Materiały źródłowe

• #1 International OCD Foundation | Comprehensive Behavioral (ComB) Treatment for Skin Picking and Hair Pulling Disorders

  https://iocdf.org/expert-opinions/comprehensive-behavioral-comb-treatment-for-skin-picking-and-hair-pulling-disorders/

  by Charles S. Mansueto, PhD & Ruth G. Golomb, LCPC […] Picking at one’s own skin and pulling out one’s own hair are two relatively common human behaviors. Who hasn’t removed hairs, popped a pimple, scratched at scabs or bit a jagged fingernail? But it’s when these behaviors get out of control — when they cause unwanted physical damage or personal distress and can’t be stopped — that they become disorders. Skin picking (excoriation) disorder (SPD) and trichotillomania (hair pulling disorder) (HPD) are their official names. These, along with similar behavior patterns that are not formally identified as psychological disorders, such as nail, lip and interior cheek biting, are called “body-focused repetitive behaviors,” or “BFRBs” for short. They are grouped within the diagnostic category of “obsessive compulsive and related disorders.” At one time they were believed to be relatively rare, but current estimates suggest that HPD and SPD occur in 1% to 4% of the population, meaning that roughly seven to 26 million people experience a diagnosable BFRB condition in the U.S. alone.

• #1 Skin picking disorder | Tidsskrift for Den norske legeforening

  https://tidsskriftet.no/en/2021/12/clinical-review/skin-picking-disorder

  Skin picking disorder is an under-recognised mental disorder that typically starts during adolescence and leads to considerable emotional distress and/or reduced functioning in important areas of life. […] This article is based on clinical experience and research and aims to give healthcare professionals a starting point for understanding, identifying and initiating treatment measures for skin picking disorder. […] Healthcare professionals should be aware of skin picking disorder and recognise that it is a mental disorder with considerable impact on quality of life and/or functioning. Diagnosis, psychoeducation, n-acetylcysteine supplementation and trialling of internet-based treatment can be performed in the primary care sector. The most serious cases of skin picking disorder, as well as relapses, should be referred for evaluation and treatment in the specialist health service. Research is needed to find out more about the effect of psychological treatment and which patients benefit the most or should be prioritised.

• #1 A case report of an atypical severe case of skin picking disorder managed by a multidisciplinary team | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-024-05712-4

  Skin picking disorder is only a recent new entity in the psychiatric classification system of the Diagnostic and Statistical Manual of Mental Disorder (DSM) 5th edition. It is described as recurrent picking of skin leading to skin lesions, repeated attempts to decrease or stop skin picking, and it is associated with significant distress or functional impairment. […] Ultimately, only a small portion of patients seek help, noted to be due to reasons such as embarrassment, stigma, belief that it is a bad habit, or that it is untreatable. In addition, many of the patients initially present to a general practitioner/family physician or a dermatologist before ever being consulted to a psychiatrist. A recent systematic review of treatment options found that current management options included both a behavioural approach (habit reversal or cognitive-behavioural therapy, specifically acceptance-enhanced behaviour) and medication management (selective serotonin reuptake inhibitor [SSRI] or N-acetyl cysteine [NAC].

• #1 Relapse Prevention Strategies for Skin Picking Disorder | SkinPick.com

  https://www.skinpick.com/relapse-prevention-skin-picking-disorder

  Skin picking disorder is a chronic condition that lasts a lifetime, which means it never goes away completely. However, it is possible to live without picking, and many people do so successfully. […] Accept that lapses will happen. If you expect to experience a setback at some point, you can have realistic expectations about your recovery and plan accordingly. Identify triggers and high-risk situations. Part of managing a chronic condition is recognizing what sets it off. […] Be prepared. In therapy, you likely learned ways to keep your hands busy or developed competing responses to take the place of picking. […] Preventative care. Take care of YOU! Live a balanced lifestyle with a healthy diet and regular exercise. Maintain low-stress levels and engage in self-care before you need it.

• #1 Skin picking disorder – NHS

  https://www.nhs.uk/mental-health/conditions/skin-picking-disorder/

  If you have skin picking disorder there are things you can try that may help. […] identify when and where you most commonly pick your skin and try to avoid these triggers. […] try to resist for longer and longer each time you feel the urge to pick. […] care for your skin when you get the urge to pick it for example, by applying moisturiser. […] tell other people they can help you recognise when you’re picking. […] keep your skin clean to avoid infection. […] do not keep things like tweezers and pins where you can easily get at them. […] Talking therapy is currently thought to be an effective treatment to help change skin picking behaviour. […] The most common type of talking therapy offered for skin picking disorder is cognitive behavioural therapy, and may include a technique called habit reversal training. […] Habit reversal training works by helping you: recognise and be more aware of your skin picking and what’s triggering it, replace skin picking with a less harmful behaviour. […] Your doctors may recommend some types of medicine to help you control your skin picking behaviour.

• #1 Picking your skin? Learn four tips to break the habit – Harvard Health

  https://www.health.harvard.edu/blog/picking-your-skin-learn-four-tips-to-break-the-habit-2018112815447

  You may be tempted to pick for a variety of reasons, from boredom, itch, or negative emotions, to blemishes or simply looking at or feeling your skin. Understanding your triggers can be a first step in deciding which treatments to pursue. […] One simple strategy to reduce picking, called stimulus control, involves changing your environment to make it harder to pick. […] Cognitive behavioral therapy (CBT) is a structured type of psychotherapy that aims to produce healthier behaviors and beliefs by identifying unhelpful thoughts and behaviors. […] While no medication has been formally approved by the FDA to treat excoriation disorder, there is evidence to suggest that selective serotonin reuptake inhibitor (SSRI) antidepressants and N-acetylcysteine (NAC), an antioxidant supplement, can be helpful.

• #1 Skin Picking Disorder: How to Diagnose and Treat It | Vogue

  https://www.vogue.com/article/skin-picking-disorder

  „Understanding ones triggers for picking can help guide which treatment to pursue,” explains Zakhary. „For example, individuals whose picking is triggered by a skin condition such as acne may benefit from a dermatologic consultation. However, if picking is triggered by sadness, anger, anxiety, or more of a general urge, consultation with a mental health professional is recommended.” […] „Most times, when people are picking, they will say they get into a trance state,” she explains. „They don’t really have an awareness of how much they have picked until they’re done.” Once triggers have been pinpointed, most experts will recommend some form of specialized Cognitive Behavioral Therapy (CBT) „It teaches strategies to reduce picking such as stimulus control, which is modifying ones environment to decrease the chance of picking,” explains Zakhary, citing examples such as keeping fingernails short, wearing gloves when likely to pick, or distracting your hands with silly putty or fidgets.

• #1 What Causes a Skin Picking Disorder and How to Treat It

  https://lightfully.com/what-causes-a-skin-picking-disorder-and-how-to-treat-it/

  What causes a skin picking disorder and how to treat it […] 5 ways to treat skin picking disorder […] Five potential ways to treat skin picking disorder are: […] Recognizing triggers Many repetitive behaviors stem from a trigger that you can encounter in your everyday life. While some people with the disorder pick their skin when they have a negative emotion, others will do it from boredom. When youre able to recognize your triggers, you can acknowledge them and increase resistance to the urge. […] Preventive changes If you use your nails to pick at your skin, make it harder for your nails to do so. This could mean cutting your nails to keep them short or wearing gloves when possible. It can also be beneficial to keep your hands busy, such as using a stress ball or a fidget toy. […] Cognitive behavioral therapy One of the most effective ways to treat OCD spectrum disorders, such as skin-picking disorder, is with cognitive behavioral therapy, or CBT. This therapy is often used by mental health providers to help you focus on how actions, thoughts and feelings affect each other. The goal of CBT is to help you learn how to alter the interaction between your thoughts and emotions that lead to skin picking.

• #1 Skin picking prevention and mitigation techniques

  https://pickingme.org/blog/blog.html/article/2018/07/19/skin-picking-prevention-and-mitigation

  Thick scrubs can decrease the likelihood that you will feel bumps or other triggering textures on your skin. […] Artificial nails can decrease damage from picking because the thick edge of the nail makes it more difficult to break the skin. […] Consider applying nail or cuticle oil. For example, before entering the bathroom at night, apply nail or cuticle oil. […] Fidget toys can be extremely helpful in preventing picking. […] Dimming or turning off lights in picking areas is helpful because if you are unable to see skin you would normally pick at, you are less likely to pick. […] If you feel the urge to pick, and you need to wash your face, try washing your face in the shower and avoiding the mirror before and after showering. […] To take the previous idea a step further, try getting ready while the mirror is foggy after showering.

