Beyond skin picking, obsessions can include constant hand-washing, to the point where the skin may be rubbed raw; counting in patterns; silently praying or repeating words or phrases; or making sure records or canned goods are all in a row and facing the same way.

The obsessive-compulsive is often aware that these behaviors are illogical and wrong, but feel powerless to control them.

NOT DANGEROUS, BUT…

Skin picking is not considered a danger to the patient, but it can reach extreme stages that embrace hair-pulling, tear at scabs, and nail biting.  Unfortunately, the obsession of performing the act can become the sole focus of the patient, interfering with life, work and relationships. But because the behavior is unconscious, many do not seek treatment for their obsessive-compulsive disorder.

For those who do seek treatment, the compulsive skin picking can be controlled with a combination of anxiety-reducing medication and talk therapy that can pinpoint the reasons for the anxiety and offer solutions that steer the patient away from destructive behaviors.

Medications include the usual regimens recommended for obsessive-compulsive disorders, including antidepressants. The medications take several weeks to achieve results, which is why they are accompanied by talk therapy with hopes of finding new outlets for the patient.

Talk therapy can include habit reversal training, which teaches the skin picker to relax and get centered through breathing exercises and muscle response exercises. It will also cover self-monitoring, which trains the compulsive skin picker to keep track of his or her picking behaviors and its triggers. By writing down the compulsion, the picker can recognize and begin to stop the behaviors as they happen.

Therapy also includes stimulus control, which aims to help compulsive skin pickers identify and avoid the triggers that drive the behavior. This can include environmental situations, various moods, or life circumstances that will cause the picker to engage in the behavior. The therapy will also include what’s termed competing response, which is a technique that will provide an alternative to the destructive picking behavior. Some competing responses that are used include knitting, beading, fidget toys and other means to keep hands busy and away from the skin.

Ultimately, the therapy aims to change the behaviors that are leading to skin picking. Over time, with the proper diversions, the urge to pick will fade, and the need to use diversions will hopefully fade away.