Pressing around on a pimple, scratching on a mosquito bite - everyone knows that. It becomes problematic when you can't stop it. When it becomes a compulsion, it's called Skin Picking Disorder. And it doesn't just affect the skin, it's often a sign of a mental disorder.
When pimples and blackheads sprout during puberty, hardly anyone can keep their hands off them. And many adults scratch until a crusted wound bleeds again or the mosquito bite sucks. But even without such "occasions" some people feel the urge to work on their skin again and again - and cannot resist it. Then there is talk of a skin picking disorder. Dermatologist Steffen Gass from Günzburg observes that women are more likely to be affected.
What those affected can cause by pinching and pressing is obvious. "Something like that leaves scars, of course," says Gass, who is also a consultant for psychosomatic dermatology at the Professional Association of German Dermatologists (BVDD). And if you work on the skin with hands that are not completely clean, "it can also cause serious infections because germs are squeezed in".
The scars are especially visible on the face. This puts pressure on those involved. You scratch and push even more - a vicious circle. And much more than a purely dermatological problem. "In the end, it's often a sign of a mental disorder," says Steffen Gass.
This can be varied and of different strengths: both anxiety or severe depression can be behind it, but also current tension. "You then practically work them off on the skin, which finally resolves with a painful event." Basically affected are areas of the body that are easy to reach with the hands, the face, but also forearms or lower legs.
However, the patients who then visit a dermatologist's practice often do not say that they have psychological problems: "They show their skin. And then the doctors can see that it is not an overgrown dermatosis," says Gass. So not a skin disease, but something that the patient has produced himself.
It is important that the doctors act sensitively, take those affected seriously and build a relationship of trust. Medicines and ointments can be prescribed for acute inflammation. However, even more crucial is to get to the bottom of the cause of skin picking. And to recognize the connection between stress, mental stress and pinching.
Because there are alternatives to pinching in stressful situations. This can be autogenic training. Or you can work on other objects with your fingers to relieve pressure - for example qigong balls, plasticine or rice balls.
Showing those affected that their skin is constantly deteriorating or that scars are developing does not help to stop them from bruising and scratching. "The patients know that themselves, you don't need to tell them that because they can see it," says Steffen Gass.
A skin picking disorder should not be downplayed. "At first glance, the phenomenon may seem unpleasant to outsiders, but it can certainly have dramatic effects on some of those affected," says psychologist Martin Grunwald.
The founder and head of the haptic laboratory at the medical faculty of the University of Leipzig is planning a joint study with the Helios Clinic in Leipzig. Among other things, they want to find out why some people experience even minimal changes in their face extremely strongly.
And also why people react very differently to a pimple. Because some say to themselves: "He'll go away again, I don't have to worry about it." Others say: "It disfigures me, maybe it disappears faster if I press around a bit and apply ointment."
And then there are those who are convinced: "There is a huge crater on my face. Everyone can see that, I absolutely have to remove it!" A real panic then sets in with these people. "The signals that go to the brain are more or less the same in all people - but what the brain makes of them is the crucial point," says Martin Grunwald.
He suspects that a skin picking disorder could be a manifestation of a so-called body dysmorphic disorder. "That means we are dealing with a perception-psychological problem here: Your own body perception is disturbed." Martin Grunwald assumes that the reason why those affected cannot simply leave their skin alone is due to misperceptions produced by the brain.
The psychologist advises taking the first signs seriously. Anyone who notices that they are pinching or pinching in acute stressful situations should first try relaxation training. Anyone who finds that this behavior is particularly common and cannot be stopped should consult a psychotherapist who has experience with the subject.