• #1 Skin Picking Disorder: How to Diagnose and Treat It | Vogue

  https://www.vogue.com/article/skin-picking-disorder

  „It’s all in an effort to bring barriers to skin picking,” explains Yip of habit reversal training, which she offers at the Renewed Freedom Center. „You could also have any type of prickly stress ball nearby to use that will give you a tactile sensation similar to skin picking. If you tend to pick when you’re cooking, then you could try holding a utensil the whole time, so your hands are never free to pick.” […] „Increased societal awareness can help people locate the appropriate providers to help to improve this chronic and difficult condition.”

• #1 A Simple Guide to Skin Picking Disorder, (Dermatillomania) Diagnosis, Treatment and Related Conditions by Kenneth Kee | eBook | Barnes & Noble®

  https://www.barnesandnoble.com/w/a-simple-guide-to-skin-picking-disorder-kenneth-kee/1143702292

  Persons can learn techniques to manage the urge to pick such as:Keeping a skin picking diary to track triggers and patterns,Finding healthy distractions,Maintaining a skincare routineUsing barrier methods (such as gloves or bandages) to prevent picking. […] Treatment for dermatillomania normally involves a combination of therapies such as cognitive-behavioral therapy (CBT) and medicines. […] Psychotherapy can treat this disorder in different ways, depending on the method used.Habit reversal therapy.Group therapy and peer support.Cognitive behavioral therapy (CBT).Acceptance and commitment therapy.

• #1 Skin picking prevention and mitigation techniques

  https://pickingme.org/blog/blog.html/article/2018/07/19/skin-picking-prevention-and-mitigation

  When not in a picking state of mind, it can be helpful to write down triggers. After creating this list, try to manipulate your environment to help further your progress. Specifically, eliminate objects that may encourage picking or are directly used for picking. […] Although it can be scary to tell someone that you struggle with a BFRB, talking to someone you trust and asking for help can go a long way in furthering your progress.

• #1 Excoriation (Skin Picking) Disorder – Center for OCD and Related Disorders

  https://mghocd.org/excoriation/

  Current consensus suggests that CBT is the best treatment intervention for Excoriation (Skin-Picking) Disorder. A form of CBT called Habit Reversal Training (HRT) is considered to be the core approach. This treatment package includes: Habit Awareness Training to bring greater attention to picking behaviors, Competing Motor Responses to engage in actions incompatible with skin picking (i.e., fist-clenching) when the urge to pick is present, Relaxation Techniques to reduce stress and potential triggering of the behavior, Social Support to provide positive feedback, encouragement, and reminders to practice coping skills. […] Stimulus control is another intervention used in the treatment of excoriation. Stimulus control is used to modify the environment to eliminate sensory input that would lead to skin picking or make it more difficult to engage in picking behavior.

• #1 Skin Picking Therapy and Counselling Kanata & Ottawa | Juniper Counselling

  https://www.junipercounselling.ca/skin-picking

  Psychoeducation: Providing information about excoriation disorder, its triggers, underlying mechanisms, and treatment options to increase understanding and motivation for change. […] Self-monitoring: Encouraging individuals to track their skin picking behaviours, triggers, and emotional states to identify patterns and develop personalized strategies for intervention. […] Skill Building: Developing coping skills and strategies, such as relaxation techniques, problem-solving skills, and healthy distraction methods, to reduce the frequency and intensity of skin picking episodes. […] Behavioural Contracting: Collaboratively establishing goals and agreements to modify skin picking behaviours, track progress, and reinforce positive changes through rewards and incentives.

• #1 26 Tips for Skin Picking: A to Z

  https://www.bfrb.org/post/26-tips-for-skin-picking-a-to-z

  A lone time can be a trigger so make the right choice even when no one is looking. […] Know your triggers; whether it’s a big test coming up, feeling bored, or a few changes at once, knowing what leads to picking can help you create a plan to reduce it. […] Let others know how they can support you. Some ideas: hugs, encouragement, listening, or suggesting an activity to take your mind off it. […] Mindfulness skills of observing and taking a non-judgmental stance can help. Observing can increase awareness and that’s the first step towards changing a behavior. […] Be Open-minded about new strategies. You won’t know if it works if you don’t try it. Most people need a variety of strategies to combat skin picking so try using a combination and not relying on just one. […] Quit beating yourself up mentally as it can make matters worse and lead to more picking. […] Use your tools. Keep them within arms reach if possible and if out of sight, it’s probably out of your mind too. […] You are not alone. You did nothing to deserve this. You can learn to manage it.

• #1 Treatment for Dermatillomania – Compulsive Skin Picking (CSP) | Psychlinks Forum — Archive Only (2004-2022)

  https://forum.psychlinks.ca/threads/treatment-for-dermatillomania-compulsive-skin-picking-csp.23585/

  Unfortunately, there are very few psychotherapists who understand Compulsive Skin Picking, and even fewer who know how to treat it appropriately. […] As with most Obsessive Compulsive Spectrum Disorders, the most effective treatment for Dermatillomania is Cognitive Behavioral Therapy (CBT). […] When treating Dermatillomania with CBT, the two most useful techniques are Habit-Reversal Training (HRT) and Mindfulness Based CBT. […] Increasing awareness of ones picking patterns is central to the process of Habit Reversal Training, and is generally done by keeping skin picking logs. […] For many with Dermatillomania, Habit Reversal Training may also be made easier if they use habit-blockers such as gloves, which help to provide a barrier to unconscious picking. […] The first of two important factors to address in reducing the picking of Bs is to gradually learn to tolerate the urge to pick.

• #1 Skin Picking Disorder (Excoriation): Symptoms, Treatment, and Causes

  https://www.webmd.com/mental-health/skin-picking-disorder

  Skin picking disorder is usually treated with a combination of medicine and cognitive behavioral therapy. […] Several different methods may help you reduce how often you pick at your skin or keep you from hurting yourself if you do pick. Try out these tips: Wear Band-Aid or finger puppets on your fingers or put gloves on your hands. Every time you start to pick, the physical barrier will remind you not to and will cut down on the satisfaction you get from picking with your fingers. […] Rather than picking at your skin, do some positive self-care, such as applying moisturizer. […] Keep your skin clean and your nails short. […] Don’t keep tweezers, pins, or other tools that you might use to pick at your skin in easy reach. […] Fidget toys or handcrafts such as knitting or beading can also help keep your hands busy. This is a technique called competing response. It’s a way of keeping yourself busy or giving yourself another way of self-soothing than picking at your skin. […] Experiment with several different types to see what satisfies your need to pick without damaging your skin.

• #1 How to Stop Skin Picking: Tips and Strategies for Dermatillomania

  https://thumbsie.co.uk/blog/skin-picking-tips-strategies-dermatillomania/

  If you’re struggling with skin picking, consider using our Thumbsie Finger Guards to protect your skin and break the habit for good. […] As noted above, the NHS recommends the use of gloves as a potentially successful prevention tool. At Thumbsie®, we have seen increasing numbers of customers doing just that. We have noticed time and time again how this habit is interconnected with conditions such as hair pulling and skin picking. […] By wearing a Thumbsie®, you can protect your fingers and thumbs from the compulsive need to skin pick. They are comfortable and unobtrusive, meaning that it is perfectly easy to wear them and carry on with daily life. We have had thousands of happy customers over the last decade, who have quit their OCD-related behaviour through the use of a Thumbsie®. Why not give it a try? […] Skin picking, along with other OCD-related behaviours can be a difficult condition to overcome. But, with a mixture of prevention, and where appropriate, treatment, the evidence suggests that the habit can be broken.

• #1 Skin picking prevention and mitigation techniques

  https://pickingme.org/blog/blog.html/article/2018/07/19/skin-picking-prevention-and-mitigation

  Before getting ready for bed, try putting on gloves before entering the bathroom and using a makeup wipe. Make sure to wash the gloves regularly. You can also put on disposable silicone gloves before entering the bathroom and wash your face with them on. Wearing two pairs of the silicone gloves may further prevent you from feeling any triggering textures on your face. […] Putting bandages on usual picking sites and perceived imperfections can help prevent picking. Putting bandages on already-picked areas can help prevent further injury. […] Makeup wipes help prevent picking in a few ways. First, makeup wipes allow you to touch your face, but not directly, making the wipe a barrier. […] Face masks provide a dual benefit. Face masks do not allow one to directly touch the skin once applied, and also have the potential to improve the health of the skin.

• #1 How I Conquered My Skin Picking Habit Once and For All

  https://www.byrdie.com/how-to-stop-skin-picking-4686903

  „When I start picking at a patch of skin, a pimple or… that one time I almost removed a mole, I suggest using these pimple patches from The Klog,” says Palermino. „They’re transparent, incredibly thin, have a beveled edge, and stick to the skin. Because you can’t feel the edge on your skin you don’t have anything satisfying to pick at.”

