As a side effect of my generalised anxiety disorder, I aggressively scratch and pick at my skin, a condition professionally known as dermatillomania. It often bears the unpleasant feeling of not being able to stop; often, individuals with the condition do it subconsciously. Every day (usually without being aware) I claw at my forehead, jawline or back until my skin bleeds; I rub and pick at the skin of my lips until it hurts to eat or drink anything hot. It is an obsessive habit.
I'm not alone. There are lots of us (figures suggest between 1.4% and 5.4% of people) who are affected by dermatillomania to varying degrees, and with an unpredictable and stressful situation like the coronavirus outbreak, it is likely that there will be many of us scratching, touching or playing with our skin as we try to process our nerves. Because it is vital that we avoid touching our face during this time in particular, I asked Dr Susan Mayou, consultant dermatologist at the Cadogan Clinic, how best to avoid it.
In Dr Mayou's opinion, it's important to form new habits. She recommends using sensory tools such as stress balls, or even jade or other crystal rollers (which must be regularly disinfected) for their cooling and therapeutic properties. Popping something like bubble wrap is also proven to help some patients, while Dr Mayou suggests distraction tactics. "The pressure point in the webbing between your thumb and index finger not only relieves anxiety but forces hands away from the face," she added. "Massage this pressure point every time you have an urge to pick or touch your face, lips or eyes."
The skin on your cheeks, chin and forehead is an easy target. If your skin is dry, you may be more inclined to pick at any flakiness. Dr Mayou says that a good skincare regime is essential in helping manage underlying skin concerns like this, and it all starts with cleanser. Dr Mayou recommends using Bioderma Sensibio H20, £10.80. "This is great for dry or sensitive skin and gently removes makeup without irritation." Also try Dermol 500 Lotion, £11.95, an antimicrobial emollient cleanser rated by most UK dermatologists, especially if you're prone to parched patches. "This is an excellent soapless skin cleanser as well as a moisturising lotion," adds Dr Mayou. "It can be used in conjunction with other products, too," which allows you to incorporate it into your current routine.
If even cleansing your skin with your hands is likely to trigger your scratching or picking, Dr Mayou recommends using a gentle facial brush. "A facial brush is good for helping to cleanse the skin. A small face stimulator will enable you to touch your face without picking at the skin and without causing trauma. It also may be a good distraction technique."
Try something with gentle silicone bristles, such as Foreo LUNA Mini 2 Facial Cleansing Brush, £99, or Nurse Jamie Brightening Bar with Exfolibrush Silicone Facial Brush, £46.
As patches of dry, loose skin are ripe for picking, it might be time to invest in a targeted skin treatment, which acts like a barrier to hands. Dr Mayou suggests using La Roche-Posay Lipikar AP+, £13. "This is a great product for dry, itchy or irritated skin." If you're tempted to paw at your skin, apply a little wherever you need it, whether that's on your face or body. Dr Mayou advises concentrating it to any areas that flare up or that you’re particularly prone to picking.
If you're prone to spots, you'll know just how tempting it is to pick at your skin, but this will only lead to scarring or red-brown skin staining, which are both difficult to minimise. For those with particularly oily skin, Dr Mayou recommends Bioderma Sébium Purifying Cleansing Foaming Gel, £10.80, to be used daily. If you have already formed open scars or spots, you may need to consider topical antibiotic creams. "It's important for any infection or inflammation to be cleared first," says Dr Mayou. An affordable high street brand she recommends for acne-prone skin is Neutrogena.
Dr Mayou also suggests investing in Kelo-Cote Scar Gel, £32.18, and Dermatix Silicone Gel, £33, as they are both effective at softening and moisturising rough skin, which means you might be less likely to touch it. Regardless of skin type, avoid any harsh products that sting or irritate skin, for example those with a high concentration of acids or high dose retinol. These are known to cause redness and itchiness, prompting you to touch your skin more.
You can also help yourself by keeping your nails in good condition. Dr Mayou advises keeping nails short, trimming or filing them regularly. Ensure you clean under the nails with a nail brush using soap and warm water, and try not to bite your nails or remove the cuticles. If stopping scratching altogether seems impossible, consider wearing gloves. "Gloved fingers are much more gentle than sharp fingernails and act as a reminder not to touch or pick." Nitrile gloves, for example, are like a second skin but make it much harder to pick and scratch.
If your eyes are the problem area, consider something simple, such as eye makeup. "Wearing statement eye makeup may make you less willing to touch around the eyes," such as eyelashes and brows, says Dr Mayou. If your issue is dry, itchy eyes, invest in some eye drops to relieve irritation and minimise the urge to touch them.
Dr Mayou also endorses deploying similar tactics for lips. "Apply a thick, sticky, glassy coloured lip gloss or balm as it's unlikely you'll want this to transfer." Making sure lips are in good condition is the first step, though. "Remove dead skin with a sugar scrub or even with your toothbrush and apply a good quality lip conditioner, such as Dr PawPaw Original Balm, £6.95. If lips are not dry or chapped you may feel less inclined to pick at them."