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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Skin picking is a habit not self harm??

99 replies

Itsahabitnotharm · 12/04/2025 16:48

I’ve always had a bad habit of skin picking due to ASD, I very occasionally get an infection due to it. I saw a new GP at my surgery yesterday and I’ve just seen they’ve recorded it as ‘self harm’ on my notes ???

It’s just a habit?! Or is it now classed as self harm? AIBU to be annoyed at this

OP posts:
PaperSheet · 12/04/2025 20:41

I think the majority of people would agree that nail biting isn’t self harm. That would normally be classed as a bad habit. But for some people it gets lower and lower over time down past the finger tip. So at some point it would have to change from a bad habit to self harm.

So I think it’s not always as black and white as habit vs self harm sometimes. You could get someone who normally just nibbles on their nails but one day goes a bit far by accident and hurts themselves. But have never done it before. I wouldn’t say that person self harmed. Just that they had an accident due to their bad habit.

People like me who often hurt themselves I agree is more leaning towards self harm even though not deliberate.

ToTheCrystalDome · 12/04/2025 20:41

So in OP's context, why isn't smoking classed as self-harm?

Genuinelyenquiring · 12/04/2025 20:44

This is OCD. I know it as a body focused repetitive behaviour.

Inthemidafternoongarden · 12/04/2025 20:44

No I wouldn’t call it self harm and I don’t think any of my mental health colleagues would either.

AndrinaAdamosballetshoes · 12/04/2025 20:53

ToTheCrystalDome · 12/04/2025 20:41

So in OP's context, why isn't smoking classed as self-harm?

And drinking alcohol.

Clafoutie · 12/04/2025 20:57

intrepidpanda · 12/04/2025 17:48

Ridiculous. I do it too. Would hate to think they gave this the same credence as people cutting themselves etc..
Mental health queues are long enough without people being added for a silly habit.
Guessing nailbiting will be classed as trauma related next.

But 3 infections, even over the course of 6 years, is not nothing.
Having said that I think everyone has a right to say if they are not happy with how they have been described.

Hoardasurass · 12/04/2025 21:04

ToTheCrystalDome · 12/04/2025 20:41

So in OP's context, why isn't smoking classed as self-harm?

Because it's clarified as an addiction

AngryLikeHades · 12/04/2025 21:07

Depends on the intentions and could be both.

ToTheCrystalDome · 12/04/2025 21:09

Hoardasurass · 12/04/2025 21:04

Because it's clarified as an addiction

But skin and hair pulling is also a type of addiction. Nobody actually wants to do it but it's extremely hard to stop.

Happyher · 12/04/2025 21:13

Im 66 and I’ve done it most of my life. I started after giving up biting my nails. It’s not self harm in my case - just a habit. Some times I pull of too much because I don’t want the skin hanging but I’m not seeking any comfort other than habit

SoManyTeeth · 12/04/2025 21:39

YANBU OP. No matter how much the literal of mind chant "You are harming yourself, therefore it's self-harm, sorry 😊" that's not what the phrase "self-harm" means in practice in the real world.

Outside of some special use cases (e.g. metaphorical usage like "a societal act of cultural self-harm", or the occasional instance of someone using "self-harm" to refer to other harmful acts or habits like overeating or procrastination, in order to make a point), the term "self-harm" is widely understood to refer to a specific type of activity in which somebody deliberately causes themselves physical harm, with the intent of causing harm (and usually without suicidal intent), for a variety of reasons and purposes, but usually in the context of distress caused by mental illness or a history of trauma (or possibly in the context of social contagion). It's often things like deliberate injury to the skin, or sublethal ODs, things with the purpose of causing harm. The intent will generally be to cause damage and/or pain, maybe as a release, a distraction, an externalisation, a rush, a sensation, a punishment, maybe something else. It's complex, but causing harm (and/or pain) is generally the point.

Skin-picking, hair-pulling, nail biting and similar behaviours are completely different. The reasons behind it, the emotions, the nature of the compulsions, the thought processes, the intended outcome, the neurobiology, the most-often-associated mental health or other conditions, the most effective types of treatment, are ALL DIFFERENT from those you see in those types of behaviours that are usually labelled as "self-harm".

