sounds like your son is pretty severe and probably in alot of psychological pain inside. He may seem pretty happy and have many friends and be a high acheiver, (I was) but he needs your help with this. Don't wait for it to go away, it won't, as you said he does it unconsciously. Anon

6-year-old biting off skin on fingertips

April 2007

My 1st grade son has developed the habit of biting and tearing off the skin on his finger tips and around he nail. So far he hasn't drawn any blood and doesn't bite his nails but rips the skin enough to leave pink ''craters'' on most of his fingertips (starting to look like he stuck his fingers in a meat grinder) When asked why he does it he insists it's ''because it tastes good''- he also eats the skin he peels(tasty, I know) This almost always occurs at school so I'm sure it's related to his stress and anxiety. However, he sometimes does it while relaxing if there's a particuarly good piece to chew at. He has never been very happy at school in general so I'm sure that's really what is at the root of this problem. He likes his teacher and in most areas he is doing ok academically, but he has just never liked school. He is strong-willed and I think he just doesn't like the idea of being told how and when to do work. Otherwise he is healthy,happy and hasn't experienced any changes at home. I'm wondering if anyone has any ideas on how to redirect this nervous energy and possibly satisfy his urge to figet and chew as it seems to be getting worse. Or is this a problem that needs to be dealt with on a larger scale? So far we've tried rewarding him for not chewing but it seems to be so automatic at school that he doesn't realize he's doing it. Concerned mother of a finger mangeler

I was your kid. I am 39 now, and only in my 30s did I finally quit biting the skin around my nails. I work in psychology, so I'm highly biased, but it's my opinion that although it seemed simple to my mother and Grandmother (just quit!), it was actually very complex and they couldn't have helped me no matter how hard they tried. It was just bigger than them - a professional would have done wonders, I am certain. They tried painting nasty-tasting stuff on my nails (Bitex?), but I was so determined that I just got used to the taste. They bought me manicure things, promised rewards, sobbed at me and begged me to stop, etc etc etc. Nothing worked. Like your son, it became automatic - I was biting when I wasn't aware of it. It progressed to chewing the inside of my lip, biting my tongue -- TMI? Anyhow, I am MOST certain you are doing all the right things, and your kid knows that you are being a good Mom. And it is fixable!! It just may take some help from someone who knows how to fix this, so that'd be my suggestion. In particular, cognitive behavioral therapy is what worked for me. Now, I feel happy , successful, and still anxious but I don't bite my fingers because of it anymore. Good luck to you and your son as you work thru this - Finally Nice Nails Nellie

I am a skin picker, and started when I was about your son's age. I did it a lot at school, more so than at home. Oddly, I had a great time at school--I loved it, and became a teacher!--so I would be hesitant to blame it on that. (If I had to point to the place of stress in my life at that time, it would have been home rather than school.) However, stress and a need to fidget seems to be a big factor. One can get that energy out more easily at home than at school (where one needs to sit still for long periods, often doing nothing with one's hands).

I wish I had a magic trick to make it stop, but the truth is I still do it when I am stressed, and sometimes when I am not stressed particularly but ''trapped''--in a meeting, in traffic, etc. Getting my fingers to heal entirely and keeping lotion on my hands seems to help me from starting up in the first place. Playing with rubber bands seems to help, too.

I did learn as an adult that my brother does the same thing--all through our childhoods and adult lives and we never knew until our spouses were complaining about our odd habits to each other! A trick my brother uses is to shred a Pinky eraser while he works--it harmlessly occupies his hands in the same sort of way. You may have to talk to teachers about approving rubber bands or eraser-shredding, but I'm sure they would understand. My neice asks her teachers to allow her to draw in class. They do, and she gets great grades. If they didn't, she would probably be a picker, too! Good Luck

Your son sounds like me when I was 6 years old. I had a whole range of ticks over the years--finger biting, eye blinking, grunting and my parents dealt with it by disciplining me and offering me rewards. This approach was totally useless and made me even more unhappy. I excelled academically and got along great with the teachers. The problem was that I didn't know how to make friends. So I focused on my strengths--school and relationships with adults which only further increased my isolation from the other children. Doing well academically is absolutely not an indicator that your child is doing well with anything except academics. It took years of therapy for me to forgive my parents for not being more curious about the signs of distress I was throwing out throughout my lonely childhood and instead just trying to stop the behavior. Please seek some kind of outside help for your child if you, like my parents, don't have a sense of how to help. I needed some sort of class or a book on how to handle teasing without telling on the other children and also some help in understanding that I was worthy of having loyal, kind friends. anonymous

How to stop skin peeling?