• #1 Excoriation Disorder Treatment & Management: Approach Considerations, Pharmacologic Therapy, Hypnosis

  https://emedicine.medscape.com/article/1122042-treatment

  Physical barriers (eg, an Unna sleeve) can be an effective treatment for neurotic excoriations. […] Setting limits for the protection of both the physician and patient; creating an accepting, empathic, and nonjudgmental environment; and closely supervising symptomatic dermatologic care permit the development of a therapeutic relationship in which psychological issues may be gradually introduced, which may occasionally permit referral to a psychiatrist. […] Patients with neurotic excoriations can be seen by psychiatrists and benefit from follow-up care to encourage the maintenance of treatment.

• #1 Excoriation Disorder (skin picking disorder) | OCD-UK

  https://www.ocduk.org/related-disorders/skin-picking/

  The treatments for skin picking are very similar to those for OCD, with the treatment found to be the most effective being a talking therapy called Cognitive Behavioural Therapy (CBT). […] With skin picking an additional element of therapy may be introduced, a technique called habit reversal training. Habit reversal training works by helping the person recognise and be more aware of their skin picking and what is triggering it and sometimes help a person replace skin picking with a less harmful behaviour. This means repeatedly learning to tolerate the resulting discomfort. […] There are of course some things you can do to help yourself whilst waiting for talking therapy, for example: Keep your hands busy try squeezing a stress toy or putting on gloves to help you identify when and where you most commonly pick your skin. Resist picking for longer and longer each time you feel the urge to pick. Take extra care with your skin when you pick it applying moisturiser may help. Tell loved ones you to tell you when you are picking to help you recognise when you’re picking. Keep your skin clean to avoid infection. Don’t let your nails grow too long. Don’t keep tweezers and picking implements in an easy to access location.

• #1 Excoriation Disorder (Skin Picking Disorder) – OCD Clinic

  https://www.ocdclinicbrisbane.com.au/disorders-treatments/excoriation-disorder-skin-picking-disorder/

  There are multiple approaches to treating excoriation disorder, some of which may incorporate the use of various medications used in conjunction with psychotherapeutic options, however, the effectiveness of these will vary across each individual case. […] The most effective form of treatment providing long lasting results for SPD is a form of Cognitive Behavioural Therapy (CBT) known as Habit Reversal Training (HRT). HRT involves identifying the individuals underlying emotional, behavioural and environmental triggers that are associated with their behaviour, and once these are identified, they are then taught various alternative methods and strategies to deal with their emotions in order to respond to their identified triggers in a more constructive manner. […] Another effective psychotherapeutic treatment for SPD is called Stimulus Control (SC), whereby the individual attempts to prevent their destructive behaviours by modifying various stimuli in their everyday environment that they have identified as trigger points for their skin picking behaviours for some this may be setting an alarm on their phone to remind them not to spend too long zoning out in front of the TV or computer where their skin picking behaviour often occurs automatically, or for others they may find it helpful to wear gloves, band-aids or other props that cover their fingers that may prevent them from feeling the same sensation that would otherwise result from bare skin contact.

• #1 Dermatillomania (Skin Picking): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/22706-dermatillomania-skin-picking

  Dermatillomania is a mental health condition, but experts still dont fully understand what causes it. That means it happens unpredictably and it isnt preventable. There isnt a known way to reduce your risk of developing it either. […] Dermatillomania usually isnt a dangerous condition unless it’s very severe. The main risk from this condition is from open wounds, which might develop infections because of repeated picking or damage. Though this condition isnt usually dangerous directly, it still commonly has severe negative effects on your quality of life and overall sense of well-being. […] Avoiding triggers when possible. People with dermatillomania often pick at their skin in certain settings or situations. Avoiding those triggers can make a big difference. […] Take away the opportunity to pick. People with dermatillomania may benefit from fidget devices or other things that can help them avoid picking behaviors by keeping their hands occupied. Other ways to avoid picking include wearing gloves or clothing that keep you from picking at your skin.

• #1 OCD Types | Excoriation Disorder | Compulsive Skin Picking

  https://www.ocdtypes.com/skin-picking.php

  Learn how to prevent compulsive skin picking. […] Nuts and seeds with the shell on can be a great way to keep hands busy and prevent picking. If skin-picking occurs at night, sleeping with gloves or mittens on will also help. Fidget toys can be an important tool to help combat the urges to pick the skin. Below are some suggested items that. People with Excoriation Disorder should try several of these strategies and stick with the ones that work the best. […] Fidget toys can help combat hair pulling disorder. […] Fidget toys can give busy hands something to do to combat compulsive hair pulling.

• #1 What Causes a Skin Picking Disorder and How to Treat It

  https://lightfully.com/what-causes-a-skin-picking-disorder-and-how-to-treat-it/

  Habit reversal training Another type of therapy method that can be beneficial for the disorder is habit reversal training. Its used to help treat body-focused repetitive behaviors such as skin picking as well as hair pulling (trichotillomania). The goal is to unlearn the repetitive habits throughout a series of steps such as replacing it with a less harmful behavior and learning to control potential triggers. […] Comprehensive behavioral treatment Comprehensive behavioral treatment analyzes what occurs internally and externally before, during, and after a repetitive behavior like skin picking. By figuring out the process of the body-focused repetitive behavior, your therapist can help you find alternatives that interrupt it to increase prevention.

• #1 Skin-Picking (Excoriation) Disorder – Mental Health Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/mental-health-disorders/obsessive-compulsive-and-related-disorders/skin-picking-excoriation-disorder

  Cognitive-behavioral therapy (habit reversal therapy) that specifically focuses on skin-picking disorder and certain antidepressants or N-acetylcysteine or memantine may help lessen symptoms. […] Cognitive-behavioral therapy in particular, habit-reversal therapy that specifically focuses on skin-picking disorder is the therapy of choice. For habit-reversal therapy, people are taught to do the following: […] Become more aware of their skin picking […] Identify situations that trigger the behavior […] Use strategies to help them stop themselves from picking at their skin for example, by substituting a different activity (such as clenching their fist, knitting, or sitting on their hands) for skin picking. […] N-acetylcysteine (NAC) and memantine both act on the glutamatergic system, and may reduce skin-picking. Treatment with selective serotonin reuptake inhibitors (a type of antidepressant) or clomipramine may also be useful and may improve the symptoms of any coexisting depression or anxiety disorders.

• #1 Dermatillomania (Skin Picking) in Older Adults | Caring Nurses

  https://caringnurses.com/dermatillomania-skin-picking-in-older-adults/

  Excoriation disorder can be treated with a combination of medication and psychotherapy. […] Older adults with excoriation disorder may also benefit from some self-help tips, such as: Keeping the nails short and smooth, and wearing gloves or bandages to prevent picking. […] Moisturizing the skin and applying topical agents, such as antibiotic ointment or hydrocortisone cream, to promote healing and prevent infection. […] Distracting oneself with other activities, such as reading, knitting, gardening, or playing games, when feeling the urge to pick. […] Seeking social support from family, friends, or online communities, and sharing one’s feelings and experiences. […] Practicing relaxation techniques, such as deep breathing, meditation, or yoga, to reduce stress and anxiety. […] Seeking professional help if the condition interferes with one’s daily functioning or quality of life. […] However, with proper medication, psychotherapy, and self-help, older adults can overcome their skin picking habit and improve their health and well-being.

• #1 Skin picking (excoriation disorder): Causes and treatment

  https://www.medicalnewstoday.com/articles/325925

  Skin picking disorder can significantly impact a persons quality of life and overall health. […] Treatment options for skin picking disorder usually include medication and therapy. Treating any underlying condition can help alleviate the impulse to pick. […] People can take action at home by practicing stress management techniques and altering their environment to reduce exposure to potential triggers. […] Tips for managing skin picking disorder at home include: applying soothing topical ointments, such as aloe vera gel or high quality coconut oil, exercising regularly, practicing yoga, meditation, or deep breathing exercises to reduce stress or anxiety, removing or covering mirrors to avoid seeing skin blemishes, hiding any tools used to pick or pull skin, such as tweezers, nail clippers, and scissors. […] CBT and other forms of therapy can help a person identify any psychological, physical, or environmental factors that may be contributing to their skin picking behavior.

