Since my dermatillomania diagnosis in 2022, I’ve implemented quite a few changes in my day-to-day life — both holistic and environmental — that do a pretty solid job at keeping my hands away from my face (I wrote about those strategies in this column, last year.) And for the most part, obsessive picking is a part of my past. But I’d be lying if I said I didn’t show up to my annual sister vacation this summer with a big self-inflicted wound on my chin, hoping the fresh air and seawater could work its magic and speedily heal my scab.
People who pick their skin know all too well the frustrating cycle that comes with compulsive picking: First, you scratch and dig at your skin under the guise of innocently “extracting a pimple,” then the obsessive face touching leads to the breakouts multiplying, and finally, in light of these new zits sprouting up, you double down and pick even more. This vicious cycle can be draining, genuinely violent, and oftentimes shameful. But the worst part, arguably, is the scarring — the weeks, sometimes months, of scabs, redness, and discoloration left behind from picking that not only serve as a gruesome reminder of the episode but can be pretty difficult to fade.
My point: Picking happens. Though I really advise you — in fact, I beg you — to consider what changes you need to prevent picking episodes from even starting in the first place (whether that’s simply changing the lighting in your bathroom or seeing a psychiatrist for more substantial treatment). In the event that you do pick, there are a few things you can do after the fact that might provide some level of damage control to heal the wound as quickly as possible and potentially control the severity of the scar left behind.
According to Dr. Ranella Hirsch, a board-certified dermatologist based in Boston, her most important tip, while it may sound obvious to some, is to try and cut yourself off as you recognize you are in the throws of a picking episode. Stopping a picking session and walking away from the mirror, she explained, is one of the most beneficial things one can do, as repeated trauma to your skin can only increase the likelihood of scarring.
Once you’ve ceased picking, Hirsch says to kickstart the skin’s healing process; it’s best to treat your skin as you would any other wound since your body can’t tell the difference between a minor scrape on your knee and a small scratch on your face. The first priority should be cleaning the area and preventing infection, which in this case can also help stop other breakouts from forming in the surrounding area. “I recommend first cleansing with something gentle, then reassessing every few hours if there is any evidence of infection, such as pain, discharge, or general worsening, which should be treated by a doctor,” says Hirsch.
While some might assume it’d be helpful to follow up with astringent alcohols, peroxides, or scrubs to help sterilize the areas you’ve picked, Hirsch explains that, conversely, using gentle, non-stripping products and keeping the areas as hydrated as possible will allow for your skin to best repair itself. “Moisture helps support the cells that aid in the healing process,” says Hirsch. “It can also prevent the formation of scabs which can leave behind a thicker and more visible scar.” Petrolatum-based products such as Vaseline as well as hydrocolloid pimple patches create a moisture-trapping occlusive barrier that protects the damaged skin and locks in hydration.
After about one or two weeks of doing the above treatment daily, your wounds from picking should appear less open, scabbed, or irritated. You can then assess the severity of the post-inflammatory hyperpigmentation or erythema, which is the flat brownish or reddish discoloration left behind from the picking, and incorporate products that include skin-brightening ingredients such as azelaic acid, glycolic acid, or niacinamide. Throughout all of this, Hirsch emphasizes it’s essential to be wearing SPF daily, as sunscreen is vital in preventing the formation of scarring and ensuring it doesn’t get worse.
Here are my recommendations for treating your skin after picking.
Hirsch says that pimple patches function by creating a physical barrier between the picked skin and the outside world, which can help avoid any bacteria or impurities from getting in the wound. The hydrocolloid patch also helps create a hydrated environment which can prevent scarring.
As pimple patches only cover a small area, they are best used when the skin you’ve picked is minimal. If you are hoping to cover a bigger area of your face, Vaseline is a better option for keeping the skin hydrated and protected. (Plus, you likely already have it in your medicine cabinet.)
Hirsch’s favorite healing balm is from Hero Cosmetics, which she likes using in conjunction with pimple patches — a pimple patch in the evening and Hero Balm in the daytime if you don’t feel comfortable wearing the patches out of the house. This is great to use on freshly picked skin, as it’s formulated with a blend of vitamin E, panthenol, and beta-glucan, which work together to lock in moisture while soothing redness and inflammation.
In a week or two after picking your skin, when there are no open wounds or scabs, you can then incorporate a treatment to start tackling the discoloration that the picked area has left behind. Hirsch’s go-to is Topicals Faded Serum, which is a mixture of skin-brightening ingredients (such as kojic acid, tranexamic acid, azelaic acid, and niacinamide) as well as soothing and hydrating ones (such as Centella asiatica, squalane, and glycerin) to fade discoloration and even out skin tone all while keeping the area moisturized and calm. Hirsch recommends using this product on clean skin after cleansing and before your moisturizer, starting off incorporating it into your routine one-to-two times a week and working your way up to daily use.
When it comes to picked skin, any sunscreen is a good sunscreen — in fact, it’s essential in making sure the scarring is minimized. Hero Cosmetic’s Force Shield sunscreen, which was formulated specifically for acne-prone skin types and uses all mineral filters, including zinc oxide, which is great for calming inflammation. It’s lightweight and also has a very slight green tint, which is excellent for counteracting redness on your skin from acne or picked spots.
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