When you ask, 'What's your worst habit?' even someone as polished as Kate Middleton can give you answer. It's normal to have something in your life you know you should stop — whether it's spending $10 on coffee every morning or incessantly clicking your pen at work — but can't quite shake.
It was during my senior year of high school, when the pressure of college applications and five different extracurricular activities had my stress at an all-time high, that I picked up my bad habit. I'm not talking about facing the two-liter soda bottles that my friends transformed into bongs or spending hours on iChat. I'm referring to the skin-picking habit that I now know is called dermatillomania.
In response to all the stress of finishing up school and starting a new chapter of my life, I was constantly picking at the skin around my nails. I knew other people didn't pick at their cuticles to the same extent, but it was as normal to me as nail biting or pimple popping. And even when I graduated from high school and made my way through college, the repetitive habit remained. It didn't matter how stressed or relaxed my life was at the moment.
But I didn't realize how much of a problem it was until people started asking me, "What happened to your fingers?" They'd assume that I was burned, and I would go along with that story saying, "Ugh, my curling iron." Because who would question that? I was also hiding my hands in photos and constantly making a fist so that my ravaged fingers wouldn't be exposed.
Sometimes I'd pick too far into my skin, and my finger would begin to sting, like a paper cut. So, I'd move on to another finger. Eventually it got to a point that I was damaging the skin to the extent of bleeding. And I didn't know it at the time, but I was opening up my fingers to all kinds of bacteria. "You can create an open wound and increase your risk of infections," says Joshua Zeichner, MD, director of cosmetic and clinical research at Mount Sinai Hospital. "Bacterial infections are most common, and they can lead to what is called an acute paronychia, where bacteria enters the skin [around the nail] causing a red, painful finger that may fill up with pus." Thankfully, it never got that bad for me.
But one day I found myself putting Band-aids around my thumbs and index fingers to stop them from bleeding all over my keyboard, and I realized that this habit was a significant problem in my life. So I went to Dr. Google, and that's where I learned that skin-picking disorders are actually pretty common.
"Skin picking is a natural grooming behavior that most humans engage in at some point or another," says Sarah Parker, PhD, who is the director and co-founder of The Reeds Center, a treatment center for anxiety, OCD, and related disorders. "It becomes a problem when a person notices that the picking interferes with things that they would rather be doing, or the picking leads to consequences that are difficult to live with, or the picking causes a level of distress."
After graduating from college and starting my career, I was at that point of distress, and so I decided to seek help. Most websites recommend seeing a therapist for treatment, since skin picking is closely linked to anxiety. Although I wasn't the biggest fan of the therapist I visited, two good things came out of my one appointment. First, I received confirmation that I had an excoriation disorder (a.k.a. chronic skin picking or dermatillomania). Second, the therapist encouraged me to look at the exact triggers that made me pick at my skin.
After catching myself in the act a few times, I realized that the catalyst for my picking was normal everyday anxieties, whether it was being late to work or a nerve-racking season finale of Scandal. I knew that there were treatments available, like habit reversal training, but my stubborn tendencies made me want to figure it out on my own — and I found my skin-picking solution in an unexpected place.
One day I was getting a manicure for an event and decided at the last minute that I wanted to get acrylic nails (which are artificial nail extensions placed over the fingernails). With my damaged skin, I needed to make my fingers look somewhat decent. And after having the acrylic on for three weeks, I realized that I hadn't picked at my fingers and my skin was actually growing back. The almond shape and the length of my acrylic nails made it impossible to get a grip to pick at my skin. So, I made the decision to keep refilling my nails, and with time, my fingers began to finally look normal.
"What helps any given person really varies," says Parker. "Some people find squeezing a [stress] ball to be helpful; some people find having substitute things to pick at to be helpful; people will put barriers on their fingers so it's hard to pick; or they'll use acrylic nails to make it very hard to pick." I came across forums on sites like Reddit and Skinpick.com, where people explained how acrylic nails helped them stop picking, too. And as comforting as it was to see that I wasn't alone, the true test came when I wanted to finally take my acrylic nails off after two months. Would I go back to picking at my skin when my natural nails returned?
The short answer: Yes. I failed after just two days, and so, I ran straight back to the nail salon and requested acrylics again.
"When you break the habit, you may find that same habit rears its head again and you have urges to pick — that's not the end of the world. It's just a part of living with a habit like this," says Parker. "Just get back to the techniques that helped before." I can now say that I no longer pick at my skin the way I used to, and I haven't gotten acrylic nails in months. Of course, I have slipped up more than once, but I am able to catch myself and stop, which I count as success.
Although regular manicure appointments worked for me, this trick might not work for someone else. No matter how many stress balls I squeezed (my mom's recommendation) or hours I spent talking to a therapist, acrylic nails ended up helping me. Now, I deal with stressful situations by either tapping my nails on my desk or listening to yoga radio on Pandora. And my bi-weekly manicures are just for fun, not a necessary coping tool for my picking habit.
For more information on skin picking and cognitive-behavioral treatments, visit thereedscenter.com or call their offices at (212) 203-9792.