Skin Picking: Is It a Sign of OCD?

Skin picking issue

Hello doctor, I have developed a habit of picking at the skin of my ears over the past two years.
I have sensitive skin, which has caused the skin on my ears to become rough.
I have seen a dermatologist and used medication, and it was getting better, but I can't help but unconsciously pick at the skin, trying to make the surface smooth.
I often end up picking until it bleeds before I stop.
This repetitive action has made the skin on my ears thicker, and I feel an urge to tear it off, which prevents the wounds from healing properly and leaves them looking unsightly.
I also have a habit of picking at uneven areas of skin on my scalp and forehead, as I want to make the skin smooth.
Could this be a sign of obsessive-compulsive disorder (OCD)? I read an article that mentioned skin picking disorder might be a form of OCD, and it talked about repetitive behaviors like picking at skin and nails.
I have had a habit of picking at my nails since childhood, but since I started picking at my ears, I have done it less frequently.
I am very concerned about causing an infection, but I still can't resist picking.
After reading the article, I am worried that I might have OCD.
Should I see a doctor about this, or is it better to leave it alone? Thank you, doctor.

Bu Bu, 20~29 year old female. Ask Date: 2016/12/19

Dr. Zhong Mingxun reply Psychiatry

Based on your description, it does not seem to align with the diagnosis of obsessive-compulsive disorder; however, the habitual picking of ear skin may likely stem from your anxiety.
It might be a good idea to seek an evaluation from a mental health professional.

Reply Date: 2016/12/19

More Info

Skin picking, also known as dermatillomania, is a condition that can indeed be associated with obsessive-compulsive disorder (OCD). It is characterized by the compulsive urge to pick at one's skin, which can lead to noticeable skin damage, scarring, and infections. Your description of picking at the skin around your ears and scalp, especially to the point of bleeding, suggests that this behavior is not merely a habit but may be indicative of an underlying psychological issue.

The connection between skin picking and OCD lies in the compulsive nature of the behavior. Individuals with OCD often engage in repetitive behaviors or mental acts in response to obsessions, which are intrusive thoughts that cause significant anxiety. In your case, the urge to smooth out rough patches of skin may stem from an obsessive thought about the appearance or texture of your skin. This can create a cycle where the act of picking provides temporary relief from anxiety but ultimately leads to more distress due to the resulting skin damage.

It's important to note that skin picking can also be a symptom of other conditions, such as body dysmorphic disorder, where individuals have a distorted view of their appearance. Regardless of the specific diagnosis, the behavior can lead to significant emotional distress and physical harm, as you have experienced with the thickening of the skin and the risk of infection.

In terms of treatment, it is advisable to seek help from a healthcare professional, particularly a dermatologist or a mental health specialist. Cognitive-behavioral therapy (CBT) has been shown to be effective for many individuals with skin picking disorders. This type of therapy can help you identify triggers for your picking behavior and develop healthier coping mechanisms. Additionally, some individuals may benefit from medications that target OCD symptoms, such as selective serotonin reuptake inhibitors (SSRIs).

In the meantime, there are several strategies you can implement to help manage your skin picking:
1. Awareness: Keep a journal to track when and why you feel the urge to pick at your skin. Understanding your triggers can help you develop strategies to avoid them.

2. Substitution: Find alternative activities to occupy your hands, such as squeezing a stress ball or using fidget toys.

3. Barrier Methods: Consider wearing gloves or bandages on the areas you tend to pick to physically prevent access to the skin.

4. Skin Care: Maintain a proper skincare routine to keep your skin healthy and reduce the urge to pick. This might include moisturizing and using gentle exfoliants as recommended by your dermatologist.

5. Mindfulness and Relaxation Techniques: Practices such as meditation, deep breathing, or yoga can help reduce anxiety and the compulsive urge to pick.

In summary, your skin picking behavior may be a sign of a deeper psychological issue, possibly related to OCD. It is crucial to consult with a healthcare professional who can provide a proper diagnosis and treatment plan tailored to your needs. Addressing this behavior early can help prevent further skin damage and improve your overall well-being.

Similar Q&A

Understanding Compulsive Skin Picking: Causes and Concerns

Hello Doctor: In the past six months, I have noticed that my friend's mother often picks at her face during her free time to the point of bleeding (on her freckles). She claims this is due to an excess of toxins in her body. Even after healing, she continues to pick at her s...

Dr. Sun Xiaoru reply Psychiatry
Dear User, From your letter, it seems that your friend's mother is experiencing significant distress. However, it is not yet clear whether this has reached the level of delusions or compulsions. The diagnosis of mental illness requires an in-person evaluation. Therefore, I ...

Understanding Lip Picking: OCD or Anxiety Disorder?

Hello, doctor. I am a senior student. For the past three years, my family has been constantly reminding me not to pick at my lips, but I don't know why I can't control it. In my memory, I started pulling my hair in elementary school, and during my third year of junior h...

Dr. Huang Xiaoxian reply Psychiatry
Dear Joseph, thank you for your question. I can tell that this situation is causing you a lot of distress. Many people exhibit repetitive behaviors to alleviate anxiety, such as leg shaking, nail-biting, or skin picking. Some individuals can regulate the frequency of these behavi...

Uncontrollable Face Picking: Understanding the Psychological Struggle

Hello, I am about to turn 22 this year. My facial skin did not have any acne issues during puberty, nor did I have any allergies. However, at some point, I started to unconsciously want to pick at my facial skin with my fingers, even though there are no pimples or blemishes on my...

Dr. Wu Enliang reply Psychiatry
Hello, internet user: It seems that these compulsive behaviors may be related to anxiety. If this is causing significant distress, it is advisable to seek help from a nearby mental health facility. Dr. Wu En-Liang.

Understanding Compulsive Habits and Depression: Seeking Help from a Psychologist

I have had a bad habit since childhood of unconsciously picking at my fingers, often to the point of bleeding. Is this a sign of obsessive-compulsive disorder? Additionally, I sometimes feel that life is devoid of joy and experience low mood. Could this be depression? Is there a ...

Dr. Chen Wenyu reply Psychiatry
Hello BOBO: It is indeed difficult to determine whether the behavior of picking at your fingers is a sign of obsessive-compulsive disorder, as such behavior can also occur in situations of anxiety. If you have been experiencing prolonged low mood, it is worth considering the poss...