Skin-picking is something that many people do at one time or another, sometimes without much thought. Maybe it happens during a stressful meeting, while watching TV, or when you’re feeling bored or overwhelmed. For some, it’s an occasional habit. For others, it can feel automatic. These behaviors can come with shame, confusion, or the quiet worry of, “Why do I do this?“

In recognition of Self-Harm Awareness Month this March, this blog provides general, educational information about skin-picking behaviors. The goal is to support understanding and offer educational resources for individuals who may be noticing this behavior in themselves or in someone they care about.

What is skin-picking?

Skin-picking refers to repeatedly touching, scratching, or picking at the skin. For some people, this can lead to irritation or injury. It may happen on purpose, which is referred to as “focused skin-picking.” However, it can also happen automatically, sometimes during moments of stress, anxiety, or boredom. While many people occasionally pick at blemishes or dry patches, it can become a mental health concern when it feels hard to control or begins to interfere with daily life or mental health.

You may see skin-picking described online by clinical terms such as dermatillomania, skin-picking disorder, or excoriation disorder. Excoriation disorder is a mental illness that is related to obsessive-compulsive and related disorders.

Skin-picking is also commonly grouped under body-focused repetitive behaviors (BFRBs). BPFRBs are a category that includes trichotillomania (hair-pulling disorder) and excoriation (skin-picking disorder). Understanding this context can help people feel more informed and more comfortable discussing their experiences.

Why do people pick their skin?

There isn’t one single reason people engage in skin-picking behaviors. Research suggests that people may use it as a way to manage negative emotions, such as tension, stress, or anxiety. In this way, it can function as a coping strategy people use when emotions feel too hard to manage.

Examples of common causes include:

  • Stress or anxiety
  • Boredom or understimulation
  • Feeling overwhelmed or overstimulated
  • Perfectionism or a strong urge to “fix” perceived flaws
  • Fatigue or difficulty concentrating

In addition, research has found that there is a link between dopamine and skin-picking behaviors. This dopamine release can make it more challenging to resist.

What can skin-picking look like?

Skin-picking can take many forms. Some behaviors are more subtle or easier to hide, while others may leave visible marks or cause physical discomfort.

Examples include:

  • Picking around the nails
  • Cuticle picking
  • Lip picking
  • Chewing the inside of the lips
  • Scalp picking
  • Picking at acne, dry patches, or perceived imperfections
  • Pulling eyelashes or eyebrows
  • Nail biting

These behaviors can show up during specific emotional states or become part of daily routines, such as during commutes or while scrolling on a phone. Over time, some people notice physical effects like soreness, infections, or scarring. These effects can add another layer of emotional distress, including embarrassment or avoidance of social situations.

Is skin-picking a form of self-harm?

Skin-picking is not generally categorized as a form of self-harm. It is often viewed this way because self-harm is often a conscious decision aimed at achieving emotional release or distraction. In contrast, skin-picking can be a behavior that many may not fully realize they’re doing. However, trichotillomania and excoriation disorder can be described as forms of self-injury.

Conversations about skin-picking and hair-pulling can benefit from nuance: acknowledging differences from self-harm while still taking the behavior seriously and responding with care and compassion.

ADHD and skin-picking

Studies suggest that people with ADHD may be more likely to experience skin-picking. This can be due to challenges related to impulse control, restlessness, emotional regulation, and sensory processing.

This connection does not mean that everyone with ADHD will pick their skin or that these behaviors indicate ADHD. However, understanding that these experiences may be linked can help reduce self-blame and support more compassionate conversations about needs, sensory regulation, and coping strategies.

Tips on how to stop skin-picking

Some people may look for ways to reduce skin-picking behaviors when they start to feel distressing. While there is no one-size-fits-all solution, coping mechanisms can help. Some common examples of coping strategies include:

  • Fidget tools or textured objects: These include fidget spinners, fidget rings, stress balls, or textured fabrics. Items like these can give the hands something to do, which can be helpful during moments of boredom or stress.
  • Keeping hands busy: Consider activities or hobbies like knitting, crocheting, or drawing.
  • Reducing visual triggers: Consider limiting time spent in front of mirrors, which can increase urges to “fix” perceived imperfections.
  • Covering or protecting areas: For example, consider using bandages, gloves, or finger wraps. These may help interrupt automatic picking and increase awareness of the behavior.
  • Nail-biting deterrents: These may help make nail biting less automatic.
  • Building in sensory breaks: Consider activities like stretching, walking, or grounding exercises to help regulate the nervous system.

These coping strategies are not treatments, and what helps one person may not help another. Some people may find it helpful to approach coping with curiosity. This can involve noticing which supports feel calming or regulating in different situations.

Therapy for skin-picking

Therapy can offer structured support for people who want to better understand or reduce skin-picking behaviors. Different therapeutic approaches may be used depending on a person’s needs, goals, and experiences.

Some common approaches that can help include:

  • Cognitive Behavioral Therapy (CBT): CBT can help people identify patterns, thoughts, and emotional triggers connected to skin-picking, while exploring alternative responses to stress or boredom.
  • Habit Reversal Training (HRT): Often discussed in relation to body-focused repetitive behaviors, HRT for excoriation disorder focuses on increasing awareness of behaviors and practicing responses that make picking harder to continue.
  • Trauma-informed therapy: For some, body-focused repetitive behaviors may be connected to past trauma or stress.

Rather than focusing only on stopping the behavior, therapy can explore what the behavior is doing for the person. This can include managing anxiety, providing sensory relief, or offering a sense of control. Some people find that addressing these underlying needs can help reduce shame and build healthier coping skills over time.

Takeaway

Skin-picking is more common than many people may realize. It can reflect underlying emotional or sensory needs. Learning more about why it happens can help reduce shame and support more compassionate self-reflection. Thoughtful conversations about behaviors that fall along a mental health spectrum can help create understanding.

If skin-picking has been weighing on you, you don’t have to navigate it alone. Learning, talking openly, and exploring local mental health support options can be meaningful steps forward. When you’re ready, you can explore therapists near you at findmytherapist.com to find support that aligns with your needs and goals.