Mirror, mirror on the wall: A Tale of Skin Picking

What if there were no mirrors. Would you treat your skin and yourself with more kindness and compassion? And would it make skin picking any less frequent?

So here’s the thing. My nails look great long. Thanks to my great grandmother on my father’s side, my hands often receive lots of compliments and as such they’re my favourite feature. But they hide a big secret. You see, it’s more common to find me with nails cut right back. And that’s because I’m a chronic pimple picker. I have been for as long as I can remember getting pimples (and that’s some time) which means I have a very interesting relationship with my nails and my bathroom mirror.

The great, and sometimes disturbing, thing about studying Psychology is that you just want to analyse and diagnose your own issues – give yourself a label to make things a bit easier. And so, naturally, when our course turned toward anxiety and OCD behaviour I wanted to know what on earth was going on with all my pimple picking.

Yes, YouTube is now filled with cathartic videos of epic pimple popping battles (Dr. Pimple Popper you are my hero) but I like to pick in private, even at things that aren’t really even there, and especially when I’ve had a hard day or not feeling so great about myself. But rather than get all DSM-5 on my own symptoms, here is where an expert is needed – because anecdote is one thing but professional diagnosis is another.

If I didn’t have a mirror, would I still pick at my face and what is behind all of this? One of my favourite dermatology textbooks has a great section call ‘skin and the psyche’ briefly delving into pathological skin picking and in particular zit picking. I took this idea to my first-year psychology tutor, Samantha Joplin, who is a clinical psychologist and says it is not uncommon for a healthy person to occasionally pick at pimples, scabs, or even healthy skin.

Samantha Joplin, who is a clinical psychologist says it is not uncommon for a healthy person to occasionally pick at pimples, scabs, or even healthy skin.

“In Clinical Practice, the condition would be diagnosed using the DSM-5 (a manual used by mental health practitioners to classify various psychiatric and psychological disorders). The ‘technical’ diagnosis is “Excoriation (Skin-Picking) Disorder” and this diagnosis falls under the ‘Obsessive-Compulsive’ umbrella,” she explains.

“The most commonly picked body areas are the face, arms, and hands, but many individuals pick from multiple body sites and still meet the diagnostic criteria. Importantly, the individual is not just picking at pimples/skin abnormalities. Indeed, in a lot of cases the individual is picking at perfectly healthy skin!”

Thinking I have a skin picking problem versus an actual disorder is a very different thing. Samantha highlighting that to be diagnosed with exoriation disorder, rather than just non-clinical ‘pimple popping’, the individual is required to meet distinct diagnostic criteria evaluated by a Clinician who would also conduct a thorough psychological assessment of the skin picking behaviour prior to knowing the best method for treating it. No, this is not the place for Dr Google or phone a friend.

And so, while I don’t have a diagnosed disorder I do have a personal action plan that involves keeping my nails short, trying to avoid over-analysing skin in the mirror and keeping the bathroom light dim – those beauty mirrors in hotel bathrooms are a real killer for me! It also includes checking on on my own mental health and self-esteem, importantly not being so hard on myself when things all get a bit much.

Like others, I know I shouldn’t pick at my pimples but sometimes it really isn’t that simple. Luckily, skin can be a forgiving beast and every day is a new skin day.

Samantha Joplin is a Clinical Psychologist: Registered Psychology (Clinical Reg.), B.Psych (Hons1), D.Psych, PhD (Candidate), MACPA #skinfitsister

SkinFit Tip

'If you think you have a problem with skin picking seek out a Clinical Psychologist. You may first need to consult your GP to obtain a mental health care plan and referral' - Samantha Joplin #skinfittip

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