• #1 Treatment and Healing for Skin Picking Disorder

  https://mavamedical.com/control-the-skin-picking-disorder/

  Managing skin picking disorder entails monitoring and altering one’s habitual conduct. Triggers such as stress and boredom can be managed using a fidget toy or a stress ball. Therefore, keeping nails short is another helpful tip that reduces picking. Moisturizing can also serve as a distraction. You may use bandages and gloves on these triggers to block rather than satisfy the urge. […] Similarly, meditative practices like mindfulness, deep breathing, and meditation are effective for managing anxiety. […] Dermatillomania, commonly known as skin picking, can be controlled through self-monitoring and healthy coping mechanisms. Managing picks begins with recognizing stress, anxiety, or boredom as triggers and replacing them with other activities, such as squishing a stress ball or fidgeting with an object.

• #1 Understanding Skin Picking In Adults: Useful Information

  https://scratchsleeves.co.uk/useful-info/skin-picking-in-adults/

  While there are currently very few effective treatments for skin picking, our specially-designed ScratchSleeves can help to break the picking cycle and prevent the resulting skin problems. […] There are a variety of measures you can take to help prevent skin picking. These include: Keep busy engage in positive and meaningful activities that keep your hands and mind busy. This will distract you from feeling the desire to pick at your skin. […] Wear clothing that covers the area you usually pick at. This will act as a barrier to prevent picking. […] Wear gloves or eczema mitts that will gently restrain your hands (especially when watching TV or sleeping). This will stop you from being able to pick at your skin, allowing the affected areas to heal without being disturbed. ScratchSleeves are designed specifically to minimise the dame done by skin-picking and scratching.

• #1 Skin Picking Disorder – Dr Davin Lim

  https://drdavinlim.com/skin-picking-disorder/

  If you are serious about treating this condition, you should see a psychologist a psychiatrist. The former can teach you coping skills, the latter can prescribe you drugs. If you are stressed highly anxious, find a solution that can reduce your stress levels. They include acupuncture, yoga, medication, trigger pointing, aromatherapy other fluffy but important avenues. Creams include vitamin E tocopherol, squalene ceramides. They can help establish barrier function reduce the chances of scarring. Do not use AHAs or BHAs on scratched or eroded lesions as this will result in more skin irritation, leading to more scratching. […] Skin picking disorder can be successfully treated if patients want to be treated. Early effective treatment will mitigate skin scars. People who dont accept their condition or have little or no insight will be left with marked, extensive scars that can be difficult to treat. The trifecta of management is via a medical dermatologist (not me), psychologist psychiatrist. A dermatologist is required to exclude organic causes including metabolic, immunobullous, endocrine, paraneoplastic inflammatory causes. In some cases tests are required, including special skin biopsies.

• #1 6 Best Ways to Stop Your Skin Picking (Dermatillomania) Habit – Advanced Behavioral health

  https://behaviortherapynyc.com/6-best-ways-to-stop-your-skin-picking-dermatillomania-habit/

  About 5.4% of people suffer from dermatillomania (compulsive skin picking) at some point in their life. Without treatment, this skin picking disorder could cause scarring or injuries and exacerbate underlying feelings of anxiety. […] Recognizing your triggers and learning effective ways to cope with these triggers will help you gain control of your reaction before it controls you. Consider talking with a behavioral therapist who specializes in skin-picking to gain a better understanding of its causes and the best course of treatment. […] With the help of a highly skilled behavior therapist, you can formulate a more specialized treatment plan to put an end to this destructive habit. […] Choose a mental health professional with an expertise in body-focused repetitive behaviors (BFRBs). They should be skilled in a cognitive behavioral therapy (CBT) technique called habit reversal training with stimulus control (HRT plus). This has been shown to be the most effective treatment for BFRBs. […] If you tend to pick at blemishes, try to identify why your skin is prone to blemishes and what you can do to prevent them. […] First, consider talking to a dermatologist. They can determine the root cause of your skin problems and how best to treat them.

• #1 Understanding Skin Picking In Adults: Useful Information

  https://scratchsleeves.co.uk/useful-info/skin-picking-in-adults/

  Keep skin moisturised, hydrated, and clean to avoid any spots or eczema outbreaks that could encourage picking. Keeping skin clean also helps to prevent skin infections if there are open wounds. […] Keep nails short. Having short nails means if you do begin to subconsciously pick at your skin, you are less likely to cause open wounds or transmit bacteria beneath the skins surface.

• #1 Skin Picking and Autoimmune Diseases: Signs and How to Treat

  https://www.healthline.com/health/skin-picking-and-autoimmune-disorders

  Excoriation disorder treatment can require a two-pronged approach. […] If you have an autoimmune disorder, treating the underlying condition is necessary to ease skin symptoms like itching. Without treating the underlying trigger of excoriation disorder, the symptoms will come back. […] However, treating an underlying autoimmune condition isn’t enough by itself. People with severe excoriation disorder will pick open areas of skin that have healed. Mental health treatments are often necessary to help modify skin-picking behaviors. […] Medications and therapeutic approaches can help you manage excoriation disorder. Without treatment, this condition can lead to complications such as infections and scarring. Speak with your doctor if you are experiencing the urge to pick your skin.

• #1 Skin Picking Disorder / Dermatillomania – OCD Center of L.A.

  https://ocdla.com/compulsiveskinpicking

  The primary treatment modality for Skin Picking Disorder / Dermatillomania is a combination of various types of Cognitive-Behavioral Therapy (CBT). Perhaps the most important of these is called Habit Reversal Training (HRT). HRT is based on the principle that skin picking is a conditioned response to specific situations and events, and that the individual with Dermatillomania is frequently unaware of these triggers. HRT challenges Dermatillomania in a two-fold process. First, the individual learns how to become more consciously aware of situations and events that trigger skin picking episodes. Second, the individual learns to utilize alternative behaviors in response to these situations and events. […] Other Cognitive-Behavioral Therapy techniques can be used as adjuncts to HRT in the treatment of Skin Picking Disorder. Among these are Stimulus Control techniques and Cognitive Restructuring. Stimulus Control techniques involve utilizing specific physical items as habit blockers to restrict the ability to pick skin, while Cognitive Restructuring helps an individual with Dermatillomania learn to think differently in response to the urge to pick their skin.

• #1 International OCD Foundation | Comprehensive Behavioral (ComB) Treatment for Skin Picking and Hair Pulling Disorders

  https://iocdf.org/expert-opinions/comprehensive-behavioral-comb-treatment-for-skin-picking-and-hair-pulling-disorders/

  In the final phase of formal treatment, the client is encouraged to continue with ongoing assessments of progress and to modify the use of interventions as needed. A shift is made from reliance on therapist guidance toward self-management and utilization of skills and techniques learned during formal treatment. The focus is on maintenance, extension of the gains achieved during formal therapy, and preparation for setbacks that are common during the recovery process. Relapse prevention training provides a systematic approach to minimizing setbacks and keeping them from leading to a full-blown resumption of hair pulling or skin picking. […] The last several decades have seen much progress toward understanding and treating BFRBs. The ComB treatment model guides assessment across a broad range of features for a comprehensive view of each individual’s BFRBs. When used as a guide, it points to a broad range of potential treatment avenues that might be unavailable with a more limited view of the disorder. While outcome research on ComB and other CBT therapies for BFRBs continues to clarify the effectiveness, efficiency, and acceptability of these approaches, decades of informal clinical observation and testimonials by numerous expert clinicians employing ComB treatment for BFRBs support the following conclusions regarding ComB:

• #1 Excoriation (Skin Picking) Disorder – Center for OCD and Related Disorders

  https://mghocd.org/excoriation/

  The goal of ACT is to teach skin pickers that when one is feeling the urge to pick or experiences a negative emotion associated with picking, one can accept the urge or emotion without having to respond to it. […] DBT teaches pickers emotion regulation strategies, as well as methods to tolerate uncomfortable emotions and urges.

• #1 Skin Picking (Excoriation) | Symptoms & Treatments | Zencare — Zencare

  https://zencare.co/mental-health/skin-picking

  Cognitive Behavioral Therapy (CBT) for skin picking often includes behavioral therapy techniques such as habit reversal therapy. It also involves education and cognitive restructuring – replacing unhelpful thoughts and beliefs with more helpful ones. […] Acceptance and Commitment Therapy (ACT), which involves elements of CBT and mindfulness, has also been found to be beneficial for treating skin picking. In this framework, therapists help clients reduce skin picking by taking an ‘acceptance’ approach to difficult thoughts and emotions, while finding new ways to respond to them. […] Find a therapist who has experience and specialized training in the treatment of skin picking, and specifically Habit Reversal Therapy, as this is an evidence-based therapy approach for this condition.

