Content warning: the following discusses Compulsive Skin Picking. While the details are minimal, if you are squeamish you might want to move along. This post also includes mentions of self harm.
CSP is an easy acronym for something that has several really long names. Sometimes called dermatillomania, excoriation disorder, or simply Compulsive Skin Picking, CSP is an offshoot of OCD, and is usually triggered by anxiety, stress, or sometimes simply boredom.
CSP is one of the first signs I showed of anxiety as a kid. I remember being sent to school covered in bandaids because I’d had an allergic reaction to the flame-retardant treatment on my nightgown and I couldn’t stop picking at the spots it left behind. It was weeks before my parents found the source of the problem and realized that a) it wasn’t just a weird thing I was doing for attention b) what was causing it and c) public humiliation wouldn’t make me stop.
It took a long time for me to understand that CSP was a symptom of something bigger. As a kid, my parents were convinced I could just stop, and didn’t understand why I did it in the first place. Clearly it wasn’t healthy. I’ve had a few near misses when those spots got infected. I hate the scars. I hate walking into a room and seeing someone I haven’t talked to in a while and having the first thing they say be “Oh my, what happened?” when they see new scars or spots. But, like my anxiety, it’s not something I’m in control of. A lot of the time, I do it without realizing what I’m doing.
It was a trend that continued to varying degrees all through grade school, high school, college, and beyond. It quickly became a form of self-harm, even before I knew what cutting or self harm was. People would notice if I cut myself, but it was completely normal for a teenage girl to have spots, or a kid (especially one as clumsy as me) to have random scrapes, cuts, bug bites, etc.
This isn’t something I like to talk about. It’s embarrassing. It leaves permanent scars. It’s a visible expression of my mental illness, and while I can mask a lot of my symptoms, I can’t hide the bright red patches on my face, or the scars.
One of the “triggers” so to speak (for me) is that if there is any surface deviation or blemish on my skin, I’m compelled to pick at it. I can’t leave it alone. I have to make it go away.
Logically, I know that’s not how this works. I know that if I pick at it, it will only get worse. But Logic Brain doesn’t control Anxiety Brain, and Anxiety Brain says IT NEEDS TO GO.
Over the years, I’ve tried a lot of things to try to curb the habit. I tried covering the spots with bandaids, but there were too many, and a lot of them were on my face. I tried the old rubber band trick, but that was absolutely useless. I tried setting up rewards for myself, which was an absolute failure.
The only thing I’ve found that helps at all is prevention. If I can stop the blemishes from forming, then I have fewer opportunities. This is no easy task, since my skin doesn’t like to play nice. It’s sensitive and will break out if I so much as look at it wrong.
The first thing that helped was understanding what caused my break outs. Washing my face, moisturizing, using toner, etc, only got me so far. Then I found maps like this one:
I’ve found in my case this is mostly accurate. I made a conscious effort to drink more water (dehydration is actually one of my most dangerous depression symptoms, but more on that another time). Starting hormonal birth control last year for the first time was also a HUGE help.
So now that I know which areas of my life I need to concentrate on, it’s time to look at skincare. If you’re a woman, you’ve probably tried every acne care regime out there, tried dozens of different kinds of makeup, and spent way too much money on products that either make things worse, or don’t do anything at all. So I’m going to go over a couple of the things I’ve been using that have helped.
Lush Scrubbee $7.95, Lush stores
Honestly, this body bar marked a turning point for me. I received one as a gift and it has made SUCH difference.
While it’s intended for use mostly on the legs to treat razor bumps, I use it on my arms, where the skin is dry and I get a lot of bumps and ingrown hairs–prime targets for Anxiety Brain. One use and it reduced the spots by about 95%. I now use it every time I get in the shower, and it’s an absolute must have.
This is a combination moisturizer and pumice stone, so while it is FANTASTIC for body parts, I wouldn’t use it anyplace delicate, or on the face.
Korean acne patches ~$10-12 for 36, Amazon
I’ve tried several different versions of this, but they are my secret weapon, especially for spots on my face.
These clear patches draw out all of the sebum and inflammation in pimples and other spots. I put one on before bed and by morning the raised area is usually almost flat. Even better, all the grossness that was inside is stuck to the patch, so I still get that “satisfaction” a lot of CPS sufferers associate with picking or popping their spots. And, because my brain reads them as “band aid” I don’t have such a strong desire to mess with a spot when the patches are on.
Bonus: I have also put these on open spots that were inflamed and infected, and they did wonders to reduce the swelling, making it easier for me to leave them alone and allow them to heal.
Budget option: These are essentially blister band aids. Blister band aids are significantly cheaper, and it’s easy enough to cut them up and use them instead. There are 3 big draw backs, however: First, blister band aids are a lot thicker than the acne patches, so they can be very difficult to leave alone if you have CPS, particularly when cut into smaller pieces. Second, the adhesive on the band aids is a lot stronger, so shouldn’t be put in sensitive areas (such as near the eyes, for example, where the skin can tear). I’m also allergic to that adhesive, so I will break out worse when I use them. I don’t have that problem with the patches.
Lastly, the drawing-out-ness is stronger in the patches than the band aids, making them more effective.
Up & Up acne spot treatment ~$4, Target
I don’t have a link for this one, because like all good things, I think it was discontinued as soon as I discovered it. It is, however, a knock off of this product by Clean & Clear.
This lives in my bag. While I can’t speak for the C&C version, the U&U is a clear gel. When I feel something forming, I just dab a little on, pat it until it’s absorbed, and then it’s good to go. Usually within an hour or two I can feel a difference, and it’s invisible. I can even use it when I’m already wearing makeup.
I’ve tried a lot of different spot treatments, and this is the best one I’ve found in years. My old favorite, a Neutrogena pen, has been languishing in my bag for years as I tried desperately to get out every last drop of product or a replacement with no luck. I was finally able to toss it after finding this.
My other essentials are a good cleanser, toner, and moisturizer. I know these vary a lot from person to person, but the ones I like for my skin type (combination, sensitive) are: Burts Bee’s Cleanser for sensitive skin, Clean and Clear Morning Burst moisturizer for night time, under makeup, or day use during the summer when my skin is more oily, Olay Total Effects moisturizer for day use in winter, especially when bare faced. For toner, I use just witch hazel twice a day before moisturizing. Oh, and about once a week or once every two weeks I exfoliate. I like Hey Honey’s Trick or Treat exfoliater, which I got a sample of. Unfortunately I can’t find it on their website, though they do have this exfoliater and other pieces from the same line, so hopefully it hasn’t been discontinued. It’s a bit more expensive than I usually got for skincare, but it’s gentle, works really well, and I don’t have an allergic reaction to it, so for me it’s worth it.
Hopefully, if you have CSP, that’s given you some ideas to help you manage it. If you have other suggestions, please leave a comment below. I’d love to know how others cope.
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