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Mental Health (Expert Forum)
Correct treatment for skin picking?
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD), bipolar disorder, dementia, electroconvulsive therapy (ECT), learning disabilities, memory, obsessive compulsive disorder (OCD), panic, personality disorders, phobias, post-traumatic stress disorder (PTSD), schizophrenia, stress, transitions, and work problems.
Correct treatment for skin picking?
by steve, Feb 01, 2000 12:00AM
I have a problem with picking/biting skin from my thumbs. I am a 29 year old, professional male. I have read several web sites concerning the subject but most deal with people who pick skin from their face, scalp or limbs due to imagined or real blemishes. I usually bite or pick at my thumbs (the knuckle area) with the forefinger of the same hand and constantly rub and feel the knuckle area of the thumbs feeling for something more to pick at. The knuckle area of both thumbs is callused over and bleeds after I pick or bite through the calluses.
I tend to pick my thumbs more due to general anxiety. social anxiety or just boredom. I have done this for about 20 years and just recently mentioned the problem to my general physician about six weeks ago after years of hiding the problem and trying to stop this behavior on my own. I also have some mild depression. He has me on Zoloft, started at 25mg and now at 100mg/day. The Zoloft has helped the depression but I haven't noticed much help with the anxiety or the picking. I am tolerating the Zoloft well after the initial two weeks. Is the picking an OCD problem, an Impulse disorder, or an anxiety problem? Is it time to try upping the dosage of Zoloft or try a new medication? Also, is the general physician able to handle this problem properly or should I be seeing a physiatrist?
I tend to pick my thumbs more due to general anxiety. social anxiety or just boredom. I have done this for about 20 years and just recently mentioned the problem to my general physician about six weeks ago after years of hiding the problem and trying to stop this behavior on my own. I also have some mild depression. He has me on Zoloft, started at 25mg and now at 100mg/day. The Zoloft has helped the depression but I haven't noticed much help with the anxiety or the picking. I am tolerating the Zoloft well after the initial two weeks. Is the picking an OCD problem, an Impulse disorder, or an anxiety problem? Is it time to try upping the dosage of Zoloft or try a new medication? Also, is the general physician able to handle this problem properly or should I be seeing a physiatrist?
Doctor's Answer
by HFHS.MD-AJ, Feb 02, 2000 12:00AM
Steve,
It is impossible to make a diagnosis without a thorough history and evaluation. Your compulsive "skin-picking/biting" may be due to Obsessive-Compulsive Disorder (OCD), which is classified as an Anxiety Disorder. The treatment of OCD consists of medications such as Zoloft, in combination with cognitive-behavioral therapy. It may take up to 8 weeks before you feel the full benefits of Zoloft. Higher doses of Zoloft (up to 200 mg per day) may be needed to treat symptoms of OCD. You may find it helpful to seek evaluation by a mental health professional, and to have your medications managed by a psychiatrist.
It is impossible to make a diagnosis without a thorough history and evaluation. Your compulsive "skin-picking/biting" may be due to Obsessive-Compulsive Disorder (OCD), which is classified as an Anxiety Disorder. The treatment of OCD consists of medications such as Zoloft, in combination with cognitive-behavioral therapy. It may take up to 8 weeks before you feel the full benefits of Zoloft. Higher doses of Zoloft (up to 200 mg per day) may be needed to treat symptoms of OCD. You may find it helpful to seek evaluation by a mental health professional, and to have your medications managed by a psychiatrist.
I have this same problem. Except that I bite/pick all my fingers on both hands. It is difficult finding someone that is willing to talk about this problem. If you would like to email me privately my address is ***@****
I'd like to hear what your family doctor said. Mine told me that there was nothing she could give me to stop it. I am 32 and my family says I have been doing it since I was little.