Skin Picking Disorder and Autism | Causes, Symptoms, and How Therapy Can Help

The human skin acts as a protective barrier, but for some individuals, it becomes the target of an intense and compulsive behaviour known as skin picking. Officially termed Dermatillomania or Excoriation Disorder, skin picking represents a multifaceted challenge for many, including people with autism. For those who experience this condition, the repetitive act of picking can cause distressing physical, emotional, and social consequences. But how does this behaviour intersect with autism? And what strategies can help bring relief?

If you or a loved one is navigating skin picking related to autism, it’s vital to understand the underlying causes and find tools to manage the behaviour with compassion. By exploring the connections between skin picking disorder and autism, we can shed light on this complex topic and offer actionable ways to foster better self-care and well-being.

This article dives deep into skin picking disorder, its symptoms, its distinct relationship to autism, and effective methods to manage and address it. Equipped with expert therapeutic knowledge, this guide is also here to support carers, individuals, and others seeking understanding and positive solutions.

What is Skin Picking Disorder?

Skin Picking Disorder, also referred to as Dermatillomania or Excoriation Disorder, is a recognised mental health condition classified under the umbrella of obsessive-compulsive and related disorders. This behaviour goes far beyond the casual picking of a blemish or dry skin. For those affected, it is a compulsive act that is difficult to resist and often repeated despite painful and noticeable consequences.

Symptoms and Signs of Skin Picking Disorder:

• Persistent picking of the skin, leading to visible sores or scabs.
• Damage caused to healthy skin, not just irregularities like spots or scabs.
• Repeated failed attempts to stop picking, which may cause psychological distress.
• Spending significant time on the behaviour, sometimes hours daily.

What distinguishes this behaviour is its impact. The individual may feel trapped, as stopping can be extremely challenging. The resulting wounds, scars, and infections may lead to feelings of shame or embarrassment, worsening emotional well-being.

The Link Between Autism and Skin Picking

Skin picking doesn’t occur by chance or at random. Research and clinical understanding have uncovered strong correlations between autism spectrum disorder (ASD) and skin picking. While not all autistic individuals engage in skin picking, studies reveal that repetitive behaviours or complex sensory needs seen in autism often overlap with activities like compulsive picking.

Why Might Autism Be Linked to Skin Picking?

• Sensory Processing Differences
  Autistic individuals often experience heightened or diminished sensitivity to sensory input. For some, the sensation of skin irregularities can feel exaggerated, making it almost impossible to ignore small bumps or scabs. Picking, in turn, may offer temporary sensory satisfaction.
• Anxiety and Stress
  Anxiety affects many autistic people, particularly when routines are disrupted or environments become overwhelming. Skin picking can serve as a way to self-soothe during these stressful situations.
• Repetitive Behaviours
  One hallmark of autism is engaging in repetitive activities. While the reasons for repetition vary, skin picking might feel like a ritualised behaviour that provides a sense of predictability or control.

Research suggests that recognising the link between autism and compulsive behaviours like picking helps create more effective, personalised intervention approaches.

Symptoms of Skin Picking in Autistic Individuals

While skin picking might look similar in autistic and neurotypical individuals, the motivations and triggers can differ significantly. Recognising these unique nuances helps in tailoring support strategies.

How It May Appear in Autistic People:

• Heightened Focus on Specific Areas: Individuals might repeatedly target particular areas of their body, such as the arms, face, or scalp.
• Sensory Triggers: Feeling a rough texture or dry patch on the skin could set off the compulsion. The act of smoothing or removing these imperfections can lead to more intense picking.
• Associated Emotional Responses: Unlike neurotypical individuals who may pick due to boredom, autistic people may engage in this behaviour during emotional overwhelm or sensory overload.
• Routine Integration: Picking might become part of a daily routine or transition, making it harder to interrupt once established.

Why Does Skin Picking Happen?

Understanding the causes behind skin picking is key to managing it. For individuals with autism, the reasons can extend beyond typical explanations and involve both internal and external factors.

Possible Causes Include:

• Stress and Anxiety: When overstimulated, picking may help release tension and offer temporary relief, similar to other self-soothing behaviours.
• Sensory Overload or Understimulation: Certain textures on the skin may feel unbearable to ignore, triggering a need to ‘fix’ or smooth those areas.
• Rigid Routines: Autistic individuals often rely on predictable routines. Skin picking may evolve as a habitual activity tied to a routine or environment.
• Coping Mechanism: Faced with overwhelming emotions or external pressures, picking can become a repetitive activity that distracts from or controls feelings.

How to Stop Skin Picking – Practical Tips

If you or someone close to you struggles with this behaviour, take hope in knowing that solutions exist. The following strategies, when consistently applied, can make a difference.

Practical Tips for Managing Skin Picking:

• Keep Hands Occupied: Fiddle toys, stress balls, or textured materials can serve as an alternative focus during moments when picking is typically triggered.
• Create Barriers: Wearing gloves or using plasters on target areas may physically prevent picking.
• Identify Triggers: Keep a journal to record what happens right before picking episodes. Over time, patterns often emerge, offering insight into what to manage or avoid.
• Implement a Sensory Kit: Provide soothing textures (e.g., a weighted blanket or smooth fabric) to meet sensory needs without harming the skin.
• Introduce Replacements: Replace picking with healthier habits such as squeezing putty, engaging in hobbies, or doing breathing exercises.

Therapeutic Support: How a Hypnotherapist Can Help

Professional support plays a significant role in managing skin picking. Modern therapeutic approaches align specific techniques to the individual’s needs, often resulting in long-lasting change.

Cognitive Behavioural Therapy (CBT)

CBT helps individuals identify the thoughts or emotions driving their actions. For instance, it allows autistic individuals who pick their skin when stressed to recognise that stress and develop alternative coping methods. By reframing thought patterns, CBT can be a powerful tool for breaking the picking cycle.

Clinical Hypnotherapy

Through hypnotherapy, clients access a deeply relaxed state where they become more open to positive suggestions. For example, a therapist could guide someone to visualise smooth skin while reframing their compulsion in their subconscious mind. This approach not only addresses conscious triggers but also works on ingrained patterns of behaviour.

Neuro-Linguistic Programming (NLP)

NLP focuses on rewiring thought and behaviour patterns. By identifying the triggers causing the picking behaviour, an NLP-based approach could help the individual associate those triggers with healthier alternatives, gradually reshaping habits.

As part of a tailored programme, one-to-one or online hypnotherapy provides the professional oversight necessary for sustained progress.

When to Seek Help

Though behaviours like skin picking might seem manageable at first, there are cases when professional intervention is vital.

Red Flags to Look Out For:

• • Persistent wounds, infections, or scarring from frequent picking.
  • Emotional distress or withdrawal caused by shame surrounding the behaviour.
  • When the behaviour interferes significantly with daily life or well-being.

Engaging a qualified therapist can prevent the challenges of skin picking from escalating further.

 

Final Thoughts

If you or someone close to you is dealing with skin picking disorder and autism, it’s essential to approach the situation with patience and empathy. Understanding the causes, triggers, and available support can empower individuals to take control and make positive changes.

At Interlude Hypnotherapy, I work with individuals grappling with challenges like skin picking using a holistic and client-centred approach. Sessions, which can be held both face-to-face in Sheffield or online, draw from hypnotherapy, mindfulness, CBT, and more to create personalised care plans.

You don’t have to endure this alone. Book a free consultation with me today to explore how tailored support can help you or your loved ones find relief and regain confidence.

You can also contact me directly on WhatsApp by clicking here.