How to Talk to Your Doctor About Skin Picking

You know you need to talk to someone about your skin picking. Maybe you've known for a while. But bringing it up feels overwhelming: the shame of admitting it, the fear of being judged, the uncertainty about what they'll say. So the appointment comes and goes, and you don't mention it. Again.

This is incredibly common. Research suggests that most people with dermatillomania wait over a decade before disclosing the behavior to a healthcare provider. Not because help isn't available, but because the barrier to asking for it is so high.

Here's how to lower that barrier.

Why It's Hard to Bring Up

Understanding why this conversation feels so difficult can help you push through it:

• Shame: Skin picking often feels like a personal failing, something you should be able to control. Admitting it to a professional can feel like admitting weakness.
• Fear of being misunderstood: Many people worry their doctor will dismiss it as "just a habit" or tell them to simply stop.
• Lack of language: If you don't know the clinical term (dermatillomania, excoriation disorder, BFRB), it's hard to frame the conversation in a way that signals "this is a real thing."
• Minimization: You might tell yourself it's "not bad enough" to mention, or that other people have more serious problems.

All of these feelings are normal. And none of them are reasons to stay silent.

Who to Talk To

Your Primary Care Doctor (GP)

A good starting point for an initial conversation. They can assess whether the behavior might have a dermatological component (acne treatment, skin infections from picking) and provide referrals to mental health professionals.

Be aware that not all GPs are familiar with BFRBs. If yours isn't, that doesn't mean you're wrong to bring it up. It just means you may need a referral to someone who specializes.

A Dermatologist

If your main concern is the skin damage from picking, a dermatologist can help with wound care, scar treatment, and managing conditions like acne that may trigger picking. Some dermatologists are aware of body-focused repetitive behaviors and can provide or recommend behavioral support alongside skin treatment.

A Therapist or Psychologist

For addressing the behavior itself, a therapist trained in BFRBs is the most effective option. Look specifically for experience with:

• Habit reversal training (HRT)
• Cognitive behavioral therapy (CBT) for BFRBs
• Acceptance and commitment therapy (ACT)

The TLC Foundation for BFRBs maintains a searchable directory of trained providers.

How to Start the Conversation

If finding the right words is the barrier, here are some scripts you can use verbatim or adapt:

With a Doctor or GP

"There's something I've been wanting to bring up. I have a habit of picking at my skin that I can't seem to stop. It's causing damage and it's affecting my quality of life. I think it might be something called dermatillomania or excoriation disorder. I'd like to discuss treatment options or get a referral to someone who specializes in this."

With a Therapist

"I'm looking for help with compulsive skin picking. I've been doing it for [however long], and I've tried to stop on my own but I haven't been successful. I've read that there are specific approaches like habit reversal training that can help. Do you have experience with BFRBs?"

If You're a Teen Talking to a Parent

"I need to tell you something that's been bothering me. I've been picking at my skin and I can't stop. It's not just a habit; I've looked it up and it's an actual thing called dermatillomania. I think I might need some help with it."

What to Expect

A Good Response Looks Like:

• Taking the concern seriously
• Asking questions about frequency, duration, triggers, and impact on daily life
• Discussing treatment options (therapy, possibly medication)
• Providing or offering a referral to a BFRB specialist
• Treating the conversation without judgment

A Less Helpful Response:

• Dismissing it as "just a habit"
• Telling you to "just stop"
• Seeming unfamiliar with the condition
• Focusing only on the skin damage without addressing the behavioral component

If you get a less helpful response, it doesn't mean your problem isn't real. It means that particular provider may not have training in BFRBs. Ask for a referral, or seek out a specialist directly through the TLC Foundation directory.

Preparing for the Appointment

To make the most of the conversation:

• Track your picking for a week beforehand: Note frequency, duration, triggers, and which areas you target. Concrete data makes the conversation more productive.
• Write down your questions: What treatments are available? Do you have experience with BFRBs? Can you recommend a specialist?
• Know what you want: Are you looking for therapy, medication, or both? Do you want to address the skin damage, the behavior, or both?
• Bring someone if it helps: If you're a teen or if having a supportive person in the room would make it easier, bring them.

Building Your Support System

Talking to a healthcare provider is one step. Building a broader support system amplifies your progress:

• Online communities: The TLC Foundation hosts support groups, and Reddit's r/Dermatillomania community offers peer support
• Trusted friends or family: Even one person who knows and supports you reduces the isolation
• Self-help tools: Untouched can help you build awareness of automatic picking patterns during computer use, supporting the monitoring that therapy often recommends

You Deserve Help

Skin picking disorder is a real condition. It has a name, a research base, and effective treatments. You don't need to meet some arbitrary threshold of "bad enough" to deserve help. If it's bothering you, that's enough.

The hardest part is starting the conversation. Everything after that gets easier.

If you'd like to start building awareness on your own while you work up to that conversation, Untouched is free to try and runs locally on your Mac with no video leaving your device.

This article is for informational purposes only and is not a substitute for professional medical or mental health advice. If you're struggling with skin picking, consider reaching out to a qualified mental health professional or visiting the TLC Foundation for BFRBs for resources and support.