How to Help a Child with Compulsive Skin Picking Behavior

If a child frequently tears the skin around their fingers, what should be done?

The little girl has just entered the third grade of elementary school and frequently picks at the skin around her fingers.
Although it does not reach the dermis and is not severely painful, it is extremely frustrating to witness.
Despite trying various approaches, both gentle and firm, there has been no improvement.
It seems she is unable to control this compulsive behavior.
We have taken her to a dermatologist and applied ointments, but she continues to engage in this behavior.
I would like to ask the doctor if she should see a psychiatrist or if there are any methods that could help her.
Thank you.

Yan Zi, 40~49 year old female. Ask Date: 2009/12/11

Dr. Wang Chongren reply Psychiatry

Dear Dr.
Wang Chong-Jen of the Tainan Hospital, Department of Psychiatry, Executive Yuan Health Department:
Greetings.
Clinically significant compulsive behavior refers to a persistent and repetitive behavior, often exhibited by individuals to alleviate intrusive thoughts or impulses that arise from within.
This indicates that the individual is frequently under considerable stress, which may stem from physiological, psychological, or interpersonal factors.
The behavior of your daughter may be indicative of compulsive behavior, but it does not necessarily mean she has Obsessive-Compulsive Disorder (OCD).
You might consider having her evaluated by a child and adolescent psychiatrist.

Wishing you good health and peace of mind from the Tainan Hospital, Department of Psychiatry, Executive Yuan Health Department!

Reply Date: 2009/12/11

More Info

Helping a child with compulsive skin picking behavior, also known as dermatillomania, can be challenging for both the child and the caregivers. This behavior often stems from anxiety, stress, or even boredom, and it can become a compulsive habit that is difficult to break. Here are some strategies and considerations to help manage this behavior effectively.

Understanding the Behavior
1. Identify Triggers: It’s essential to observe when and why your child engages in skin picking. Is it during stressful situations, when they are bored, or perhaps when they are watching TV? Understanding the triggers can help in addressing the underlying issues.

2. Emotional Connection: Children often engage in compulsive behaviors as a way to cope with emotions. It’s crucial to create an environment where your child feels safe expressing their feelings. Encourage open communication about their emotions and validate their feelings.

Practical Strategies
1. Keep Hands Busy: Providing alternative activities that keep your child’s hands occupied can be beneficial. Consider giving them stress balls, fidget toys, or engaging them in crafts that require the use of their hands.

2. Set Up a Reward System: Implement a reward system for days when your child refrains from picking their skin. Positive reinforcement can motivate them to change their behavior.

3. Create a Routine: Establishing a daily routine can help reduce anxiety and provide a sense of stability. Incorporate calming activities such as reading, drawing, or yoga to help your child manage stress.

4. Skin Care Routine: Sometimes, skin picking can be exacerbated by dry or irritated skin. Establish a gentle skin care routine that includes moisturizing to reduce the urge to pick. Consult a dermatologist for suitable products that can help soothe the skin.

Professional Help
1. Consult a Mental Health Professional: If the behavior persists despite your efforts, it may be beneficial to consult a mental health professional, such as a psychologist or psychiatrist. They can provide cognitive-behavioral therapy (CBT), which is effective in treating compulsive behaviors. Therapy can help your child develop coping strategies and address any underlying anxiety or stress.

2. Consider Family Therapy: Sometimes, involving the family in therapy can help address dynamics that may contribute to the child’s behavior. Family therapy can improve communication and support within the family unit.

3. Medication: In some cases, medication may be prescribed to help manage underlying anxiety or obsessive-compulsive tendencies. This should always be discussed thoroughly with a qualified healthcare provider.

Monitoring Progress
1. Keep a Journal: Encourage your child to keep a journal of their feelings and behaviors. This can help them become more aware of their triggers and patterns, and it can also serve as a tool for discussion during therapy sessions.

2. Regular Check-ins: Have regular discussions with your child about their progress. Celebrate small victories and provide support during setbacks. This can help them feel understood and less isolated in their struggle.

Conclusion
Compulsive skin picking can be a distressing behavior for both the child and the caregivers. By understanding the triggers, providing alternative activities, and seeking professional help when necessary, you can support your child in overcoming this challenge. Remember that patience and consistency are key, and it’s essential to create a supportive environment that encourages open communication about feelings and behaviors. If the behavior continues or worsens, do not hesitate to seek help from a mental health professional who specializes in childhood behavioral issues.

Similar Q&A

Helping Your Child Overcome Nail Biting and Anxiety Issues

Hello Doctor: I have three children at home, and my second daughter is in the second grade of elementary school this year. She has been raised by her grandmother since she was little, and every week when she comes back, she cries very hard. She started school in kindergarten, but...

Dr. Song Chengxian reply Psychiatry
Hello, everyone: Nail biting, picking at nails, or digging at the skin around the fingers in children is often a sign of anxiety. Your older child not only bites their nails but also experiences nighttime crying and difficulty sleeping, which clearly indicates some distress or di...

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 ...

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.

Managing Finger Biting in Children with Rare Metal Excretion Disorders

Dr. Hsu: I would like to ask you a question. A colleague's child has a metal excretion disorder and was originally a lively child. Gradually, they have lost the ability to walk and their body has become stiff. Currently, they are uncontrollably biting their left index finger...

Dr. Xu Shanjing reply Rare Disease
Hello Ah Hua: The child's behavior resembles obsessive-compulsive disorder, but it may not be typical OCD. It would be advisable to consult a child psychiatrist in the mental health department to explore this aspect. You might consider trying OCD medications for 1-2 months t...