Skin picking, habit or disorder? (Photo: Getty Images)

When cuticle picking becomes a compulsion (and how to give it the flick)

We all have bad habits, picking her cuticles till they bleed is Ruby Clavey’s. She went on a mission to get to the roots of her compulsion – and how she can finally be free of it.

Nail-biting, hair pulling, nose-picking, scab picking — most of us have bad habits. Some of us have more than others. Then there are normal self grooming measures, like shaping your eyebrows, giving yourself a manicure, or cleaning under your nails when they’re dirty. 

But there is a line between normal behaviour and intrusive habits that disrupt your life, and a further line between these habits and psychological disorders. 

Dermatillomania is a psychological condition that falls under the category of  body-focused repetitive behaviours (BFRBs). Other BFRBs include trichotillomania (compulsive hair pulling) and onychophagia (compulsive nail biting). BFRBs affect millions but aren’t portrayed in the media, resulting in the behaviours being seen as “bad habits” that could be curbed if the individual tried hard enough. 

Dermatillomania manifests as a compulsive and repetitive habit of picking skin until injury, in order to improve perceived imperfections. 

Dermatillomania has been associated with perfectionism, leading to over-grooming. It can bring relief to people when faced with stressful events and can be triggered by frustration, impatience, dissatisfaction and boredom. While dermatillomania that expresses itself as cuticle picking might appear to be a similar habit to biting your nails, it’s in fact the same kind of compulsion that makes people inclined to pull out their hair. 

Cuticle picking is a body-focused repetitive behaviour, like nail biting (Photo: Getty Images)

An Australian study found that those who have clinical levels of body-focused repetitive behaviours (BFRB) are two to four times more likely to suffer from depression, anxiety and other mental health problems. 

I don’t know when I started picking at my cuticles, but by the end of my final year of university I couldn’t avoid my dry and damaged hands any longer. A simple google search taught me that this isn’t just a bad habit, but a result of stress that could lead to tissue damage, scarring, discolouration and possible staph infections. 

Maybe it was the stress of final assignments that triggered me to over self-groom, or maybe the grim year of 2020 decided to throw another curve ball in my direction. Either way, Aunty Google gave me some advice on how to combat my cuticle compulsion: 

1. Establish your triggers – they could be stress, dry hands, boredom, conflict or social media –  and write them down. 

2. Give yourself regular manicures to keep your nails and cuticles groomed and clean.

3. Keep your hands moisturised with hand creams, Vaseline or hydrocolloid plasters (you know, those pimple patches you have at the back of your bathroom cabinet? Yeah, use those).

Finally,

4. Distract yourself, keep your hands busy with other objects to ‘pick’ or play with. Like pens, bottle caps, stress balls, bits of paper – whatever works.

Not everyone who picks at their skin has a disorder, in fact, the psychology world has debated whether skin picking is a disorder, or an unfortunate habit. 

Associate professor Caroline Bell is the head of the Mental Health Clinical Research Unit at the University of Otago. Bell says that in order for a bad habit to become a disorder, it must significantly impair your life. 

“Often if it’s a habit you might spend some time doing it but it doesn’t stop you functioning. But for some people it really does. They can pick at scabs, [or at] their face, and spend hours a day doing it. It causes significant stress for them and impairs their functioning,” says Bell. 

Dermatillomania was only included in the Diagnostic and Statistical Manual of Mental Disorders (DSM 5) – the authoritative guide to the diagnosis of mental disorders – in 2013. Though it clearly existed before, there were still debates surrounding the disorder due to the spectrum of mild to severe skin picking.  It also was competing with many mental health issues for a spot in research. 

“Is it a sort of habit compulsion, like over-grooming? An obsession that’s gone wrong? Or is it something that is more to do with impulses when you’re feeling stressed that you do that as a way to relieve stress?” says Bell. 

“There are very few studies because it’s not really been seen as a disorder to be researched up until very recently. So the evidence around it is pretty new and not that established.”

There are two main approaches for treatment; cognitive behaviour therapy and habit reversal training. Bell says there are self-help methods that could benefit sufferers, depending on an individual’s skin picking severity. 

Bell recommends “recognising it as a problem in the first instance, then trying to recognise things that might be triggering you to do it, or feelings that you’re having at the time that you do do it. Then trying to address those things.” 

Determining whether you pick when watching TV, or sitting at your computer or are nervous is another key step, she says. 

Then, as my googling suggested, it’s vital that you keep your hands busy.  

“You’ve got to do something using your hands. It’s not just distracting yourself and looking away, you’ve got to be doing something with your hands to distract you from picking. Often it is really, really helpful for that.” 

Having the urge to pick your cuticles is a frustrating compulsion to have, especially as a perfectionist. You begin picking consciously but often can carry on over-grooming subconsciously, ending up with results opposite to perfect — you don’t realise you’ve hurt yourself until it’s too late and think ‘I wanted to make them perfect and now I’ve made a real mess of them’. 

Now stop picking, and go pick up that fidget spinner.




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