Very often, people with these body-focussed repetitive behaviours are following a powerful instinct (one which we share with other animals, which can develop similar difficulties) to remove irregularities or anomalies, in an attempt to heal, not harm. And it feels good to remove things your brain is telling you need removing. People who do these things might be seeking correctness, perfection, a good sensation, satisfaction, focus, or something along those lines. Sometimes their hands and mouths will automatically carry out these behaviours, outside their conscious awareness, in the same way you might jiggle your leg, brush hair out of your eye, or scratch an itch.

The self-injurious behaviours sometimes seen in e.g. some autistic children are different again.

Just because self-harm means "harm to the self" doesn't mean that, in practice, the term is actually used to cover any behaviour that causes harm to the self.

People who read that a person "self-harms" are probably going to proceed on the basis that this person likely cuts or maybe burns themselves, maybe takes ODs, deliberately causing themselves harm with the intent to cause harm, and probably as a maladaptive way of dealing with overwhelming distress.

They're pretty unlikely to think it might mean the person has a compulsion to remove hairs that don't feel like they belong where they are, or that they're in a neverending cycle of feeling compelled to make their fingertips perfect and smooth knowing it's only making it worse even though that's the last thing they want, or that their mouth and/or hands automatically drift to doing that whenever their attention is elsewhere, without realisation that it's occurring, let alone an intention to cause harm.

Using "self-harm" to refer to BFRBs (and SIBs) is misleading and potentially damaging, because a lot of people will interpret it to mean those specific kinds of behaviours (with their associated thoughts, feelings, and intentions) that are normally being referred to when people say "self-harm", and which need completely different management.

KezzaMucklowe · 12/04/2025 21:48

I used to do this, it was purely habit, I did it all the time. Obviously the more I picked the worse it hot which meant I had more skin to pick.
I think it's up to you if you would prefer to have your records changed and calling the practice manager sounds like a good plan.
If anyone is interested in stopping I found having my nails done - short, rounded with gels,stopped me from picking because I couldn't physically do it.

SueSuddio · 12/04/2025 21:48

OP I'm with you. I bite my nails and the skin around them.

It's habitual, I don't always realise I'm doing it and it big time self soothes me, in the way sucking my thumb used to as a young child.

Paranochyia is the harm it can sometimes cause, but that's when the bitten skin later leads to an infection. I don't bite to hurt myself or cause pain in the moment.

Big tip. The moment you see a redness, apply sudocreme or savlon then cover with a plaster. Keep reapplying every day. Works every time so I can keep on being a dirty nail chewer.

AmberTH12 · 12/04/2025 22:08

I do the exact same thing and I’m also ASD. I’ve recently made my skin really really sore to the point it’s quite painful to even have clothes over the areas. I’d never say it was self harm as I’m not doing it to intentionally hurt myself but reading it back it is clear that it is harming us so it must be self harm.

Hoardasurass · 12/04/2025 22:15

ToTheCrystalDome · 12/04/2025 21:09

But skin and hair pulling is also a type of addiction. Nobody actually wants to do it but it's extremely hard to stop.

Edited

No they are types of compulsive behaviour which is completely different from an addiction

SoManyTeeth · 13/04/2025 03:19

AmberTH12 · 12/04/2025 22:08

I do the exact same thing and I’m also ASD. I’ve recently made my skin really really sore to the point it’s quite painful to even have clothes over the areas. I’d never say it was self harm as I’m not doing it to intentionally hurt myself but reading it back it is clear that it is harming us so it must be self harm.

The way words are used, and the meanings they're used to communicate, don't always necessarily line up with the broadest literal interpretation of their components. I bet most Scottish people would be surprised to be served steamed trout with green beans if you'd promised them a fish supper. To most people who use the term, "self-harm" has come to refer to one specific type of behaviour that results in harm to the self, like "fish supper"in Scotland means going to the fish and chip shop, not any random fish-based evening meal. If you suffer from BFRBs but tell people, especially mental health professionals, that you self-harm, you will not be correctly understood, and it would be unhelpful for any further care you may need.

