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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by lumpynikit on November 7, 2003, at 22:28:50
Hello, i am newly arrived here, after a little google searching. Your messages seem so supportive i thought i would try posting this most likely already exhausted topic..
i have ripped up my nails since i was 6, constantly have a 'lip problem' and will peel anything i can, often including others...(but not severly enough to warrrant any scarring, just a 'habit')
i have a high pain tolerance,
would consider myself impulsive, and would say that i 'zone out' when i engage in these behaviours.
i don't know what to call myself, am i impulsive/compulsive, am i episodic...
i am sorry but i have never really analyzed this as a truly abberant behaviour, i don't even know where to begin.
If anyone could share any information that might outline the scope and treatment of this behaviour, i would be really really gratefull.
Posted by galkeepinon on November 8, 2003, at 2:10:49
In reply to a redundant skin-picking question, posted by lumpynikit on November 7, 2003, at 22:28:50
Hi and Welcome!!! :-)
Have you ever been informed about OCD, BDD and Trichotillomania?
I read about the efficacy of fluoxetine (Prozac) in the treatment of pathologic skin picking in a double-blind, placebo-controlled, parallel trial.
21 adults with chronic pathologic skin picking agreed to participate and received 10 weeks of placebo or fluoxetine with a flexible dosing schedule up to 80mg a day. Three skin-picking measures were employed: the Clinical Global Impression-Improvement (CGI-I) scale, the Skin Picking Treatment Scale (SPTS), and a visual analog scale of self-rated change (VAS). In addition, depression, anxiety, and obsessions-compulsions were rated using the Hamilton Rating Scale for Depression (HAM-D), the Hamilton Rating Scale for Anxiety (HAM-A), the Spielberger State-Trait Anxiety Inventory (STAI), and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) for the duration of the study.
The results were pretty interesting:
17 subjects (6 treated with fluoxetine and 11 treated with placebo) completed the trial, at a mean fluoxetine dose of 55mg a day. Fluoxetine was significantly superior to placebo in the treatment of skin picking according to two of the three measures for the completer analysis and to one of the three measures for the intent-to-treat analysis. Maybe, if you are open to taking psychiatric medication, this controlled trial, one of many, possibly, of the treatment of pathologic skin picking suggests that fluoxetine may be of therapeutic benefit, maybe it would be for you also.Also, the primary treatment modality for CSP depends on the level of awareness the individual has regarding the problem. If the CSP is generally an unconscious habit, the primary treatment is a form of Cognitive-Behavioral Therapy called Habit Reversal Training (HRT).
HRT is based on the principle that skin-picking is a conditioned response to specific situations and events, and that the individual with CSP is frequently unaware of these triggers. HRT challenges the problem in a two-fold process. First, the individual with CSP learns how to become more consciously aware of situations and events that trigger skin-picking episodes. Second, the individual learns to utilize alternative behaviors in response to these situations and events.
Alos, skin picking is being identified as an obsessive compulsive disorder.
Are you perceiving imperfections or blemishes on yourself that no one else sees? You said 'i have ripped up my nails since i was 6, constantly have a 'lip problem' and will peel anything i can, often including others...(but not severly enough to warrrant any scarring, just a 'habit')'
It's also a condition where people say they don't know why they're doing it, but they can't stop despite the embarrassment. It is something that people do for no apparent reason, which interferes with their lives and work.This is just information that might outline the scope and treatment of this behaviour.
Best wishes to you,
Kristen
=========================================================================================
> Hello, i am newly arrived here, after a little google searching. Your messages seem so supportive i thought i would try posting this most likely already exhausted topic..
> i have ripped up my nails since i was 6, constantly have a 'lip problem' and will peel anything i can, often including others...(but not severly enough to warrrant any scarring, just a 'habit')
> i have a high pain tolerance,
> would consider myself impulsive, and would say that i 'zone out' when i engage in these behaviours.
> i don't know what to call myself, am i impulsive/compulsive, am i episodic...
> i am sorry but i have never really analyzed this as a truly abberant behaviour, i don't even know where to begin.
> If anyone could share any information that might outline the scope and treatment of this behaviour, i would be really really gratefull.
>
Posted by KimberlyDi on November 10, 2003, at 16:22:47
In reply to a redundant skin-picking question, posted by lumpynikit on November 7, 2003, at 22:28:50
Don't really have any answers for you, just wanted to share that "you aren't alone". I'm a picker also. My husband gripes at me (yet his nail biting is perfectly ok). ha. I do it less when I'm in a better state of mind. I peel the lips too. Don't like bumps, tags of skin, anything. Just get this relentless feeling that it's wrong, I just HAVE to get rid of it.
Aren't we funny in a way? lol
Hope someone has answers for you!
KDi in TX> Hello, i am newly arrived here, after a little google searching. Your messages seem so supportive i thought i would try posting this most likely already exhausted topic..
> i have ripped up my nails since i was 6, constantly have a 'lip problem' and will peel anything i can, often including others...(but not severly enough to warrrant any scarring, just a 'habit')
> i have a high pain tolerance,
> would consider myself impulsive, and would say that i 'zone out' when i engage in these behaviours.