• #1 How does ERP Treatment Work for Skin-Picking?

  https://www.kairoswellnesscollective.com/blog/how-does-exposure-response-prevention-erp-treatment-work-for-skin-picking-hrd5h

  Exposure and Response Prevention (ERP) is a cognitive-behavioral therapy technique commonly used to treat various anxiety disorders, including skin picking disorder (also known as excoriation disorder). […] ERP for skin picking involves exposing oneself to the urge to pick the skin and preventing the subsequent picking response. […] During the exposure exercises, the individual actively resists the urge to engage in skin picking. They are encouraged to tolerate the discomfort and anxiety that arises from not engaging in the picking behavior. This response prevention is essential to break the cycle of the urge-response-reinforcement pattern. […] Once progress is made, the individual continues to practice the skills learned in therapy and applies them to real-life situations. The goal is to maintain the gains achieved and prevent relapse by integrating the new coping strategies into their daily life.

• #1 Skin Picking Disorder / Dermatillomania – OCD Center of L.A.

  https://ocdla.com/compulsiveskinpicking

  One of the most effective CBT developments for the treatment of Skin Picking Disorder is Mindfulness-Based Cognitive Behavioral Therapy. The primary goal of Mindfulness-Based CBT is to learn to non-judgmentally accept uncomfortable psychological experiences. From a mindfulness perspective, much of our psychological distress is the result of trying to control and eliminate the discomfort of unwanted thoughts, feelings, sensations, and urges. In other words, our discomfort is not the problem our attempt to control and eliminate our discomfort is the problem. For those with Skin Picking Disorder, the ultimate goal of mindfulness is to develop the ability to more willingly experience their uncomfortable thoughts, feelings, sensations, and urges, without picking their skin. […] The OCD Center of Los Angeles offers individual therapy for the treatment of adults, children, and adolescents with Skin Picking Disorder / Dermatillomania. Using the Cognitive Behavioral Therapy techniques outlined above, clients with Skin Picking Disorder learn to respond differently to thoughts about their skin, and to resist the urge to pick their skin.

• #1 A systematic review of nonpharmacological treatment options for skin picking disorder – PubMed

  https://pubmed.ncbi.nlm.nih.gov/39215568/

  Skin picking disorder (SPD) is a well-described neuropsychiatric disorder that causes severe stress and impairment. However, there is no clear protocol for treating patients, and only a relatively small body of literature evaluating treatment approaches. This review aims to summarize and compare recent publications and provide an up-to-date guide of current nonpharmacological treatments for SPD. […] Studies implementing CBT, habit reversal therapy, AE-GBT, online self-help modules, and expressive writing demonstrated the best results in treating SPD. Several studies achieved significant outcomes for participants with SPD, confirming the usefulness of nonpharmacological treatment in SPD. Based on our results, CBT, AE-GBT, online self-help modules and expressive writing appear to be the most effective in treating SPD. Additionally, most of these treatment modalities can be tailored to meet patient-specific needs.

• #1 Treatment and Healing for Skin Picking Disorder

  https://mavamedical.com/control-the-skin-picking-disorder/

  Additionally, mindfulness and some stress management techniques, such as meditation or even deep breathing, can help a lot. If self-intervention doesn’t help, then one should consider professional help through medication to deal with the root of the issue and develop better-coping mechanisms. […] Medication to alleviate compulsive urges and anxiety related to picking at skin disorder(Excoriation Disorder) can be helpful in Skin picking disorder treatment. SSRIs (Selective serotonin reuptake inhibitors) such as fluoxetine or sertraline are the commonly used mood stabilizers to control mood swings and decontrol. […] Moreover, a study of N-acetylcysteine (NAC) modulating glutamate levels shows its efficacy in reducing repetitive behaviors. In the case of severe symptoms, antipsychotic medications or mood stabilizers may be used. In addition, a psychiatric evaluation helps choose the right treatment plan. An individual is expected to seek adequate management with an integrated approach to skin picking.

• #1 Excoriation (Skin-Picking) Disorder – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/obsessive-compulsive-and-related-disorders/excoriation-skin-picking-disorder

  Patients with excoriation disorder try to stop picking their skin or to do it less often, but they cannot. […] Treat using cognitive-behavioral therapy that is tailored to treat specific excoriation symptoms (including habit reversal training) and/or an SSRI, clomipramine, N-acetylcysteine, or memantine.

• #1 Antioxidants help treat skin-picking disorder in mice, researcher says | News Center

  https://med.stanford.edu/news/all-news/2015/07/antioxidants-help-treat-skin-picking-disorder-in-mice.html

  Two antioxidant supplements were found to be effective in treating a skin-picking disorder in mice, suggesting they may be useful in people with the condition. […] The finding suggests that people with the potentially serious disorder might benefit from this therapy. […] Garner believes that NAC works by combating oxidative stress that causes certain cells in the brain to die or become inactive. […] Intra-nasal glutathione, on the other hand, may avoid these potential side effects by bypassing the gut and liver, delivering the compound directly to the brain. […] Garner said his next step is to plan a clinical trial in patients to test the value of intra-nasal glutathione.

• #1 New study: drug option for hair-pulling, skin-picking disorders – UChicago Medicine

  https://www.uchicagomedicine.org/forefront/research-and-discoveries-articles/2023/march/new-research-points-to-drug-option-for-hair-pulling-skin-picking-disorders

  New research at the University of Chicago Medicine has found that a drug commonly used to treat symptoms of Alzheimers disease effectively reduced symptoms of adults who experience compulsive hair-pulling and skin-picking. […] Treatment with the drug memantine was associated with significant improvements compared to a placebo for patients with trichotillomania (a disorder where individuals cannot resist the urge to pull out their hair) and skin-picking disorder (also known as excoriation disorder). […] Cognitive behavioral therapy is a first-line treatment, but finding therapists well-versed in the disorders can be difficult, he said. […] An analysis found that memantine is more effective than other treatments studied thus far, including behavioral therapy, the drug olanzapine (used to treat schizophrenia and bipolar disorder), the drug clomipramine (used to treat obsessive-compulsive disorder), and N-acetylcysteine (an over-the-counter supplement).

• #1 New study: drug option for hair-pulling, skin-picking disorders – UChicago Medicine

  https://www.uchicagomedicine.org/forefront/research-and-discoveries-articles/2023/march/new-research-points-to-drug-option-for-hair-pulling-skin-picking-disorders

  The comparisons suggest that memantine might be considered a first-line treatment equal to behavioral therapy in the treatment process for these conditions, according to the study. […] Grant said the results point to several additional areas for research, including combining memantine with behavioral therapy or with N-acetylcysteine, which showed promise in previous studies led by Grant. Longer-term use of memantine and different doses also are potential avenues for study, he said.

• #1 Relapse Prevention Strategies for Skin Picking Disorder | SkinPick.com

  https://www.skinpick.com/relapse-prevention-skin-picking-disorder

  Social Support. Social support is a huge benefit, and when you enlist the help of your supportive others, they can help you recognize signs or triggers before you are aware. […] Be gentle with you. Life happens, and sometimes setbacks occur too. Resist the urge to scold, berate, condemn, or otherwise beat yourself up. […] Process. Discuss with your therapist or a supportive other what happened. The key to processing is not to dwell on the lapse, but to determine what the trigger may have been or what you may have needed to prevent the lapse. […] Celebrate your victories. For example, maybe you interrupted your picking behaviors and stopped it before you injured yourself. Even though you had a setback, find something that went good, that you did right, or anything positive that resulted. […] Changing language is not cause for complacency. Trading the negativity associated with the word relapse and accepting that lapses will happen does not open the door for relaxing into apathy. Positive recovery experiences require active engagement to maintain.

• #1 How I Conquered My Skin Picking Habit Once and For All

  https://www.byrdie.com/how-to-stop-skin-picking-4686903

  „Mindfulness meditation practice can be helpful so folks are more aware of what they are doing at the moment and find other ways to deal with discomfort in the present moment,” says Dr. Young. […] „You want nothing but the pads of your fingers when your palm faces you,” says Palermino. „Also use a glass nail file to round the edge of your nails so they are blunt, not sharp. You want zero ability to scratch when you touch your skin.” […] „Don’t be afraid to seek support from friends, family, and professionals. Loved ones can help point out triggers, and kindly try to offer up distractions during those times you start to fixate on picking.” […] „I found it incredibly helpful in my healing process to stay positive. When I was doing really well, and then had a setback, I was bummed, no doubt. But I knew that getting down on myself or demoralized wouldn’t help.”

