If the symptoms I have described are familiar to you, and you need to get help, initially, see your GP. Many in the UK are still less informed about CSP than they are OCD, but you should ask to receive a referral to psychologist or psychiatrist. Very often patients are referred, first of all, to a dermatologist, which may be appropriate if there is a skin disorder that needs treating, but ultimately you will also need to see a psychologist or psychiatrist for CBT. It is completely within your rights to ask to see a health professional with the appropriate training for CBT,
A regular form of Cognitive Behavioural Therapy may be used, although nowadays Habit Reversal Training (HRT) is the preferred method of treatment for CSP.
Habit Reversal Training challenges CSP in two ways. Firstly, the individual learns how to become more consciously aware of situations and events that trigger skin-picking episodes. Secondly, you learn to utilise alternative behaviours in response to these situations and events.
Habit Reversal was developed in the 1970s by psychologists Nathan Azrin and Gregory Nunn for treating nervous habits which are done automatically, such as tics, stammering and skin-picking. Therapy should focus initially on developing Habit Awareness and patients may be asked to keep records of when, where and under what circumstances they normally pick.
Tips for quitting
• If you get the urge to pick, try doing something that ties up your hands for a period of time until the urge passes, or even put oven mitts on your hands until the urge decreases. Even if you hold the urge off for 15 minutes you can work with it, next time try holding it off for 20 minutes and so on. One of the greatest things that has helped me is drawing and taking photographs. Both require the fingers to be busy and help calm the mind!
• Keep your skin as clean as possible. Use anti-bacterial soap or an oil-free cleanser. Try to see a dermatologist. The more clear your skin is, the less of an urge you’ll have to pick at it.
• Cover your mirror with cloth or paper if your face is the usual area that your picking focuses on.
• Use long or false nails! The thick tips help reduce picking.
• As with all disorders in the OCD spectrum, stay busy. The busier you are the less time your mind has to play with the urges to pick.
• When tempted to pick, care for your skin by applying a moisturising lotion instead.
• Get rid of all implements such as tweezers and pins used for picking.
• Try replacing some of the sensory aspects of skin-picking with a more desirable alternative. For example, keep an object by you that you can manipulate (squeeze or pull) such as a soft rubber ball or some Blu Tak. Textural materials are also really helpful like bubble wrap.