7 Common Mistakes in Skin Picking Treatment and How to Avoid Them

Skin picking disorder, clinically known as dermatillomania or excoriation disorder, is a complex disorder that requires a multifaceted approach to treatment and proactive participation from the person living with it. While there are effective strategies to manage skin picking, treatment doesn’t always happen in a linear, orderly process. Certain factors can hinder your progress, sometimes without you realizing it’s happening.

The good news is there are things you can do to increase your chances of success. Recognizing these common mistakes and understanding how to avoid or manage them can make a significant difference in your journey toward healing.

1: Relying On Willpower

Willpower is no match for the complex neurological, psychological, and behavioral components of skin picking. Skin picking is more than just a “bad habit” and requires more than just willpower to stop.

Willpower is like a muscle. You flex it hard. It works for a little while. But it gets tired and wanes while the urge to pick remains. It’s a short term fix at best and does nothing to address the underlying causes of your picking behavior and can leave you feeling defeated. 

Try this instead:

• Accept that your skin picking is a condition that requires a structured, comprehensive approach.  
• Seek professional help from a therapist specializing in body-focused repetitive behaviors (BFRBs) like skin picking. Self-help has a place in the process but it’s likely you’ll need help addressing the complexities of skin picking.  
• Be proactive. Rely on evidence-based strategies such as Habit Reversal Training (HRT) and Cognitive Behavioral Therapy (CBT) which are proven to be effective in managing skin picking. 

2: Ignoring Emotional Triggers

We all have triggers that influence our actions, but we aren’t always aware of them. Studies have found that many people with skin picking disorder struggle with recognizing the emotional triggers that drive their behavior. 

Instead of ignoring emotional triggers, get to know them: 

• Work with your therapist to explore emotional triggers and possible strategies for coping with them. 
• Keep a journal to track picking episodes and the factors associated with those episodes. (e.g., being bored, a spat with a friend, anxiety)
• Identify patterns in your emotions and behaviors that lead to picking episodes.

3: Not Addressing Underlying Mental Health Conditions

Skin picking often co-occurs with other mental health disorders such as anxiety and depression. 

It is a common misconception that if you have a comorbid condition with your skin picking, you can’t treat both at the same time. On the contrary, comorbid conditions affect each other. Focusing solely on the skin picking without treating comorbid conditions can actually limit your progress. 

Instead of just focusing on skin picking:

• Focus on treatment that targets both skin picking and other mental health issues you may have. Choose providers with expertise in assessing and treating your skin picking and co-occurring conditions.

4: Failing to Modify Your Surroundings 

Your physical surroundings might not immediately come to mind when considering how to manage your skin picking but they can have powerful effects on mood and behavior.

A common mistake in treatment is not making changes to the environment that encourages picking behavior. When you’re in a space every day, it’s easy to overlook or not recognize those things that might trigger you. (Think tweezers, mirrors, stashed picking tools, etc.)

What you can do:

Set yourself up for success. Take a good look at your surroundings and where possible, remove or reduce exposure to things that may trigger you. And keep a few tools/strategies ready for those unexpected times. 

• Cover mirrors
• Keep some fidgets or sensory toys handy
• Keep your skin well-moisturized to help heal scabs and reduce dryness that may be triggering

5: Being Too Hard on Yourself

When you’re struggling, it’s easy to indulge in self-blame and criticism. The cycle of picking and shame can be difficult to break and progress isn’t linear. It’s important to give yourself grace. You’re doing the best you can.

Try this instead:

• Practice self-compassion. Recovery is a journey with many twists and turns. 
• Focus on progress rather than perfection. Every small victory is a sign of progress. 
• Celebrate those victories to give you a boost of motivation and confidence.

6: Expecting Immediate Results

One of the biggest challenges in treatment is expecting a quick fix. Breaking the picking cycle takes time and patience. 

What you can do: 

• Set yourself up for success. Set realistic goals.
• Track your progress 
• Remember that relapses are part of the journey and not a sign to give up.
• Use relapses as learning experiences. What can you do differently going forward? 

7: Trying to Go It Alone

Trying to manage your skin picking on your own is hard on a good day. The fear of judgement is real. It can be tempting to keep it all to yourself but that’s exhausting and can leave you feeling isolated. 

Finding support:

• Consider sharing your situation with a few trusted friends or family members. Ask for their support and let them know how they might be able to support you. 
• Consider joining online or in-person support group.
• Educate close friends or family members about your condition. Understanding is the key to building support.

Conclusion

Recovering from skin picking disorder is more than just stopping the picking. It’s also about addressing the underlying issues and finding coping strategies that work for you. When you are able to recognize and avoid common pitfalls to treatment, you are setting yourself up for success.

References

1. Baumgardt, D. (2024, February 29). Skin picking is often trivialised as a bad habit – but dermatillomania can be dangerous. The Conversation. https://theconversation.com/skin-picking-is-often-trivialised-as-a-bad-habit-but-dermatillomania-can-be-dangerous-224659

2. Skin Picking: Identifying and Working with Triggers [Video]. (2021, February). YouTube. https://www.youtube.com/watch?v=4_w_0ecc500

3. Anderson, S., & Clarke, V. (2017). Disgust, shame and the psychosocial impact of skin picking: Evidence from an online support forum. Journal of Health Psychology, 24(13), 1773-1784. doi:10.1177/1359105317700254