How can I stop picking on my acne until it scars if I have body dysmorphic disorder?

Doctor's Answers (2)

Dr Beng Yeong Ng

"Psychiatrist with over 20 years of experience"

There is a condition called skin-picking (excoriation) disorder, the core features of which include  recurrent picking of the skin and the individual finds it hard to resist the urge to pick their skin. It is commonly classified under OCD (obsessive compulsive disorder) spectrum disorder. While any part of the body can be the target, the primary sites are arms, hands, and face.

Some of my patients report picking skin that is healthy and intact. More commonly, they report picking at irregular areas of the skin such as pimples, or scabs from previous picking, injury, or insect bites. Various tools can be used like tweezers or biting skin off, but fingernails are the norm. Some of my patients with excoriation disorder also rub or squeeze their skin.

The majority of people with this disorder are women. It occurs in less than two percent of the population. Skin-picking often begins during adolescence in response to acne or another skin condition. The individual is distressed by the symptom and is not able to stop picking his skin. He may also do it when in social situations. Very often the symptoms are severe that it affects his work or social functioning.

Many patients do go on to develop social isolation and secondary depression. Do seek treatment early. Many of such cases respond well to SSRIs (serotonin specific reuptake inhihitors) medications which will help them resist the temptation to pick their skin. Oftentimes, they also respond to psychological interventions like supportive therapy and behavioural therapy. 

Dr Chin Yee Choong

"Dedicated to the ethical practice of Aesthetic Medicine"

Hi there,

You are in a difficult position here. May I suggest you first see your doctor who will assess the severity of your acne and prescribe appropriate treatment to control the acne inflammation.

If you respond well and are able to resist further skin picking, that is perhaps all that is needed. If your acne improves but you are still unable to stop skin picking, then your primary doctor may refer you to a psychiatrist to help co-manage your body dysmorphic disorder.

It is important that you recognise that professional medical help is needed to help you recover from this difficult period of your life. Hang in there, have hope and allow your doctors to guide you slowly to full recovery.

Take care and hope you recover soon.

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