By Philip Tajanko

FEB 20, 2023

We’ve all done it - picked at our skin even though our sensible side knows there won’t be a good outcome. It could be in response to the scab or skin that has healed over a recently popped pimple or injury, or it could be a nervous tic when daily stressors become overwhelming.

Whatever the reason, picking your skin has a tendency to initiate a vicious cycle, as the skin often becomes further wounded which can cause additional stress, resulting in an increasing urge to pick at your skin even more. Despite the temptation, it's important to overcome this habit in order to maintain a healthy skin barrier.

Throughout this blog, you will learn about the fundamentals of picked skin, the potential harm associated with it, and how best to recover from it. Freshly picked skin will typically look irritated, with displays of redness, scabbing, dry skin or bleeding. Skin is most often picked on the face, scalp, and extremities, as these areas are usually exposed and easily accessible by our hands. Picked skin that has recovered from the initial injury can become scarred, which can be identified by raised or discolored patches.

This discoloration is a result of melanin production increasing as part of the natural healing process. For skin that has been picked over time, the skin may appear uneven and rough from a cycle of scarring and reinjury. The longer the habit of skin picking continues, the likelihood of permanent damage being sustained increases, which could lead to a compromised skin barrier¹. What happens to your skin if you pick your face too much? The most notable of these is the risk of long-term discoloration and an uneven surface. As the surface has been constantly injured and scarred over, the collagen used to build the skin is arranged parallel to the plane of the skin rather than in a cross-weave as in normal skin². This results in the telltale appearance of a scar and its permanence, as even if new collagen is sent to the area, it remains structured in the parallel manner. As more injury is incurred and the skin must heal already scarred tissue, it becomes less able to smooth out the gaps created by picking, resulting in pits and bumps across the area and skin damage which may become permanent.

This may also lead to emotional distress and lower self-esteem, causing additional stress and anxiety that can fuel the compulsion to pick skin or any acne present.³ If the habit seems too difficult to break on your own, it may be best to seek professional help for guidance, as there is likely unresolved anxiety and stress leading to the compulsion. Healing skin that has been picked requires patience and discipline. First and foremost, you must break the cycle and overcome the urge to continue picking skin as every time you pick it, the healing process must begin again. Additionally, it’s best to completely refrain from touching the wounded areas to give your skin the best opportunity to heal itself. If picking is triggered from restlessness, occupying your hands with an object or activity will help distract you and prevent you from picking. If the picking is a compulsive response to stress or anxiety, you may want to consider addressing the underlying emotional triggers with therapy or counseling.

Once you have overcome the urge to pick your skin, healing skin that has been picked is much like healing any other injury. You’ll want to keep the skin hydrated and well-supplied with nutrients through a protein-rich healthy diet. To optimize the healing process, you’ll want to be in the know of which foods to avoid during wound healing.

Using a simple, gentle, and fragrance-free peptide moisturizer can also help to keep the skin hydrated and prevent irritation or itching that may otherwise prompt a picking response⁴. As well, topical products containing salicylic acid or benzoyl peroxide have been shown to reduce inflammation and the chance of infection⁵.

This may be surprising since benzoyl peroxide and salicylic acids tend to be drying ingredients but in particular, salicylic acid has been shown to suppress the production of prostaglandins, a class of proinflammatory mediators ⁶. In the case of benzoyl peroxide, it aids with the release of reactive oxygen species⁷. Applying a spot treatment of these products sparingly can help give the skin the greatest opportunity for a speedy and healthy recovery.

The length of time it takes to heal picked skin can vary greatly. Depending on several factors including the severity of the picking, how long the picking has been going on, and how well the skin is cared for during the process can quicken or slow wound healing. In general, while small wounds caused by picking can heal within a week, larger and more severe wounds may take months to fully heal. Beyond that, even if the wound is healed there may be scars that remain, and these scars can take longer to disappear⁸. It's important to be patient throughout the stages of wound healing, as it can take time, and it's not always possible to completely restore the skin that has been picked back to its original state. Stopping the urge to pick is largely a mental battle. As such, many of the most effective methods for limiting skin picking are based on finding effective solutions to distract your brain from the compulsion. Despite this, it can still be beneficial to have a physical approach to preventing the picking behavior, especially since many compulsive face pickers don’t even notice when they’re doing it. What works for one person may not work for another, so it's important to experiment with different methods and find what works best for you. Some places to start are: Being aware of when and why you pick your skin can aid in discovering what emotions or events trigger you to pick at your skin. It can be helpful to keep a journal and track what prompted you to have the urge to pick your skin, noting what you were doing, when it occurred, and what you were feeling at the time. If a common reason for picking is restlessness, keeping your hands busy with other activities or objects can help to reduce the urge to pick. Examples of this include stress balls and journaling. Stress and anxiety are some of the most common reasons for compulsive skin picking. Engaging in relaxation techniques such as yoga or meditation can help reduce feelings of stress and anxiety. As an added bonus, meditation has been shown to improve longevity as well!⁹ Compulsive skin picking can be a symptom of underlying emotional or psychological issues and mental disorders, such as OCD or body dysmorphic disorder³. It can even be a form of disorder itself, called excoriation disorder or skin picking disorder. Talking to a therapist or counselor can help to address these underlying issues and develop strategies to manage them. Wearing long sleeves or long pants can help to prevent picking at the skin on your extremities by providing a barrier that can help to remind yourself not to pick your skin.

• Picked skin is prone to infection as the fingers carry bacteria into the freshly created wound.
• Picking can lead to an uneven skin texture as scarification heals the skin imperfectly.
• Stress and anxiety are the largest causes of the compulsion to pick at your skin.
• Picked skin should be well-hydrated and protected with topical skin care products during the healing process to ensure it heals without complications.
• Scars from picked skin can sometimes take years to improve in appearance.
• Be patient and dedicated in regard to the healing of your skin. Try various methods for avoiding picking your skin to find what works best for you.

 

By Philip Tajanko:
Philip is studying Bioengineering at the University of California - San Diego and is passionate about scientific writing and hormonal research.

Sources:

1. https://my.clevelandclinic.org/health/diseases/22706-dermatillomania-skin-picking
2. https://pubmed.ncbi.nlm.nih.gov/10441462/
3. https://pubmed.ncbi.nlm.nih.gov/10453800/
4. https://pubmed.ncbi.nlm.nih.gov/34526860/
5. https://pubmed.ncbi.nlm.nih.gov/6824360/
6. https://www.sciencedirect.com/topics/neuroscience/salicylic-acid
7. https://pubmed.ncbi.nlm.nih.gov/8204465/
8. https://pubmed.ncbi.nlm.nih.gov/29016538/
9. https://www.nature.com/articles/s41598-020-61241-6