• #1 How to Stop Skin Picking: Treatment for Skin Picking | HealthyPlace

  https://origin.healthyplace.com/ocd-related-disorders/excoriation-skin-picking-disorder/how-to-stop-skin-picking-treatment-for-skin-picking

  Many people do not know how to stop skin picking once it becomes a true disorder. […] Effective treatment for skin picking is available: Cognitive behavioral therapy (CBT) therapists typically employ a combination of different types of CBT (cognitive behaviorial therapy), but the most commonly used is Habit Reversal Training (HBT). […] Another effective way to help individuals stop skin picking involves Mindfulness-Based CBT. […] Medications certain medications have been found effective in treatment for skin picking. […] Individual and group therapy led by a licensed health care professional these sessions help to reinforce concepts of CBT and augment any medications the patient may take to help stop skin picking. […] You may also find it helpful to join a support group that focuses on helping people refrain from picking at their skin.

• #1 Skin Picking Disorder / Dermatillomania – OCD Center of L.A.

  https://ocdla.com/compulsiveskinpicking

  In addition to individual therapy, the OCD Center of Los Angeles also offers six weekly, low-fee, therapy/support groups for adults with OCD and related conditions, including a group exclusively for adults with Dermatillomania and Trichotillomania. This group is led by one of our professional staff therapists, Chanel Taghdis, MA, and uses the same treatment protocol as our individual Cognitive-Behavioral Therapy program. […] The OCD Center of Los Angeles also offers webcam based online therapy and telephone therapy to clients around the world suffering with Skin Picking Disorder / Dermatillmania. Telephone and online therapy are cost-effective options for clients who have physical and/or psychological limitations that restrict their ability to come to our office, and for those in remote areas who cannot find specialized Skin Picking Disorder / Dermatillomania treatment close to their home.

• #1 Im new here and need help! | SkinPick.com

  https://www.skinpick.com/node/101085

  Im just looking for effective preventative measures some other folks take? […] But Id love some suggestions to help prevent further picking. […] Have you tried creating barriers like wearing gloves or using adhesive bandages on the fingertips to make picking more difficult? […] Additionally, practicing mindfulness and deep breathing exercises can assist in managing the impulse to pick. […] I’d highly recommend considering therapy as it can help minimize the urges and provide effective tools to manage skin picking behaviors. […] They can assist in developing personalized strategies to cope with the urges, identify triggers, and work towards reducing skin picking episodes. […] I have found success with mindfulness exercises including deep breathing, watching the Naturescape channel which shows scenes of nature 24/7 and spending time with my puppy.

• #1 How to use ERP for Skin Picking

  https://www.kairoswellnesscollective.com/blog/how-to-use-erp-for-skin-pickingsaved-to-drive

  Exposure and Response Prevention (ERP) is a widely used and effective therapeutic approach for treating conditions like Dermatillomania (skin picking disorder). […] It’s crucial that these exposure exercises are tailored to the individual’s specific triggers and compulsions and are conducted under the guidance of a qualified therapist experienced in treating skin picking disorder. The therapist’s role is to help the person resist the urge to pick and gradually reduce the frequency and intensity of the behavior. […] Over time, ERP can help individuals with skin picking disorder gain better control over their urges and develop healthier coping strategies to manage stress and anxiety without resorting to skin picking.

• #1 Treatment for Dermatillomania – Compulsive Skin Picking (CSP) | Psychlinks Forum — Archive Only (2004-2022)

  https://forum.psychlinks.ca/threads/treatment-for-dermatillomania-compulsive-skin-picking-csp.23585/

  By waiting, you teach yourself that you are able to resist the urge to pick immediately that you can wait it out and see what happens. […] The more you practice doing this, the better you will become over time at resisting the urge to pick. […] This is what you teach yourself by mindfully acknowledging and accepting the urge to pick without automatically giving into that urge. […] When you teach yourself these two new techniques, the likelihood of getting to a place where you are relatively pick-free is significantly improved.

• #1 Skin Excoriation Therapy | Treat Skin Picking in Philadelphia

  https://anxietyocdphilly.com/skin-excoriation-therapy-philadelphia/

  Skin excoriation disorder, also known as dermatillomania or compulsive skin-picking, transcends a simple habit to embody a profound mental health challenge. […] Our Center for Anxiety, OCD, and Cognitive Behavioral Therapy in Philadelphia is dedicated to offering a beacon of hope. […] Early intervention can be key to helping younger people develop healthier coping mechanisms and can foster resilience against the disorder. […] Various forms of specialized cognitive behavioral therapy (CBT) methods may be part of your journey toward a future of greater self-acceptance and control. […] Understanding the multifaceted origins of skin excoriation disorder can be helpful for personalized treatment. […] Our therapy programs aim to address the psychological factors contributing to hair-pulling behaviors, utilizing a range of specialized CBT approaches.

• #1 Skin Picking Disorder – Dr Davin Lim

  https://drdavinlim.com/skin-picking-disorder/

  Skin picking disorder is also known as dermatillomania. This is a common condition that affects 5% of the population. Depression, stress anxiety are predisposing factors. This is a form of obsessive-compulsive disorder. Skin scars are a frequent sequela of skin picking. If you are serious about treatment, a team consisting of medical dermatologists, psychiatrist psychologist can help you. […] Treatments include cognitive behaviour therapy SSRIs. Anti-anxiety drugs can reduce the urge to pick. Skin picking can lead to scars. Skin scars are best treated when this condition is in complete remission. Hypopigmented scars are treated with lasers, surgery pigment stimulators. Most cases require a team of dermatologists, psychiatrists psychologists. […] Early and effective management of picking will markedly reduce the risk of scarring. This requires a team approach with input from your psychologist, psychiatrist medical dermatologist. Simple strategies that your dermatologist will use include trimming of nails, ice packs, as well as mitts at night. If picking is focal, you can buy some hydrocolloid dressings from a pharmacy. These include acne patches.

• #1 Excoriation (skin-picking) disorder: a systematic review of treatment | NDT

  https://www.dovepress.com/excoriation-skin-picking-disorder-a-systematic-review-of-treatment-opt-peer-reviewed-fulltext-article-NDT

  A significant benefit for nonpharmacological treatments, such as cognitive-behavioral therapy (CBT) and habit reversal therapy (HRT), in ED has been suggested. […] Cognitive-behavioral interventions for ED may also be useful when presented in a self-help format that patients access themselves. […] Acceptance and Commitment Therapy (ACT), which entails acceptance and mindfulness strategies, as well as commitment and behavior change strategies, has also been investigated in ED. […] The literature systematically reviewed here, and previous meta-analyses, emphasize the relatively sparse evidence base, but also point to the benefit of behavioral treatments. […] SSRIs have been a mainstay of pharmacotherapy, but there is now evidence from a RCT that NAC should also be considered as a potential intervention. […] In the interim, there is also a need to improve accessibility to efficacious treatments.

• #1 Lisa Zakhary, MD PhD on Skin Picking or Excoriation Disorder – MGH Psychiatry News

  https://mghpsychnews.org/lisa-zakhary-md-phd-on-skin-picking-or-excoriation-disorder/

  In order to better care for this population, the MGH Excoriation Clinic and Research Unit was opened with the goal of providing state-of-the-art, empirically-based treatments for skin picking symptoms. […] The clinic is committed to advancing the current treatments for Excoriation (Skin Picking) Disorder through ongoing clinical research.

• #1 International OCD Foundation | Comprehensive Behavioral (ComB) Treatment for Skin Picking and Hair Pulling Disorders

  https://iocdf.org/expert-opinions/comprehensive-behavioral-comb-treatment-for-skin-picking-and-hair-pulling-disorders/

  ComB treatment encompasses a wide range of techniques drawn from standard behavioral, cognitive, and CBT practice. These are familiar to CBT practitioners as they are widely used to treat a broad range of disorders. Individual therapists are encouraged to draw upon and integrate their training, knowledge and skills into their approach to ComB as client needs become clearer over time. […] As ComB treatment is uniquely tailored to the individual needs of each patient, the treatment process is expected to be both creative and fluid rather than rigidly applied. The flexible and patient-oriented nature of the treatment process results in therapy that may appear quite different from one patient to another, due to factors such as the therapist’s skill set, judgment, and decision-making as well as each patient’s preferences. The ComB approach addresses this complexity by providing a systematic framework that guides therapists as they design and implement a treatment plan that uniquely fits each patient.

• #1 International OCD Foundation | Comprehensive Behavioral (ComB) Treatment for Skin Picking and Hair Pulling Disorders

  https://iocdf.org/expert-opinions/comprehensive-behavioral-comb-treatment-for-skin-picking-and-hair-pulling-disorders/

  It provides a unique and likely more effective alternative to existing CBT treatment approaches; […] It addresses the diverse nature of elements that foster hair pulling in each individual; […] It guides the assessment of relevant information and organizes that information into important domains of human experience; […] It generates a broad variety of possible therapeutic interventions; […] It guides the therapist through the process of clinical decision-making to ensure that therapeutic interventions fit well with the unique characteristics of each patient; […] It has been adapted for use with children and adolescents and for self-help applications. […] At this time no other single treatment formulation provides these features within an integrated conceptual framework and treatment model.

