The whole process starts innocently enough: You notice the zit that's been brewing on your cheek is really starting to come in strong, so you give it a little squeeze. When it doesn't go away, you give it another one. Then another. And, when it finally pops and scabs, you pick it more, because your makeup isn't falling the right way. Before you know it, you're left with a big, ugly hole in your face that's basically impossible to cover up with makeup.
Skin picking is something everyone has likely dabbled in before. "It comes up a lot in my practice and can be classified in two ways," says Dr. Josie Howard, a San Francisco-based psychologist and psychodermatologist on the advisory board for Simple Skin Care. "There is the disorder and the syndrome. The latter is a less intense, less problematic form of the disorder."
Most people will fall into the syndrome category, as it's characterized by people who pick here and there and then go on their merry way. "When there have been repeated attempts to try to stop picking, coupled with a lot of distress and impairment of functioning, that's when it starts to get into the disordered behavior," Howard says. "Patients may avoid participating in other activities — maybe because of a scar or actually skipping things in order to spend more time picking."
While there is no known cause of skin picking, it's generally believed to be the result of a genetic predisposition. "It's more in people with anxiety," Howard explains. "A lot of folks use it as an emotional outlet or regulation. It becomes a coping mechanism for boredom, anxiety, and feeling tense and fearful." The same can be said for someone with the syndrome, but Howard stresses that the difference comes down to guilt. "A lot of patients with the disorder will report that [extracting] is pleasurable but then feel immense guilt and distress after picking," she explains. It's important to note that picking isn't always acne-related — individuals who cull their skin can also suffer from dryness, scabbing, or keratosis pilaris (also known as chicken skin).
This practice may seem harmless at first, but it can lead to scarring and infection. "That said, I think one of the biggest dangers is the decreased quality of life," Howard says. "People feel shame and embarrassment, and it starts to affect them."
Individuals with the disorder should seek professional help to find the root cause of their picking. If it sounds like you fall more in the syndrome category, however, there are steps you can take to curb your bad habit. "People are definitely helped by noticing what their patterns are," Howard says. "They'll sit at the computer and mindlessly pick, so it helps to have something in your hands. People also cut their nails short and do manicures to help them stop."
Once you do quit the pick, you may find your skin looks a lot better, too. "It's usually the reminder that your skin heals faster when you're not picking at it that turns people around," Howard explains. "They realize that once they stop touching, their acne clears up, and what they were doing...was actually the opposite of helpful." Sounds like reason enough for us to keep our paws off our pimples.
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