Face picking is a common manifestation of dermatillomania, a form of obsessive-compulsive disorder in which people pick at their skin. People might pick at pimples, freckles, moles, or other features on the face, or they might just pick at plain skin.
Treatment for Skin Picking and Face Picking
Treatment for skin picking often involves a combination of medication and therapy.
Medications used to treat dermatillomania include antidepressants like Luvox, Prozac, Paxil, Celexa, Effexor, Lexapro, Zoloft, and Anafranil. These medications help relieve depression and anxiety, which can trigger skin picking. They also increase the amounts of serotonin and other chemicals in the brain, which sometimes helps relieve symptoms of obsessive-compulsive disorder, even in people that don’t experience depression or other forms of anxiety. Medication doesn’t help everyone with dermatillomania but it does help many people with the condition and may be worth a try, especially if your face picking is severe or if you’ve tried other treatments without success.
Counseling, also referred to as therapy, can help with skin picking. There are a number of different types of therapy known to help with dermatillomania, including cognitive behavioral therapy (CBT), habit reversal training (HRT), and exposure and response prevention (ERP). A professional counselor can also teach stress reduction and relaxation techniques, which help reduce the anxiety that often leads to skin picking.
Stimulus control techniques help people avoid skin picking by simply making it more difficult to engage in the behavior. For instance, since many people look in the mirror while picking at the skin on their face, covering mirrors or removing mirrors from the home may help. Some people pick at their faces with their fingers, but others use tweezers or some sort of sharp objects like needles. In those cases, removing tweezers, needles, or other items used for face picking from the home can help.
Sometimes people with acne or other skin problems on their faces tend to do a lot of picking, and if that’s the case, they sometimes benefit from seeing a dermatologist to treat the acne or other skin problems.
Finding Treatment for Skin Picking
If you think you need help for skin picking, start by talking to your primary care doctor. Sometimes people with dermatillomania are embarrassed or uncomfortable talking about skin picking with their doctors, but most doctors have seen the condition before and will be sensitive to your feelings about it. If your doctor seems insensitive or judgmental, you can find a new doctor.
If you want to try therapy to help you stop picking your skin, ask your doctor to refer you to a counselor. You can also check with your insurance company, if you have health insurance, to find out which counselors are covered on your plan. Look for a counselor that has experience treating dermatillomania or other forms of obsessive-compulsive disorder.
If you want to try medication for dermatillomania, ask your doctor to refer you to a psychiatrist. You can also check with your insurance company to find out which psychiatrists are covered on your plan. While your primary care physician can prescribe medication for dermatillomania (any licensed physician can), psychiatrists have much more experience treating the condition and are more familiar with the most effective medications and their potential side effects, so we recommend seeing a psychiatrist for this issue.
Psychiatrists are medical doctors and most don’t do counseling, so if you want to try both medication and counseling, you’ll probably need to see two separate health care professionals. However, in some states psychologists can prescribe medication, and they do counseling, so you might be able to get both from the same provider if you choose to see a psychologist.