• #2 Relapse Prevention Strategies for Skin Picking Disorder | SkinPick.com

  https://www.skinpick.com/relapse-prevention-skin-picking-disorder

  Social Support. Social support is a huge benefit, and when you enlist the help of your supportive others, they can help you recognize signs or triggers before you are aware. […] Be gentle with you. Life happens, and sometimes setbacks occur too. Resist the urge to scold, berate, condemn, or otherwise beat yourself up. […] Process. Discuss with your therapist or a supportive other what happened. The key to processing is not to dwell on the lapse, but to determine what the trigger may have been or what you may have needed to prevent the lapse. […] Celebrate your victories. For example, maybe you interrupted your picking behaviors and stopped it before you injured yourself. Even though you had a setback, find something that went good, that you did right, or anything positive that resulted. […] Changing language is not cause for complacency. Trading the negativity associated with the word relapse and accepting that lapses will happen does not open the door for relaxing into apathy. Positive recovery experiences require active engagement to maintain.

• #2 Compulsive skin picking causes and how to stop

  https://www.treatmyocd.com/blog/compulsive-skin-picking

  Compulsive skin picking is a known mental health condition and there’s effective treatment available to address your symptoms. […] One of the most effective therapies for skin picking disorder and any BFRB, for that matter, is habit-reversal training (HRT). HRT involves tracking specific details about when you’re most likely to engage in a habit so that you can gather as much information as possible about when it occurs. […] Habit-reversal training involves increasing awareness of when you have the urge to pick, and learning behaviors that directly compete with the skin-picking—clenching your fists, clapping your hands, or putting your hands underneath your legs until the feeling subsides. […] If your compulsive skin picking is linked to body dysmorphia disorder (BDD), the preferred treatments for this condition are cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT).

• #2 Dermatillomania (Skin Picking): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/22706-dermatillomania-skin-picking

  Dermatillomania is a mental health condition, but experts still dont fully understand what causes it. That means it happens unpredictably and it isnt preventable. There isnt a known way to reduce your risk of developing it either. […] Dermatillomania usually isnt a dangerous condition unless it’s very severe. The main risk from this condition is from open wounds, which might develop infections because of repeated picking or damage. Though this condition isnt usually dangerous directly, it still commonly has severe negative effects on your quality of life and overall sense of well-being. […] Avoiding triggers when possible. People with dermatillomania often pick at their skin in certain settings or situations. Avoiding those triggers can make a big difference. […] Take away the opportunity to pick. People with dermatillomania may benefit from fidget devices or other things that can help them avoid picking behaviors by keeping their hands occupied. Other ways to avoid picking include wearing gloves or clothing that keep you from picking at your skin.

• #2 Pathological skin picking: a disorder that will hurt your skin – The Diamond Rehab Thailand

  https://diamondrehabthailand.com/what-is-pathological-skin-picking/

  Persons who are prone to pathological skin picking should keep their nails trimmed and avoid letting them grow long. Tweezers and other similar objects that aid in skin picking should be kept out of reach. […] Another important preventative method is to be proactive about managing underlying problems that contribute to skin picking behavior. For example, patients with depression, anxiety, substance use disorder, OCD, and other conditions may prevent skin picking by managing symptoms of those problems theyre experiencing.

• #2 How to Stop Skin Picking for Even Just a Second | SELF

  https://www.self.com/story/how-to-stop-picking-skin

  When I get super anxious, like right before a date (or during a date), its hard to resist picking at my cuticles or fiddling with bumpy patches of skin on my arms. […] If your urge to bother your skin is getting out of hand (like you really cant seem to stop, your skin is visibly damaged, or your picking is causing you more stress), consider reaching out to a therapist. […] This tactic is called habit reversal training (HRT). This form of cognitive behavioral therapy (CBT) is the top treatment for BFRB. […] If you have one handy, you could always play with a fidget spinner or another little toy that keeps your hands busy and wait until the urge to pick goes down, Nathan Peterson, LCSW, a therapist specializing in obsessive-compulsive disorders and BFRBs, tells SELF. […] When you get the urge to pick, delay it for another time. By putting the picking off, youll get the chance to pause and think about whether you really need to pick or not, says Dr. Piacentini.

• #2 How I Conquered My Skin Picking Habit Once and For All

  https://www.byrdie.com/how-to-stop-skin-picking-4686903

  „Mindfulness meditation practice can be helpful so folks are more aware of what they are doing at the moment and find other ways to deal with discomfort in the present moment,” says Dr. Young. […] „You want nothing but the pads of your fingers when your palm faces you,” says Palermino. „Also use a glass nail file to round the edge of your nails so they are blunt, not sharp. You want zero ability to scratch when you touch your skin.” […] „Don’t be afraid to seek support from friends, family, and professionals. Loved ones can help point out triggers, and kindly try to offer up distractions during those times you start to fixate on picking.” […] „I found it incredibly helpful in my healing process to stay positive. When I was doing really well, and then had a setback, I was bummed, no doubt. But I knew that getting down on myself or demoralized wouldn’t help.”

• #2 Skin Picking Disorder – Dr Davin Lim

  https://drdavinlim.com/skin-picking-disorder/

  If you are serious about treating this condition, you should see a psychologist a psychiatrist. The former can teach you coping skills, the latter can prescribe you drugs. If you are stressed highly anxious, find a solution that can reduce your stress levels. They include acupuncture, yoga, medication, trigger pointing, aromatherapy other fluffy but important avenues. Creams include vitamin E tocopherol, squalene ceramides. They can help establish barrier function reduce the chances of scarring. Do not use AHAs or BHAs on scratched or eroded lesions as this will result in more skin irritation, leading to more scratching. […] Skin picking disorder can be successfully treated if patients want to be treated. Early effective treatment will mitigate skin scars. People who dont accept their condition or have little or no insight will be left with marked, extensive scars that can be difficult to treat. The trifecta of management is via a medical dermatologist (not me), psychologist psychiatrist. A dermatologist is required to exclude organic causes including metabolic, immunobullous, endocrine, paraneoplastic inflammatory causes. In some cases tests are required, including special skin biopsies.

• #2 Skin Picking Disorder: How to Diagnose and Treat It | Vogue

  https://www.vogue.com/article/skin-picking-disorder

  „Understanding ones triggers for picking can help guide which treatment to pursue,” explains Zakhary. „For example, individuals whose picking is triggered by a skin condition such as acne may benefit from a dermatologic consultation. However, if picking is triggered by sadness, anger, anxiety, or more of a general urge, consultation with a mental health professional is recommended.” […] „Most times, when people are picking, they will say they get into a trance state,” she explains. „They don’t really have an awareness of how much they have picked until they’re done.” Once triggers have been pinpointed, most experts will recommend some form of specialized Cognitive Behavioral Therapy (CBT) „It teaches strategies to reduce picking such as stimulus control, which is modifying ones environment to decrease the chance of picking,” explains Zakhary, citing examples such as keeping fingernails short, wearing gloves when likely to pick, or distracting your hands with silly putty or fidgets.

• #2 Compulsive Skin Picking – Therapy & Counseling for OCD & Eating Disorders

  https://kimberleyquinlan-lmft.com/compulsive-skin-picking/

  There is no one exact cause of Excoriation disorder. However, one important step of learning how to stop picking your skin involves identifying the stressors and triggers that cause your urges. […] Overcoming these and other body-focused repetitive behaviors such as trichotillomania is not as easy as a quick Google search of how to stop picking your nails and is not just a matter of willpower. […] Our staff are all thoroughly trained in Cognitive Behavioral Therapy (CBT), the gold-standard treatment for Excoriation Disorder. […] Habit Reversal Training (HRT) is a specific science-based behavioral modality used by our staff to help you reduce your urges and strategically plan for triggers and urges. […] We also teach our patients and clients how to implement mindfulness skills into their daily life. […] Lastly, research has shown that implementation of compassion-focused therapies can improve your recovery success and can increase relapse prevention. […] Our therapists are all highly skilled in assessing and treating Excoriation Disorder.

• #2 Skin Picking (Excoriation) | Symptoms & Treatments | Zencare — Zencare

  https://zencare.co/mental-health/skin-picking

  Many treatment options are effective in reducing skin picking behavior, such as: […] Therapy is an important component of treatment for skin picking disorder. Treatments such as Habit Reversal Therapy help people increase awareness of how and when they pick their skin, make changes to reduce triggers, and overall better manage and reduce their skin picking behavior, leading to an improved quality of life. […] Given the relative recency of the addition of this condition to the DSM-5, more research is needed to identify the most appropriate treatments. Existing research suggests that, with the help of therapy, many people can successfully reduce their skin picking behavior. […] Habit Reversal Therapy helps reduce skin picking by increasing awareness of how and when urges to do so develop. Clients learn to intervene and make changes to their environment to reduce triggers, and learn alternative behaviors to replace the habit of skin picking.