> i don't know what to call myself, am i impulsive/compulsive, am i episodic...
> i am sorry but i have never really analyzed this as a truly abberant behaviour, i don't even know where to begin.
> If anyone could share any information that might outline the scope and treatment of this behaviour, i would be really really gratefull.
>
Posted by lumpynikit on November 10, 2003, at 18:26:46
In reply to Re: a redundant skin-picking question » lumpynikit, posted by galkeepinon on November 8, 2003, at 2:10:49
thank you very much, i appreciate the information and support. I could never have imagined the prevalence of this sort of thing.
Posted by EREIAMJH on November 11, 2003, at 11:34:54
In reply to a redundant skin-picking question, posted by lumpynikit on November 7, 2003, at 22:28:50
It could be an obsession, a tactile sensitivity (common in those with sensory integration dysfunction) or even a tic. My son and I both have Tourette, and skin picking, nail biting, skin chewing or lip chewing are very common tics among Touretters.
Posted by TexasChic on November 13, 2003, at 8:37:23
In reply to Re: a redundant skin-picking question, posted by EREIAMJH on November 11, 2003, at 11:34:54
I also have this problem. It's especially bad this time of year when my lips and cuticles get dried out. I pick at them until they are raw and bleeding and feel as if I can't stop myself. I sometimes don't know if I do it because of the need to get rid of the skin sticking out and make everyting smooth, or if it's some underlying need to hurt or damage myself (if only in a minor way). I think it may start as the first, and lead to the last. I know I always feel very ashamed afterwards about how terrible it looks.
Posted by lumpynikit on November 13, 2003, at 15:01:25
In reply to Re: a redundant skin-picking question » lumpynikit, posted by galkeepinon on November 8, 2003, at 2:10:49
yes, i think that is at least one of the underlying motivations that seem direct. I can't believe there are so many people who are as averse to any felt deviations from the elusive 'smooth skin' as myself. Usually i am aggravating some skin condition while someone tells me to stop and leave it alone. But it won't leave me alone...i feel it all the time, and eventually, although i might initially abstain, i end up unconsciously picking at it.
thanks..
Posted by Mariposa on November 14, 2003, at 11:45:08
In reply to Re: a redundant skin-picking question, posted by lumpynikit on November 13, 2003, at 15:01:25
I have been a picker/biter for as long as I can remember....had a verbally abusive father and I believe that is part of what started it all. Now I still do it and can't stop myself, for some reason the *act* is comforting even though it hurts,... a distraction from boredom or worry??? Currently on Lex, which has done wonders for me in other areas, but has not helped deter me from this bad habit.
Posted by TexasChic on November 14, 2003, at 14:26:47
In reply to Re: a redundant skin-picking question, posted by Mariposa on November 14, 2003, at 11:45:08
> I have been a picker/biter for as long as I can remember....had a verbally abusive father and I believe that is part of what started it all. Now I still do it and can't stop myself, for some reason the *act* is comforting even though it hurts,... a distraction from boredom or worry??? Currently on Lex, which has done wonders for me in other areas, but has not helped deter me from this bad habit.
>
I had a verbally abusive father also. I think keeping my hands busy doing this compulsive thing was the alternative to lashing out like I wanted to. My therapist told me my anxiety is left over from this time in my childhood too, she said back then, it served me well, it kept me alert when I needed to be so I could deal with the situation at hand. But now that I am no longer in that situation, my body doesn't know how to let that go. It made me feel better to think of it in a medical light. Maybe you can thing of your picking and biting in that light as well – a reaction you needed when you were young to protect yourself, but your body just doesn't know how to let go of it yet. It helped me to understand it a little, even if I can't stop it yet. Good luck to you.
Posted by TexasChic on November 14, 2003, at 14:54:48
In reply to Re: a redundant skin-picking question, posted by TexasChic on November 14, 2003, at 14:26:47
P.S. I'm on Lexapro 20mg as well as Topomax 75mg with no luck with the compulsive stuff so far either. Anybody know of anything that helps compulsive disorders such as this?
Posted by elleff on November 15, 2003, at 7:32:49
In reply to Re: compulsive disorder med question, posted by TexasChic on November 14, 2003, at 14:54:48
Hi all
I suggest you have a look at these previous threads which discuss this issue (in gruesome detail - not for the squeamish):
http://www.dr-bob.org/babble/20030619/msgs/236240.html
https://dr-bob.securesites.com/babble/20031015/msgs/270927.html
As mentioned in my previous posts I have found, after many failed trials, that Selegiline is the only thing that is effective for me.
The best regime seems to be 5mg sublingual per day, plus 500mg DL phenylalanine twice daily.
regards
elleff
Posted by TexasChic on November 17, 2003, at 9:06:47
In reply to Re: compulsive disorder med question, posted by elleff on November 15, 2003, at 7:32:49
Wow, thanks! That was very informative. It never occured to me to simply search for 'cuticle destruction". I never think so many people will have exactly the same odd problem I do. Its very enlightening when you discover it.
This is the end of the thread.
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