Helping with the psychological effects of skin problems and picking

Dear Dr. Irwin, I have been a California State Board Licensed Esthetician and graduated from the Dermal Institute. I owned my own day spa and sold it more than ten years ago. I am no 78 years old and have practically to wrinkles because of good genes and skin care practices. After menopause at 58 I started to pick on my skin, which is still ongoing. I went to a very good Dermatologist who was very understanding. I am on antidepressant, and still can't stop doing this without realizing it. I had many losses and was neglected as a child. My mother passed away when I was 4 years old. My arms, shoulders and legs are very scared. Is there anything you know that can reduce some of the scarring. I am German with sensitive skin, I had one Obagi peel in my face and do not pick on my face but my neck because of the painful bumps from rosacea. I had several IPL treatments for it. Are there any products or peels I can use myself to reduce some of the scarring. I can't believe I cannot stop and I cover it all up with long sleeves and pants. Do you have any suggestions. I am a patient at Scripps in La Jolla. My primary care doctor does not know about the picking and even eating the scab. I need help! Thank you.

I’m am so happy you reached out. I know anyone reading this feels a tremendous amount of empathy. Our hearts go out to you and you are not alone on these skin problems.

I often talk to my patients about picking behavior. And really… almost ALL of us pick something at certain times. Some of us pick a spot on our scalp, or our cuticles, or hangnails, or spots on our skin, or pull on hair, and even more. Think of this as a scale or continuum with very mild on one end and much more severe on the other.

You are clearly on the more severe end and are really suffering. Please, please, please go and talk to your primary care doctor, show her/him and ask for a referral to a good psychologist or psychiatrist to help you. Often depression is part of the problem, but there are often other issues as well. Sometimes this is a variant of obsessive-compulsive disorder (OCD), and some believe that they have small mites in the skin, etc. Help is out there for you!

In the past, we have sent patients to work with biofeedback therapy to increases awareness of the picking. Meditation, which can increase awareness, may be another good option. Pema Chodran in Getting Un Stuck may be a good resource.

When you have conquered and controlled the picking behavior, please write back to me, and I’ll be happy to give you some ideas for the scarring and skin changes you are seeing.

Hope this helps,
Dr. Brandith Irwin
Founder, SkinTour
Director, Madison Skin & Laser Center
Follow my skin tips and travels on Instagram!
Dr. Brandith Irwin, MD

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Hi, I’m Dr. Irwin. I believe that consumers deserve a medically trained and unbiased skin care advocate.

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