May 2006

Does anyone have any experience with overcoming a very strong subconscious habit of chewing the top layer of skin off of either the inside of your mouth or finger tips?

I know it sounds so gross. I hate that I do it and have tried to stop. I tried hypnosis with no success. Chewing on gum or toothpicks doesn't help.

Somehow I get a sense of relief from peeling the skin. When I here cutters describe why they cut themselves, it sounds similar, but I don't think my problem is as severe.

Does anyone know which kind or doctor to see to cure this terrible habit?
Peeler who wants to stop

Check out the website for TLC (Trichotillomania Learning Center.) anonymous

I've had this same habit since I was a preteen. It varies in degree, but I'm not sure why. It seems to be a lot worse if I'm under a lot of stress or overtired, or in the winter when the skin on my hands is really dry. I've tried taking a vitamin supplement with some degree of success. It's 5HTP, and is readily available at natural food stores/co-ops. I've read that the chewing, ripping compusion has been linked with low seratonin levels (book called Beyond Prozac). I'd also appreciate hearing about anything you find out about this! Elaine

Hi, I've done both of these things for years, plus all sorts of other obsessive-y nail biting, picking behaviors. What works really well for me is to wear a rubber band on my wrist and snap it medium hard every time I catch myself doing the thing I want to quit doing (You're not trying to get welts, just inflict a small amount of pain). Part of the problem with these behaviors is that they are often not totally conscious.

Once you start snapping that rubber band you become much more aware of what you are doing and your body develops a negative sense memory associated with the habit. For me, it reduces the target behavior by about 95% within two or three days. It's really just good old basic behavioral training. I used this method in my early twenties for several weeks and it rid me of a serious nail-biting habit I'd had since I was a toddler. I haven't used it as much for other stuff because the other things don't bother me as much. However, I recently used it successfully when I realized I was picking at the skin around my nails way too much.

Hope this helps, Another Picker

I did exactly the same thing from age of seven until I was 30. I know how difficult it is to stop. I found that will power just didn't do the trick. I realized that I had to somehow get to the underlying need or needs I was meeting by doing it and meet those needs in some other way. With the help of my therapist in combination with techniques described in any book written by Laurel Mellin, I was able to stop in about three months. I totally lost interest in biting my nails, picking my cuticles or chewing the inside of my lip. And I didn't miss it at all except under times of absolutely extreme stress. Like now, when I have a three week old baby. Good luck to you! reformed cuticle picker

3-year-old is repeatedly picking at scab

June 2003

My 3 1/2 old started with a tiny scratch on the bridge of her nose about two months ago, and has picked at it so much that it is now an open sore 1/4'' in diameter. As soon as a scab forms, she picks it until it bleeds. We have tried everything we can think of to deter her, but nothing has worked so far: Explaining that she makes it worse, that it could become infected; keeping a bandaid on it (she removes it when we're not looking & picks); rewarding her for NOT picking a whole day; disapproval & punishments when she does... These have worked short-term but she always goes back to picking it again. Help!

Have you tried liquid band-aid? Our baby had a little cut on her finger the other day and kept pulling off the regular band-aids and scratching her finger etc..... The liquid band-aid made a big difference. I put it on while she was asleep. Good luck. Hope this works for you. Priscilla

oh my, i hear you! we had the SAME thing with my 3 year old. this too was a scab on her face that she just picked and picked, until it became infected. we did try everyting, and what finally worked was we made a chart for her and that if she did not pick it for 4 days we would go for ice cream (big treat!). but i think what really helped (and don't ask me how i started this) but everytime she went to pick it, i would say in a loud but very silly voice ''remember, no pickin' means ice cream''!! and then i would tickle her or do something silly to distract her in any other way. basicly trying to make it a game. eventually, (it took more than 4 days) it healed enough so she didn't feel it on her face (as a pain or a itch), and she seemed to forget about it. but she does still have a small, faint scar. i know how you feel. it drove me a bit batty, but we did finally get to the other end. good luck. Andrea