(Unfortunately, there are also some health professionals who haven't learnt that these are very different problems with very different causes and solutions, and instead just superficially lump it all together, as OP experienced.)

sadmillenial · 13/04/2025 04:29

read up on dermatillomania - i have been doing this for over 20 years but it is certainly (in my case) linked to anxiety and so i can understand why some heath professionals might add other mental health labels to their notes

OneTealMentor · 13/04/2025 04:38

ToTheCrystalDome · 12/04/2025 20:21

But trich (usually) doesn't cause infections. It's more for the 'buzz'.

In the DSM skin picking and trich are under the same category along with nail biting. Trich also can do a lot of physical damage too.
I don't class any as self harm. They are all self soothing BFRBs

BooseysMom · 13/04/2025 04:57

Pigeonqueen · 12/04/2025 16:57

I have autism and OCD and I’ve done this all my life, as long as I can remember. I pick the skin around my nails until they bleed. Sometimes it’s so bad I have to put plasters on them to stop myself doing it. Despite what others think it isn’t actually better or worse if I’m stressed or depressed, it really is a habit for me and I do it Al the time as a sort of self soothing thing I think. I don’t consider it to be self harm because when I’m doing it it doesn’t even hurt (!) although yes if I continue doing it too much it does, and that’s when I know I’ve gone too far. I’ve never been able to stop it. I am 44 now.

Edited

I am exactly the same. I'm 53 and have been doing this since I hit puberty so I think it's linked to hormones. Mine does get worse when I have extra stress and it's particularly bad now as I'm in peri. I do it until it hurts. I've tried to stop but I can't as something always triggers it again. I'm just resigned to it now. It's kind of comforting to know I'm not alone.

BooseysMom · 13/04/2025 05:05

Clafoutie · 12/04/2025 20:57

But 3 infections, even over the course of 6 years, is not nothing.
Having said that I think everyone has a right to say if they are not happy with how they have been described.

Edited

Agreed

IVFlife · 13/04/2025 05:16

I work in children's mental health. Yes we would classify that as self harm and alert parents to it.

It's a risk that it could lead to more serious self harm and also a sign that new, safer, coping mechanisms would be helpful.

You've attended the NHS 3x for infections due to this. That's quite a lot. I know it must be hard to hear what it's classed as though. From their point of view they also don't know how many infections you've managed yourself at home before needing help.

I think some people are being deliberately obtuse in the comments. Of course pulling off a random bit of loose skin thats half off beside your nail as a one off when it happens isn't SH. It's the repetitive nature or it and it becoming a coping mechanism that is the worry...particularly when it's causing repeated infections.

sunsu · 13/04/2025 05:38

as a skin picker I don’t like it being called self harm either as I don’t have the intention of hurting myself but it has always been called this as, whether intentional or not, it is harming ourselves.

PinkyFlamingo · 13/04/2025 05:50

Itsahabitnotharm · 12/04/2025 18:22

I will try to speak to the practice manager next week and see if they can amend it or add more information so it’s not just ‘self harm’

Why does this bother you so much?

Itsahabitnotharm · 13/04/2025 06:08

PinkyFlamingo · 13/04/2025 05:50

Why does this bother you so much?

Because ‘self harm’ and then just details of the medication prescribed doesn’t add any context at all and I want my medical records to be accurate. At any point in the future this could become an issue and make me seem like I have severe problems when I don’t , I have ASD and I have a skin picking issue. It makes it sound worse than it is and I’d rather it had more information and was the correct terminology.

OP posts:
HoldYourHat · 13/04/2025 06:33

My DH does this and I think he does it without thought.

I loathe it personally. Hate seeing it at the corner of my eye when we are talking or watching tv. Just going at his hands. I don’t know what to do but it’s getting very annoying to say the least. I fully train myself to ignore it.

I have tried to broach it but he is extremely sensitive and I feel I’m out of my depth actually to address it.

I’m hoping this thread gives me an idea how I can ask him to stop while I’m in the room.

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