Skin Picking and Social Situations: Strategies for Healthy Coping

Living with skin picking disorder, clinically known as excoriation disorder, presents unique challenges, particularly in social situations. The skin lesions and damage resulting from the picking can leave you feeling vulnerable, ashamed, and not feeling as confident as you’d like to be. It can lead to those inevitable questions that you don’t want to deal with. Sometimes it just feels easier to avoid the situation altogether. Yet, you want to be engaged with your family and friends.

The good news is, you don’t have to be isolated or feel fearful. There are strategies that can help you build social comfort and boost your confidence and self-esteem.

Navigating social interactions and maintaining a positive self-image can seem daunting, but with the right strategies, it's possible to manage these challenges effectively. You can have a fulfilling social life. You can feel confident. This article offers practical advice on handling social situations, addressing self-confidence issues, while fostering a positive self-image.

Skin Picking and Self-Esteem

Not surprisingly, skin picking can impact your confidence and self-esteem. People living with skin picking often describe feelings of guilt, shame, embarrassment, and fears of being judged. These feelings can lead to a cycle of negative self-perception that impacts self-esteem, making social situations even more challenging. 

The fear of being judged can be overwhelming. After all, who wants to risk being judged when you are already hard on yourself? The result is often an avoidance of social situations, even when you desperately want to go, and you want to connect with others. 

It's important to recognize that skin picking is a disorder that you have. It is not who you are, and it does not define you. It is not a reflection of your character or your worth. Understanding this can help reduce the self-blame that often exacerbates the emotional toll it takes. Acknowledging the psychological impact of skin picking is the first step toward developing strategies to boost self-esteem and improve social interactions.

Managing Social Situations with Confidence

Inevitably, there will be social situations that you will want or need to attend. With some planning and preparation, you can navigate them with confidence. 

Planning for the Event

Plan Ahead

Before attending a social event, take time to prepare. 

• Consider how you might respond if someone asks about your skin or notices lesions. 

• Practice a few responses so that in the moment, you won’t have to struggle for words. 

  For instance, if someone asks about your skin, you might say, “I’m dealing with a medical condition that affects my skin, but I’m managing it.”

Choose Familiar Settings

Start with smaller, more familiar social settings where you feel comfortable. Gradually work your way up to larger, more public situations as your confidence grows. Expect that you may feel uncomfortable at first. That’s OK. 

It’s important to know that for some people, social situations can be triggering. Have a plan for dealing with uncomfortable feelings or situations. One option might be to enlist the support of a buddy. Have a “signal” that you can use if the situation is overwhelming, or you’ve reached your limit. 

As you learn to navigate social situations, your confidence will increase. 

Responding to Questions and Comments

This is the part that is hard. You can’t always know what someone will say but there are ways to navigate the situation. 

Keep It Simple

If someone asks about your skin, a brief, honest explanation is sufficient. You don’t owe anyone a detailed account of your struggles. A simple statement like, “It’s a skin condition I’m managing,” can be enough to satisfy curiosity without delving into details.

Shift the Focus

If you’re uncomfortable discussing your skin, gently steer the conversation away from the topic. You might redirect the conversation to a topic you’re more comfortable with or ask the other person a question about themselves. “Tell me about your new puppy!” 

Build a Support Network

A support system can make navigating social situations easier. It’s like having a whole cheering section and can give you that boost of confidence you need. 

Seek Understanding Friends

Surround yourself with friends and family who are supportive and understanding. They can offer encouragement and help you feel more at ease in social situations. Seeing a friendly face can help calm those fears. 

Join Support Groups

Consider joining a support group, either in person or online, where you can connect with others who understand what you’re going through. Sharing experiences and strategies with others who deal with skin picking can provide comfort and reduce feelings of isolation. And it’s good practice for socializing with others. 

Boost Your Self-Esteem 

Boosting your self-esteem can give you the confidence you need to handle whatever comes your way.

Be Your Own Cheerleader!

Focus on your strengths and achievements. Regularly remind yourself of what you’re good at, whether it’s a skill, talent, or personal quality. Keeping a journal where you note daily accomplishments, no matter how small, can help reinforce a positive self-image too!

Practice Positive Affirmations

Practicing positive affirmations like “I am worthy and valuable” or “I am strong and capable” can help counteract negative thoughts and boost your self-esteem.

Practice Self-Care

Do things that make you feel good. Make time for activities that bring you joy and relaxation. Taking care of your overall well-being can improve your self-esteem and help you feel more confident.

Grooming and Personal Style

Adopt a skin care regime. Many people find caring for their skin helpful. Focusing on other aspects of your appearance, like clothing or makeup, can also help boost your self-image too.

Seek Professional Help

Therapy can help you develop coping strategies, improve your self-esteem, and address any underlying emotional issues related to skin picking. Cognitive Behavioral Therapy (CBT), particularly Habit Reversal Training (HRT), can be effective for skin picking. Additionally, CBT can help challenge negative thought patterns that contribute to low self-esteem.

Cultivate Resilience and Self-Acceptance

Living with skin picking requires resilience and self-compassion. It’s important to accept that everyone has challenges. Practice self-acceptance by recognizing that your worth is not defined by your skin or appearance but by your character, actions, and the way you treat others.

Conclusion

Over time, as you implement these strategies, you’ll likely find that social situations become less daunting, and your self-esteem improves. Remember that change takes time, and setbacks are a natural part of the journey. Celebrate your successes, no matter how small, and continue to focus on building a positive self-image and a fulfilling social life.

References

1 Anderson, S., Clarke, V., & Thomas, Z. (2022). The problem with picking: Permittance, escape and shame in problematic skin picking. Psychology and Psychotherapy: Theory, Research and Practice, 96(1), 83-100. https://bpspsychub.onlinelibrary.wiley.com/doi/10.1111/papt.12427

2. Cascio, C. N., O'Donnell, M. B., Tinney, F. J., Lieberman, M. D., Taylor, S. E., Strecher, V. J., & Falk, E. B. (2016). Self-affirmation activates brain systems associated with self-related processing and reward and is reinforced by future orientation. Social cognitive and affective neuroscience, 11(4), 621–629. https://doi.org/10.1093/scan/nsv136

3. https://www.reddit.com/r/Dermatillomania/comments/v4zux7/fatigue_in_social_situations_and_picking/