Body Image and Skin Picking: Understanding the Connection

Skin picking disorder and body image concerns often go hand in hand, and it’s not just about the skin. Unlike dermatological conditions that can also cause skin damage, skin picking goes far beyond the skin. It is a complex combination of behavioral, emotional and psychological factors that can create intense distress. In fact, when compared to people with dermatological conditions, people with skin picking tend to experience higher rates of depression and heightened concerns about their appearance and fears of rejection. Understanding the link between body image and skin picking can be a crucial step in breaking free from the cycle and cultivating self-compassion and healing.

The Role of Self-Perception 

Self-perception - the way we see ourselves - can significantly influence behaviors like skin picking. For many people with skin picking, it begins as a response to a perceived imperfection – a blemish or patch of rough skin – that must be eliminated. People with poor body image may already feel dissatisfied with their appearance, making them more likely to focus on small imperfections. Over time, this hyper-focus and urge to “fix” can lead to increased picking, which ironically worsens the skin’s condition and fuels further distress. The skin picking becomes a coping mechanism that may temporarily relieve the distress, but the resulting shame and guilt sets up a cycle that becomes self-reinforcing and difficult to break. 

You might think that skin picking sounds an awful lot like body dysmorphic disorder, and in fact, they are connected. Both skin picking disorder and body dysmorphic disorder (BDD) are classified as obsessive compulsive and related disorders (OCRDs) and share similar qualities. They can even co-occur, but they are distinct disorders. The most salient difference is that BDD is more about perceived body image and perceived imperfections (whether or not they actually exist). Skin picking is focused solely on the skin and perceived imperfections, often originating with an actual blemish of some sort. 

Perfectionism 

Perfectionism is a trait closely associated with skin picking and body image. Those who struggle with perfectionism often feel an intense need for their appearance to meet high or unrealistic standards, fueling the need to “fix”. Worries about appearance and the need for perfection can be exacerbated by social standards of beauty which are not always healthy or realistic. 

Appearance-Related Concerns and Social Anxiety

Concerns about appearance can extend beyond just personal dissatisfaction. Social standards of beauty can exert powerful influence on how one perceives their appearance. Social anxiety and worries about judgement and criticism of one’s appearance can increase emotional distress and feelings of self-consciousness, leading to more picking as well as social isolation and avoidance.  

People living with skin picking describe sometimes going to great lengths to cover the damage or avoid certain social interactions altogether. This avoidance can further deepen feelings of isolation and reinforce the belief that their skin is unacceptable.

Building a Healthier Body Image

Addressing body image concerns is an essential part of recovery. Here are some strategies for building a healthier relationship with your body:

Practice Body Acceptance

Practicing body acceptance or body neutrality is about seeing your body in a neutral way as opposed to “positive” or “negative”. For example, accept that your body’s appearance doesn’t define who you are. And you can focus on what your body does for you. It is strong. It allows you to run or to play with your kids. Look for ways to shift away from appearance-based standards and embrace things that help you appreciate what your body can do. 

Challenge Negative Self-Talk

Pay attention to the way you talk to yourself about your appearance. If you catch yourself thinking negative or self-critical thoughts, challenge them with more compassionate and realistic ones. Remind yourself that nobody’s skin is perfect and that your worth is not defined by your appearance.

Practice Self-Compassion

Self-compassion involves treating yourself with kindness, especially when you’re struggling. Instead of berating yourself for picking, acknowledge your feelings and offer yourself the same grace and compassion you’d offer a friend. 

Set Small Goals

It might feel good to set big, lofty goals but the reality is, it’s usually a recipe for failure. 

Instead, set yourself up for success! Set small, manageable goals. For example, aim to reduce picking in specific situations or replace picking with a healthier habit, such as squeezing a stress ball or using a fidget. Small achievements add up to big wins!

Progress Not Perfection

Accepting that imperfections are a natural part of being human and that perfection is an illusion can be a game-changer. When you find yourself struggling with the idea that your skin must be flawless, remind yourself that healing takes time and includes a lot of ups and downs. It’s part of the process. Rather than focusing on controlling your appearance, try prioritizing things that support your overall well-being.

Seek Professional Support

Trying to manage skin picking on your own is challenging. If you find that your skin picking is significantly impacting your life, there is help. Therapy can help you work though issues and find healthy ways to manage your skin picking. 

Breaking free from the cycle of skin picking and negative body image is not easy, but it is possible. Remember that your appearance doesn’t define you, and that you deserve compassion and support. Healing is possible and you don’t have to do it alone. 

References

1. Schmidt, J., Gallinat, C., & Martin, A. (2023). Appearance-related concerns in individuals with pathological skin picking—a comparison with individuals with dermatological conditions and skin-healthy controls. Frontiers in Medicine, 10. https://www.frontiersin.org/articles/10.3389/fmed.2023.1075743/full

2. Anderson, S. (2021). The Problem with Picking: Permittance, Escape and Shame in Problematic Skin Picking (Doctoral dissertation, University of the West of England). (2021). Retrieved from https://uwe-repository.worktribe.com/preview/8675330/The%20Problem%20with%20Picking%20-%20Full%20thesis_%20with%20Appendix%206%20redacted.pdf 

3. Pinto, A., Dargani, N., Wheaton, M. G., Cervoni, C., Rees, C. S., & Egan, S. J. (2017). Perfectionism in obsessive-compulsive disorder and related disorders: What should treating clinicians know? Journal of Obsessive-Compulsive and Related Disorders, 12, 102-108. https://www.sciencedirect.com/science/article/abs/pii/S2211364916300574

4. Beneath the Surface: Exploring Body Image and Skin Picking [Video]. (2024, November 27). YouTube. https://www.youtube.com/watch?v=ZuRACYp4AB0