Stress and Skin-Picking: Controlling the Urge

As I was talking to my son, I was playing with a little piece of loose skin on the side of my hand. My son had tested positive for COVID-19 in a rapid test and was waiting for the results of the definitive PCR test. I fiddled with the piece of skin, pushed the loose part back and forth. Then I left it alone. That is, until I got a text from my other son the next day.

I had asked if he could bring my 6-year-old granddaughter to visit so I could take her to The Nutcracker. I remember going with my parents to see it at Lincoln Center. The local production was only an hour. I texted that I thought that was the perfect length. I remembered that, as a child, I thought the full-length production was fabulous but too long.

After he said, maybe, I envisioned holding her small hand as we walked to our seats. I pictured the hot chocolate we would get after. (My daughter is much better at talking, but my two sons seem to prefer texting. So, I texted away.)

Saddened and stressed, I ripped off my dead skin

I texted that I thought that weather-wise, Sunday was better than Saturday. He didn’t get back to me. Finally, I called him. He didn’t answer. He texted that he was sorry he couldn’t talk, but he forgot to say that the kids were going with my daughter-in-law to visit her mother in New Jersey over the weekend. She couldn’t come to the ballet after all.

I ripped the piece of skin off my hand.

My other son did eventually get his PCR test back. He had COVID. Luckily, there was no more loose skin to pick at that moment.

Skin cancer, stress and skin-picking are related

But a few days earlier, I had gone after another piece. It was between two fingers. I was stuck in traffic and getting stressed, so I started fiddling with this piece of skin. I twisted and turned. It was hanging by a thread, like a child’s loose tooth. Before I got home, it was gone.

I can see the pattern. Awareness is a partial victory. I fiddle with loose pieces of skin when I get stressed. They are not all the same variety. Some are pieces I have treated with the Efudex/calcipotriene combination. These will eventually come off by themselves. Sometimes, I can leave them alone. At other times, I dig a fingernail under a loose piece of treated skin and peel it off. It is the same feeling of satisfaction as peeling off sunburned skin. Others are probably pre-cancers, little baby squamous-cell-carcinomas-to-be. A couple might be warts. One of my dermatologists calls them little guys. The satisfaction is short-lived. Sometimes they bleed, and I feel sorry that I have opened myself up to infection.

OCD makes peeling dead skin more tempting

This picking results partially from Obsessive Compulsive Disorder (OCD). I take an anti-depressant, Trintellix, that is supposed to work well against OCD, but nothing is perfect. Back when I was a newspaper reporter, I would call a friend into the ladies’ room when I had an eruption of OCD-ish thoughts, and she would do the same when she had one. Sometimes, for both of us, it would be an overwhelming sudden onset of fear of death, either sparked by a news story or coming out of nowhere. It would make us sick to our stomachs and give us panic attacks.

We both found it beneficial to put a band around our wrists and give it a little snap to snap us out of it. I don’t do that anymore, but I do try to exert my willpower to come back down to earth.

In the case of my two sons, I told myself that even though my granddaughter couldn’t come to The Nutcracker, we would do something else and that it was OK to sit with disappointment. With the other son, the one with COVID, I started to catastrophize and think, “What if he dies?” But then I recentered, reminding myself he was fully vaccinated and didn’t seem too sick.

Bad habit or a symptom of mental illness?

The skin-picking habit is in the same family as excoriation disorder. Mental Health America explains that it is “a mental illness related to obsessive-compulsive disorder” and is “characterized by repeated picking at one’s own skin which results in skin lesions and causes significant disruption in one’s life. … The symptoms are not caused by a substance or medical, or dermatological condition.”¹

How do you fight the urge?

I depart, in that it does not cause significant disruption and in that my skin-picking is related to a dermatological condition – recurrent, or chronic, squamous cell carcinomas. But it remains a problem, and I know I have to be as vigilant about it as I am about putting sunscreen on.

If you have this tendency, what do you do to control the urge?