Supporting Your Teen with Skin Picking Disorder: Practical Tips and Strategies

No matter how grown up they seem, your teen is still maturing, and you want to protect and nurture them as they make their way to adulthood. That path isn’t always easy. And, for a teen dealing with skin picking, clinically known as excoriation disorder, the task of parenting them can be especially challenging.  

The visible skin damage due to the repetitive picking can result in significant emotional distress and difficulties with psychosocial functioning. Shame and embarrassment are frequently expressed by those living with skin picking. Avoiding social situations where they may feel judged becomes a way of coping with the distress. 

The teen years are already fraught with emotional ups and downs. Dealing with a disorder like skin picking, and the impacts it can have both personally and socially, can be a lot for your teen to handle. And they might not know how to talk to you about it. 

To help you support your teen, we’ve compiled a comprehensive guide of practical strategies and tips that you can use to connect with your teen. You’ll find ways to support them, foster communication, and ways to help them navigate a sometimes difficult path. 

Understand Skin Picking Disorder

The first step in supporting your teen is understanding the disorder they’re dealing with.  Despite appearing to be a dermatological condition, skin picking is, in fact, a mental health disorder classified as an obsessive-compulsive related disorder (OCRD). It is not OCD, but it does share similar qualities. Skin picking tends to begin in late childhood or early adolescence. While we don’t know what causes skin picking, it is thought to be triggered by stress, anxiety, or other emotional disturbances, even boredom. In fact, it is not uncommon for skin picking to co-occur with other mental health disorders such as anxiety and mood disorders. The act of picking is not self-harm but is thought to be a way to cope with negative emotions. 

If your child is struggling with skin picking, it’s important that you keep the lines of communication open with your teen so that you can support them and make treatment and coping decisions together. 

What Do I Say to My Teen?

Finding the right words doesn’t always come easy. The TLC Foundation for Body-focused Repetitive Behaviors (BFRBs) offers these tips for things you can say that show support:

What to Say

• I love you
• You are beautiful
• You are important
• You are worthy
• Your skin picking does not define you
• I am here for you
• You can talk to me and let me know what you need

What Not to Say

• Stop pulling, picking, biting
• You look like you've been pulling, picking, biting a lot
• Cover that spot
• Do not tell other people about your child's skin picking without their permission
• Do not scold, shame, or punish your child for picking. It is not something they can control on their own and it is not their fault. ‍Or yours.

Tips for Keeping The Lines Of Communication Open

Communication is an important part of the process. You and your teen will need to make decisions together. 

Here are some tips to foster open communication:

Practice Active Listening

When your teen talks, listen. Show genuine interest in what they’re saying. Avoid interrupting or offering solutions immediately. Sometimes, they just need to talk and know, “I hear you.”

It’s also important to avoid the dreaded “just stop”, scare or shame them, or use language that they will internalize. They really cannot just stop. 

Express Empathy

Acknowledge their feelings without judgment. Statements like, “I see this is really hard for you,” validate what they’re feeling and encourage them to open up more.

Be Patient

Your teen may be struggling and not quite ready to talk. They may share in tiny bits. That’s ok. Give them time and let them know you are ready to listen when they are ready to share. 

Focus on Solutions

Instead of focusing on the problem, focus on finding solutions. Learn about the disorder together and find ways to address it together. Encouraging your teen to participate in the process helps them gain a sense of empowerment and confidence. 

Practical Strategies to Support Your Teen

Support is more than just finding treatment. Supporting your teen involves a combination of emotional support and practical strategies. Here are some effective approaches to try:

Seek Professional Help

Seek out a mental health professional who specializes in skin picking disorder. Habit Reversal Training (HRT), a specialized type Cognitive-behavioral therapy (CBT), is often effective in treating skin picking by helping individuals understand and change their behaviors.

Develop Coping Mechanisms

Help your teen identify their triggers to picking and develop healthier coping mechanisms. This could include stress-relief techniques such as deep breathing, practicing mindfulness, journaling, using fidgets, or engaging in physical activities. Encourage and praise the use of their strategies. 

Create a Supportive Environment

Make home a safe space where your teen feels comfortable and supported. Encourage activities that boost their self-esteem and distract from skin picking, such as hobbies or activities that they enjoy and can feel successful with.

Promote Self-Care

Encourage your teen to take care of their overall well-being. This includes maintaining a healthy diet, getting regular exercise, and ensuring adequate sleep. A healthy body can positively impact mental health. Self-care is important for you too. Helping your teen through this process can be emotionally taxing. Taking time to refill your cup will help you fill theirs. 

Conclusion

Supporting your teen in this journey requires understanding, patience, and a proactive approach. The journey may be long but by fostering open communication and implementing practical strategies, you can help them manage their skin picking and work towards recovery. 

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. For parents – TLC Foundation for BFRBs. (2024, March 27). Retrieved from https://www.bfrb.org/faq-categories/for-parents

3. FAQs for parents of skin pickers. (2024, January 31). Retrieved from https://www.skinpickingsupport.com/resources/faqs-for-parents/

4. News. (2023, February 28). Hair pulling and skin picking: How to help your child stop repetitive behaviors. Retrieved from https://health.ucdavis.edu/news/headlines/hair-pulling-and-skin-picking-how-to-help-your-child-stop-repetitive-behaviors/2023/02