Question 1

Can you tell me more about skin picking. Is it anxiety or OCD related. How is it treated? Are medications helpful?

Matthew Traube · Accepted Answer

When treating skin picking, hair pulling or other body-focused repetitive behaviors it’s important to recognize that it can be both a behavioral problem and an emotional one. Both problems need to be treated. Skin picking for example, can be used to relieve emotional discomfort, physical discomfort, or a blend of the two. People tend to pick when they are anxious or stressed, but many people are surprised to learn that people also pick when they are feeling relaxed, watching television or using a computer. Many of my clients often describe being in a trance-like state and not being fully aware of the behavior. They might be working on a stressful project while they are simultaneously picking. They might be watching a stimulating television show and unaware that they are simultaneously picking. It is widely believed that skin picking can be associated with anxiety or OCD. People are often unaware that they are doing it.

Although there is seldom a magic bullet, the key is to figure out when it is happening and what the motivation behind the behavior is. Then find practical tools to change it. For example, on one level I might advise someone to spend less time in the bathroom if looking into the bathroom mirror triggers the urge to pick the skin. If you are vulnerable to picking your scalp while working at the computer, you might wear a hat. It’s common for people to pick more when they are alone, so I might suggest creating a weekly schedule that reduces the time someone is spending alone. Social support is an important tool.

Question 2

Question 3

Question 4

What is psychodermatology?

Matthew Traube · Accepted Answer

Psychodermatology is how the mind influences the skin and how the skin influences the mind. I help people deal with the psychological aspects of skin conditions. Skin conditions can affect self-esteem, relationships and professional development. I help people put the skin problem in perspective so they can better deal with their lives.

Question 5

What are the first steps to stopping a routine of fixating on the skin?

Matthew Traube · Accepted Answer

First, consciously identify your behavior patterns. So much of how we live is on autopilot. Many people that I speak with will say that the first thing they do in the morning is think about their skin. Then there will be predictable times throughout the day where they gravitate towards focusing on their skin. Here’s the tricky part, when I ask people during sessions when they focus on their skin, most people can tell me without thinking too much about it, but in the moment, many people don’t fully recognize when they are putting so much focus on their skin. I believe it’s hard to change a habit if we do not consciously identify when it’s happening. I generally tell my clients to start by consciously identifying when they are focusing on the skin. Once they get better at identifying the habit, they will then get an opportunity to learn how to make a choice about how to manage it. They can either continue the habit or work on changing the habit.

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