Tactile Sensations and Skin Picking: Strategies for Managing the Urge To Pick

Skin picking, clinically known as excoriation disorder, is a mental health disorder characterized by repetitive picking at one’s skin resulting in visible skin damage, emotional distress, and impaired functioning. Picking episodes can be triggered by a variety of factors, including stress or boredom. The sense of touch is also thought to play a key role in skin picking. 

While skin picking disorder is not a sensory processing disorder, many people with the disorder report a heightened sensitivity to physical sensations on their skin, sometimes due to some imperfection on the skin. Urges to pick may also stem from a need for tactile stimulation, or even as a means for self-soothing especially when stressed or bored. Some research suggests that skin picking may be related to what’s known as affective or “soft touch” and how the body interprets that touch. 

Understanding how tactile sensations influence the urge to pick can help you find strategies that can help manage those sensations and how they affect your skin picking. 

The Role of Tactile Sensations in Skin Picking

For many people with skin picking, the act of picking is not merely repetitive or habitual but deeply sensory. The texture of the skin, the sensation of picking, and the tactile feedback you get from touching, rubbing, or even squeezing the skin can all be intensely satisfying. For example, you may be drawn the texture of certain areas of your skin, or you may be drawn more to the sensation from your picking style (e.g., peeling a scab, using tweezers, etc.)

These tactile sensations can create a cycle of compulsion and relief. The act of picking may provide a brief, pleasurable sensory reward, reinforcing the behavior over time. Identifying and addressing these sensory triggers is a crucial step in managing skin picking.

Tactile sensations can influence skin picking in many ways:

• Some people experience an intense craving for tactile input. Picking may be a way of fulfilling this need, eliciting a feeling of satisfaction or relief. 
• Tactile sensations may be related to one’s emotional state. For example, when stress is high, sensitivity to touch may be heightened adding to the urge to pick. Picking may serve as a self-soothing response. 
• The presence of skin irregularities like blemishes or textures such as a rough patch of skin can create a sense of distress or discomfort. The brain may interpret this discomfort as something needing to be “fixed” by picking, setting up a cycle of repetitive behavior. 

Given the relationship between tactile sensations and skin picking, finding strategies that incorporate alternative textures and tools that provide similar sensory stimulation can help manage the urge to pick. 

Tips and Tools to Manage Tactile Sensations

Fidget Toys 

Tools like fidget toys and stress balls, especially textured ones, such as silicone pop-its, spiky rings, rocks with interesting textures, or textured stress balls, can satisfy the sensory craving for tactile input. These types of tools offer repetitive motions and textures that can redirect the urge to pick. Keeping a small fidget toy nearby can offer an easy and discreet way to occupy the hands.

Textured Items

Items with appealing textures like scarves, gloves, or even fabric (think Velcro) can help too. Feeling these textures when you get the urge to pick can be a satisfying way to avoid a picking episode.

Sensory Integration Tools

Occupational therapists often recommend using sensory integration tools like therapy putty, weighted blankets or sensory mats. These tools provide a gentle pressure that many people find soothing and may reduce the urge to pick. Therapy putty has a can be  kneaded, picked, or squeezed, mimicking some of the repetitive motions associated with skin picking. 

Skin Care 

Practicing good skin care can help to keep your skin healthy and minimize areas of blemishes or rough patches that can cause discomfort leading to the urge to pick. 

Practice Mindfulness

Engaging in mindfulness practices can help you to become more aware of your unique tactile experiences and how they may influence your picking. Meditation and deep breathing can help you be aware of sensations in the moment. Journaling can also help build awareness and give you a way to process experiences. As your awareness increases, so does your opportunity to choose healthy alternatives.

Build a Tactile Toolkit

Urges to pick can happen anytime, anywhere. Being prepared with a “tactile toolkit” can help you manage sensory needs when they arise with personalized strategies at the ready. Your kit might include a variety of fidgets, fabrics, putty, picking rocks or other tactile items. Try a few different tools and choose the ones that work best for you. 

The Takeaway

Tactile sensations are a key factor in skin picking urges. They can also be a pathway to healthier coping strategies. By incorporating tools that help meet those sensory needs, you may be able to reduce the frequency and intensity of picking episodes. With a little patience, self-compassion, and a well-equipped tactile toolkit, you are prepared for managing these urges proactively and confidently. 

References

1. Schienle, A., Übel, S., & Wabnegger, A. (2018). Neuronal responses to the scratching and caressing of one's own skin in patients with skin-picking disorder. Human brain mapping, 39(3), 1263–1269.  https://pubmed.ncbi.nlm.nih.gov/29218753/

2. https://www.reddit.com/r/ADHD/comments/x4as05/advice_on_sensory_issues_and_skin_picking/?rdt=42986