Most of us have squeezed a pimple at some point in our lives. But for some, the temptation to squeeze or pick at a spot can turn into an obsessive compulsion. This obsessive picking of the skin is especially common in women with chronic breakouts, and is often a response to dealing with stress or anxiety.

What is skin picking?

Skin picking is a mental health disorder associated with obsessive compulsive disorder (OCD). It’s characterised by a compulsion to pick at the skin, which often causes a wound or permanent damage.

With chronic breakouts, the skin picking is directed at picking active inflammations, as well as the squeezing and picking of blackheads and clogged pores. Skin picking is more common when the breakouts appear on the face or neck areas, as the visibility can cause stress and anxiety.

The condition begins with obsessive thoughts about the skin feeling “dirty”, or as if the core of an inflammation or clogged pore needs to be squeezed out in order for the skin to heal faster. It can also be that the you feel a compulsion to keep looking in the mirror at your breakouts, or to study each spot up close and in more detail.

In reality, the healing process is not sped up by picking or squeezing the skin at all, and definitely not by spending more time looking at it. And in most cases the picking makes the inflammation worse, or visible wounds are created out of nothing.

What causes the compulsion to skin pick?

The root cause of skin picking is usually tension, anxiety or stress. Experiencing breakouts is stressful, especially for women who may feel pressure to have clear and beautiful skin.

Along with the general stress of having breakouts, healing blemishes can take days, and even weeks if there’s scarring. So a woman’s anxiety levels can be stretched out to uncomfortable lengths of time, as she needs to be patient with her skin’s appearance, even if she’s on a good regime and her skin is healing.

This anxiety and stress can manifest as a compulsion to pick at the skin in the hope that it will clear up faster. In some very rare cases technically this can be true if the core of the inflammation is removed, but in most cases squeezing or picking will make the inflammation worse, or even cause permanent scarring or an infection. Here’s how:

• Picking or squeezing can worsen the inflammatory response around the lesion, causing increased redness and swelling.
• The inflammation can bleed or release serous fluid, causing a visible scab.
• Squeezing a pimple can cause the bacteria to enter into the bloodstream of the body, spreading the bacteria and causing an infection.
• Aggressive picking can cause permanent scarring to the skin.

People tend to pick at their skin because there’s a sense of satisfaction or relief in the physical act. As if by squeezing an inflammation it’s going to make the pimple go away faster. Focusing so intensely on the task can also put the skin picker’s mind into the present moment, where all of their uncomfortable emotions and anxieties temporarily dissolve away.

However, after a skin picking episode it is common to feel a sense of depression. In the case where it was a breakout that was being squeezed or picked, this is usually because the picking made the appearance worse.

How to recover from skin picking

Recovering from skin picking requires self compassion and patience.

The first step is to be aware that picking and squeezing your skin is not going to help speed up the recovery process. In fact it’s likely going to make it worse.

It’s also important to reflect on why you feel that you’re doing it. Are you picking your skin because you think it’ll help it heal faster? Or do you find that you’re picking when you feel overly stressed or anxious about something? Be curious with your why, and learn what the root motivation is for you.

Once you have the awareness you can begin to retrain yourself to deal with stress and tension in healthier ways. Even if it’s stress and tension about your skin.

First, it’s recommended to refrain from looking in the mirror so much. If there are mirrors in your house that you pass by often and don’t need to look into, consider temporarily covering them. Don’t worry, you won’t need to do this forever, it’s just while you’re in the process of recovery.

As skin picking is usually a response to tension, stress or anxiety, managing your anxiety levels is going to be very important in your recovery.

There are so many ways that you can work on reducing your stress and anxiety, and what works best will be unique to you. You might be helped by working with a calming app on your phone, a daily meditation practice, breathing techniques, regular exercise, or by working with your parasympathetic nervous system. Whatever you choose, make it a daily practice.

The next step is to set yourself an achievable goal. How long do you feel that you can go without picking or squeezing your skin? Perhaps begin with just 24 hours.

If you don’t reach your goal it’s okay! Just reset the clock and begin again, you’ll get there.

After you’ve made it to your first timeframe goal, set a new one that’s a little bit longer. The same rules apply here – if you don’t make it, don't be hard on yourself, just reset the clock and try again. There is no such thing as failure, just a “not yet”.

Eventually you’ll find that you’ve managed to kick the habit and you’re no longer acting on the compulsion to pick or squeeze at your skin. The obsessive thoughts may come up from time to time, especially in stressful moments, but you’ll have taught yourself to bust out of the pattern, and you’ll no longer be acting on the compulsion.

If however you find that you’ve tried the above methods and you’re still struggling with obsessively picking at your skin, please book in with a therapist or psychologist for better individual support.