There are three types of skin-having people: those who actually heeded their mothers’ constant nagging, never squeezing at a bump, and let scabs survive full-term; those who maybe scratch at a mosquito bite one too many times before realizing the error of their ways and opt for some hydrocortisone, who only occasionally pop a zit—as a very last resort, when and if the little guy is ready; and then there are those who plant themselves in front of their billion-watt, 10x magnifying mirror, inspecting and poking and squeezing and prodding—mostly at stuff that barely even qualifies as a clogged pore, until, an hour later, they’ve completely annihilated the surface of their skin, left it swollen and red, shaking their fists at the heavens screaming, ‘DEAR GOD, WHAT HAVE I DONE?!”

Compulsive skin picking, sometimes referred to as dermatillomania, is like less-than-sober 3AM loops through the Whataburger drive-thru: kind of embarrassing, potentially harmful, and most people don’t like to admit they do it, let alone reach out for help. But unlike mindless late-night treks for Honey Butter Chicken Biscuits, we’re here to offer some guidance. Or actually, Dr. Amy Wechsler, double board-certified dermatologist and psychiatrist, is:

“Some people aren’t pickers and some are—you know scabs, pimples, you name it—from when they were kids, and that kind of picking is made worse during times of stress and anxiety. But picking and doing self-surgery is so bad. It can leave marks and scars, and can even be on the OCD spectrum, which is an anxiety disorder. You can cause an infection, and you can actually make the pimples worse. When you are squashing a pimple, you’re often pushing stuff back down into your skin when you squeeze. So even if you get that one out, you might be irritating another one right next door to it. Most people are not so extreme where they are doing it everyday for a long time. It’s just when they are particularly stressed out, or they’re sleep-deprived, or their skin is really breaking out and it hasn’t in a long time. The first thing I do, obviously, is try to fix whatever the skin issue is, so if someone is breaking out I treat their acne aggressively so there is nothing to pick at, but that can take a couple of months before it gets better so in the meantime, there are a few things I have people try...”

Enlist A Nagging Friend



“ It’s hard to stop, and people lose sense of time, so I have them enlist a partner. Unless someone lives by themselves—when you live on your own, it’s a lot harder—it will be whoever your roommate is, a spouse, a boyfriend, a good friend, a sister, whatever. You have to tell them, ‘I’m having this problem; I’m picking my skin and you can’t let me be alone in the bathroom for more than five minutes. Knock on the door, check on me. I’m not going to mind.’”

The Post-It Method



“What I will also do—this might sound goofy—but I will have people put up sticky notes in the bathroom that say things like, ‘Don’t pick!’, ‘Stop picking!’, ‘Don’t touch your face!’ People get into this state where they are not really mindful of what they’re doing, so that kind of a note helps jolt them back into reality like, ‘Ah, I have to stop that,’ is actually really helpful.”

Throw Out Your Tools



“Sometimes people are using tools like tweezers or needles, and I make them throw them out. And if they have a magnifying mirror, I usually make them toss it. It makes a big difference, and your skin never looks like what it looks like in a magnifying mirror. That’s not reality at all.”

Up Your Self-Awareness



“ A lot of people have this type-A personality where they are trying to control their lives and take charge, and these people think they are making themselves better when they pick at their skin. And it might be something where—let’s say that the period of stress that caused you to pick at your skin goes away—inevitably, you will get stressed out again at some point, and that will be your vulnerable spot. You might be tempted to do it again. So it’s all about learning who you are and being more mindful and self-aware and asking for help if you need it. You have to realize that you are not actually making anything better; you’re just making things worse.”

Consider Laser Hair Removal



“ For girls who pick on their legs and things like that when they get ingrown hairs, it’s the same problem. Ingrown hairs are caused by a lot of different factors. One, someone could have just extremely thick hair. Or if they wax or use a razor with too many blades on it, the hair is pulled out really deep and will inevitably curl a little bit. But you want your hair to curl when it’s sticking back out of your skin, not when it’s still underneath your skin. It’s like when a splinter is stuck beneath the skin, and you have a body reaction, which is an irritated ingrown hair. So you have to figure out how to remove your hair in a way that decreases your ingrowns. The best way to do that is laser hair removal. If you have no hair, you have no ingrown. Ingrown hairs are usually pretty thick and the laser hair removal damages the follicle, making the follicle and hair narrower before eventually making it completely go away.”

Seek Professional Help



“ If picking at your skin really is a problem, go talk to somebody. People are sometimes embarrassed and feel like they’re the only one doing it, but it’s very common. They are not going to be judged. Your doctor will have treatments and other things to do for it. If it’s preoccupying you during the day, or if you find yourself alone doing it everyday, and are having to wear more and more cover-up just to conceal the damage you’ve done, you should ask for help.”

Clearasil ad by Rolando Ancheyta.