Dermatillomania in 7yo

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My DD is 7 and has a skin-picking disorder. She’s always had a bit of a tendency to pick but I had previously thought it was mainly a bad habit…now I think it’s a compulsive disorder.

She’s mainly picks her face…she’s also a thumb sucker and will stroke and scratch her nose while sucking and once she has one scratch it seems to trigger more picking and she’ll end up with multiple sores. We remind her as much as we can to stop sucking her thumb and stop scratching but she also does it at night/in her sleep and has on numerous occasions come to us in the morning with blood all over her face.

It does seem to come and go in phases - a general pattern is that it tends to be worse in the winter months and clear up a bit in the summer (although a slight tan really shows up her scars)…possibly because of dryer skin but we always keep her skin moisturised. She doesn’t have eczema.

For the past 6ish months it’s been worse than ever. We’ve been to the GP and she’s had a referral to CAMHS and also dermatology, but don’t know how long the wait will be and I don’t know how to help her in the meantime. Her face is covered in sores at the moment and they aren’t healing because she won’t stop picking and she has also started picking her arms. We keep her nails short, have tried gloves but she takes them off, fidget toys and keeping her skin moisturised but she just keeps picking.

I’m so worried about it. I had a good cry today as I feel completely out of my depth and completely helpless. Has anyone or is anyone dealing with something similar and could offer some advice?

I have trichotillomania so not the same but needing my hands to be busy is very important.
Id look out for things that she naturally does that requirw the use of both hands and direct where possible to that activity. For me it was things like origami, crochet or video games with a controller. It's not perfect all the time but it's better to redirect with a let's play a game or come help me with this craft
It is such a tough one, I hope you find some great tactics for you!

She may like a picky pad - there are lots on Etsy. They are useful to keep your hands busy.

Thank you both for replying. I have ordered some
picky pads.

@Jambagsthank you for your insight and sorry this is something that affects you. Yes, I have found that keeping her hands busy is definitely the best distraction.

I hope you don’t mind me asking, but my DH and I are really trying to understand what is behind it…my DH thinks it is a form of self-harm and is scared about how that might develop as she gets older. I have read it is often stress or anxiety-led but this doesn’t really fit with my DD…she’s a happy girl and doesn’t seem anxious. She does struggle a bit academically but there’s no pressure on her at 7. My cousin also suffered with trichotillomania and has talked of uncontrollable urges that could only be satisfied by hair pulling and a kind of release…but my DD often seems to do it so absent-minded and like she doesn’t know what she’s doing until she’s done it. Are you able to identify what first started it for you?

I’m just feel like I’m struggling generally at the moment…I have 3 DC and they all need different types and levels of support at the moment, including my other DD who has ADHD. I also have ADHD and struggling with perimenopause symptoms and everything just feels so heavy and overwhelming and I’m feeling very low. It seems like if I spend time helping one of my other DC, I come back to my DD and find her bleeding and having picked at her sores again and I feel terrible and guilty and like I’m failing her. I’m just exhausted by it all and feel so sad whenever I see her beautiful face 😔

By the sounds of it, the skin picking that your daughter is doing is not self-harm. It seems more like a sensory habit.

She'll probably always want to be doing something with her hands, but you might be able to redirect the skin-picking to a more acceptable habit. I have a DD who used to absentmindedly pick at her fingers (not her face, thankfully). I got her a ring (you can get special fidget rings with a rotating bezel, but i just got a normal one) and she learnt to fiddle with that instead...the good thing about a ring is that it's right there, 24/7. My DD hardly picks at all now and her fingers look fine.

Stopping the skin picking while she's sleeping is tricky, but it might be facilitated by her sucking her thumb, so would Stop N Grow, painted on her thumb every night before bed, help to break the habit?

Another idea: what about putting a pair of tights on her arms instead of her legs at night, with pyjams over the top? These would be really hard for to remove in her sleep, and might stop the picking. If she's up for it, you could maybe try the same thing during the day (perhaps over half term or the Easter holidays, as she probably won't want to go to school with tights on her arms) - maybe a sustained period of no picking would break the habit, and you could have various treats/rewards planned along the way to reward her. You will probably have to help her get them on and off when she goes to the loo so she can wash her hands, but try to get her to keep them on at all times other than toilet/shower/eating. Have an alternative soothing sensory activity that she can do even with the tights covering her hands, like poppets, and keep her busy and distracted.

From my experience, this is a habit that does sometimes start up again even after apparently being broken, so be prepared to do it all over again from time to time. It's not a failure, just a relapse.

Oh yes, and another thing that helped my daughter was Vaseline! Because it's so greasy, it made it hard for her fingers to grip the little bits of skin around her fingers. So that might help too.

FWIW, my DD does still have a bit of scarring on her hands, but the scars have faded a lot over the years (they used to be pink, but now they're almost white) and aren't all that noticeable. And your daughter will be able to wear make-up if she's bothered (my DD isn't) about the scars on her face - there are some good concealers, so that will help too.

@CyberWithRosiethank you so much for this. You have no idea how grateful I am that you took the time to respond with such excellent and new suggestions for me to try.

I think you are right about it being more a sensory thing than anxiety-led or self harm. I like the idea of a fidget ring. She is allowed to have a fidget toy in school so long as it’s silent and not distracting. At the moment she has a marble in a mesh net thing but she keeps mislaying it. I will speak to her teacher and see if they will allow a ring (there’s a no jewellery policy but they are aware of her skin-picking/thumb sucking habit so they may make an exception if it helps her).

We have tried stop and grow previously for her thumb sucking, but weirdly she likes the taste so it wasn’t effective for her. My friend suggested a plaster dipped in chilli oil(!) which seems slightly brutal but may have more of the desired effect…I’m just concerned about it being transferred to her eye or something.

I’ll have an experiment with tights…but I agree that she needs something that is more difficult to take off.

Thanks again for your thoughts x