• #2 Excoriation (skin-picking) disorder: a systematic review of treatment | NDT

  https://www.dovepress.com/excoriation-skin-picking-disorder-a-systematic-review-of-treatment-opt-peer-reviewed-fulltext-article-NDT

  A significant benefit for nonpharmacological treatments, such as cognitive-behavioral therapy (CBT) and habit reversal therapy (HRT), in ED has been suggested. […] Cognitive-behavioral interventions for ED may also be useful when presented in a self-help format that patients access themselves. […] Acceptance and Commitment Therapy (ACT), which entails acceptance and mindfulness strategies, as well as commitment and behavior change strategies, has also been investigated in ED. […] The literature systematically reviewed here, and previous meta-analyses, emphasize the relatively sparse evidence base, but also point to the benefit of behavioral treatments. […] SSRIs have been a mainstay of pharmacotherapy, but there is now evidence from a RCT that NAC should also be considered as a potential intervention. […] In the interim, there is also a need to improve accessibility to efficacious treatments.

• #2 Compulsive skin picking causes and how to stop

  https://www.treatmyocd.com/blog/compulsive-skin-picking

  The most effective treatment for OCD is a specialized form of CBT called exposure and response prevention (ERP) therapy. During ERP, a therapist will teach you response prevention techniques, which are exercises that help you refrain from engaging in compulsions. […] If you believe you might be dealing with a BFRB and OCD simultaneously, speak with your therapist about a combination of HRT and ERP to get your symptoms under control.

• #2 International OCD Foundation | Comprehensive Behavioral (ComB) Treatment for Skin Picking and Hair Pulling Disorders

  https://iocdf.org/expert-opinions/comprehensive-behavioral-comb-treatment-for-skin-picking-and-hair-pulling-disorders/

  ComB treatment (Mansueto et al., 1997) is the clinician’s task of working collaboratively with the patient, first to identify and then to change relationships with factors that trigger BFRB behaviors, and variables that serve to maintain the BFRB (i.e., what is happening that is reinforcing the behaviors). Treatment begins with an in-depth structured assessment to identify an individual’s unique pattern of variables that foster the performance of their BFRB. Change is accomplished when established behavior patterns are interrupted, and non-harmful or healthy alternatives are substituted to meet the functions served by hair pulling or skin picking for a given individual. […] Alternative behaviors are carefully chosen within five categories of factors that have been identified as relevant to each person’s unique BFRB profile. Treatment is modified, as necessary, in response to feedback regarding the usefulness of specific treatment recommendations. With practice, it is expected that triggers and reinforcers for pulling hairs or picking skin will weaken as healthy alternative habits are established.

• #2 Im new here and need help! | SkinPick.com

  https://www.skinpick.com/node/101085

  Im just looking for effective preventative measures some other folks take? […] But Id love some suggestions to help prevent further picking. […] Have you tried creating barriers like wearing gloves or using adhesive bandages on the fingertips to make picking more difficult? […] Additionally, practicing mindfulness and deep breathing exercises can assist in managing the impulse to pick. […] I’d highly recommend considering therapy as it can help minimize the urges and provide effective tools to manage skin picking behaviors. […] They can assist in developing personalized strategies to cope with the urges, identify triggers, and work towards reducing skin picking episodes. […] I have found success with mindfulness exercises including deep breathing, watching the Naturescape channel which shows scenes of nature 24/7 and spending time with my puppy.

• #2 Skin-Picking (Excoriation) Disorder – Mental Health Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/mental-health-disorders/obsessive-compulsive-and-related-disorders/skin-picking-excoriation-disorder

  Cognitive-behavioral therapy (habit reversal therapy) that specifically focuses on skin-picking disorder and certain antidepressants or N-acetylcysteine or memantine may help lessen symptoms. […] Cognitive-behavioral therapy in particular, habit-reversal therapy that specifically focuses on skin-picking disorder is the therapy of choice. For habit-reversal therapy, people are taught to do the following: […] Become more aware of their skin picking […] Identify situations that trigger the behavior […] Use strategies to help them stop themselves from picking at their skin for example, by substituting a different activity (such as clenching their fist, knitting, or sitting on their hands) for skin picking. […] N-acetylcysteine (NAC) and memantine both act on the glutamatergic system, and may reduce skin-picking. Treatment with selective serotonin reuptake inhibitors (a type of antidepressant) or clomipramine may also be useful and may improve the symptoms of any coexisting depression or anxiety disorders.

• #2 Skin picking prevention and mitigation techniques

  https://pickingme.org/blog/blog.html/article/2018/07/19/skin-picking-prevention-and-mitigation

  When not in a picking state of mind, it can be helpful to write down triggers. After creating this list, try to manipulate your environment to help further your progress. Specifically, eliminate objects that may encourage picking or are directly used for picking. […] Although it can be scary to tell someone that you struggle with a BFRB, talking to someone you trust and asking for help can go a long way in furthering your progress.

• #2 Hair pulling and skin picking: How to help your child stop repetitive behaviors

  https://health.ucdavis.edu/news/headlines/hair-pulling-and-skin-picking-how-to-help-your-child-stop-repetitive-behaviors/2023/02

  With younger children, if a high-risk time for pulling or picking is watching TV, we would have a basket of fidget toys by the couch. […] Another strategy we use is stimulus control. This means were doing something that blocks the behavior. […] One goal is to really reinforce the strategies. If you catch your child picking up a fidget before watching TV, praise them or give them a reward for that.

• #2 How to Stop Skin Picking for Even Just a Second | SELF

  https://www.self.com/story/how-to-stop-picking-skin

  If you do start picking, think of your reasons for wanting to break the habit in order to help you stop, says Dr. Piacentini. […] This is a very tough habit to break, so dont be too self-critical, says Petersoninstead, these redirections are helpful to remind the person that they are stronger than the urges, he says. […] There are a million other things to do with your handsand with a little focus and effort, youll find what works for you too.

• #2 Skin Excoriation Therapy | Treat Skin Picking in Philadelphia

  https://anxietyocdphilly.com/skin-excoriation-therapy-philadelphia/

  Explore our treatment approaches for a deeper understanding of how we can support your journey to recovery. […] If you’re ready to confront compulsive skin-picking and embark on a path toward recovery, contact us for a personalized consultation. […] For a comprehensive selection of websites, books, and specially designed therapy worksheets including tools for tracking BFRBs, make sure to explore our Skin Excoriation and BFRB Resources Page. […] We are committed to your wellness journey, every step of the way. Reach out to us today for further information about skin excoriation therapy options.

• #2 A case report of an atypical severe case of skin picking disorder managed by a multidisciplinary team | BMC Psychiatry | Full Text

  https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-024-05712-4

  Healthcare providers need to be aware that skin picking disorder can have significant impact on a patients life. If presenting primarily to a non-psychiatrist, the treating clinician needs to be aware of when to escalate for further treatment. Diagnosis, education, psychotherapy and potentially pharmacological management may be required. Severe cases should be referred to a psychiatrist specialist service and due to the level of mortality, comorbidity and even mortality that can be associated with this, may even need to be prioritized as urgent.

• #2 International OCD Foundation | Comprehensive Behavioral (ComB) Treatment for Skin Picking and Hair Pulling Disorders

  https://iocdf.org/expert-opinions/comprehensive-behavioral-comb-treatment-for-skin-picking-and-hair-pulling-disorders/

  In the final phase of formal treatment, the client is encouraged to continue with ongoing assessments of progress and to modify the use of interventions as needed. A shift is made from reliance on therapist guidance toward self-management and utilization of skills and techniques learned during formal treatment. The focus is on maintenance, extension of the gains achieved during formal therapy, and preparation for setbacks that are common during the recovery process. Relapse prevention training provides a systematic approach to minimizing setbacks and keeping them from leading to a full-blown resumption of hair pulling or skin picking. […] The last several decades have seen much progress toward understanding and treating BFRBs. The ComB treatment model guides assessment across a broad range of features for a comprehensive view of each individual’s BFRBs. When used as a guide, it points to a broad range of potential treatment avenues that might be unavailable with a more limited view of the disorder. While outcome research on ComB and other CBT therapies for BFRBs continues to clarify the effectiveness, efficiency, and acceptability of these approaches, decades of informal clinical observation and testimonials by numerous expert clinicians employing ComB treatment for BFRBs support the following conclusions regarding ComB:

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