Skin Care for Skin Pickers

Before and after skin

This is a post written by my coaching client Martha. She is so enthusiastic about the skin care routines and products that have helped her scars fade and was happy to write this generous article for you:

Decreasing Skin Picking First

When I began coaching sessions with Annette, I had been picking for 25 years. I had tried to quit many times before without success, using every imaginable intervention: tracking, psychotherapy, turning off the lights while in the bathroom.  Nothing seemed to work, and I was very discouraged.  With Annette’s assistance, using the techniques described in her books, I was able to drastically reduce my picking in a matter of months. As I replaced bad habits with good ones and found new coping mechanisms to deal with stress and painful feelings, my urge to pick subsided until it was virtually gone, much to my amazement.

(Note from Annette: If you would like to explore coaching with me, read about my coaching programs or schedule a free session.)

Niacinamide and Azelaic acid

In addition to the interventions I learned from Annette, I credit my success to a few skincare products that have dramatically improved my complexion and, therefore, reduced my temptation to pick.  Specifically, niacinimide and azelaic acid have done wonders to reduce my pimples, pore size, and inflammation.  The Toronto-based skin care company, The Ordinary, sells suspensions for less than $10.  An added perk of both products is that they fade dark spots and textural irregularities, which are common consequences of picking.

The downside of niacinimide and azelaic acid is they should not be used on broken skin, as they will only delay the healing process.  So, you need to already be somewhat on the path to recovery from your skin picking addiction for either product to be of much benefit.  Additionally, niacinimide is known to have a purging effect, which means your skin could get worse before it gets better as pimples come to the surface.  If this is still a trigger for you, then I recommend against using niacinimide until you are further along with your recovery.  Another complaint common with both products is that they have a tendency to pill under makeup.  If this proves to be the case for you, then I suggest using them at night.

Skincare Routine

With my skin picking mostly under control thanks to the forgoing products and the interventions I learned from Annette, I began to further refine my skincare regimen to target more of the damage caused by years of skin picking.  I experimented with different anti-oxidants, chemical peels, and brightening serums until I found a regimen that worked for me.  Here is my skincare routine, followed by an explanation of why I chose these products:

Morning: 

 Evening: 

 1-2x week: 

 As Needed: 

 

Cleansers

I prefer cleansers that are gentle and pH balanced.  Our skin is covered by a thin film called the “acid mantle,” made up of sebum and sweat, that protects the skin from bacteria and pollutants.  Because of the acid mantle, our skin is naturally acidic, with an average pH of 4.7.  Since cleansers are more alkaline, every time we wash our face we are disrupting the acid mantle.  That is why toners were invented, to restore the acidic pH of the skin after cleansing.  These days, most cleansers are “pH balanced,” with a pH of 5.5 to 6.5, eliminating the need for a toner.  (I don’t use a toner for this reason). Lately, I’ve been using The Ordinary’s Squalane Cleanser with great results.  It’s an oil-based cleanser, which means you apply it to dry skin, first rubbing it between your hands to emulsify the product.  I like that it removes makeup, dirt, and oil without stripping the skin of moisture.  Since I started using this product, I’ve found that I no longer need a nightly moisturizer after my serums.  It takes a while to get used to the lack of lather, but I assure you it works. 

Serums

After cleansing, I apply serums, starting with lighter, water-based formulations followed by heavier creams and oil-based suspensions.  In addition to niacinimide and azelaic acid (discussed above), I have begun to experiment with other products to target discoloration and textural irregularities.  I avoid products containing hydroquinone, as I have found it is much too harsh for my sensitive skin.  Instead, I like alpha arbutin, a gentle skin-lightening ingredient derived from berries that interferes with melanin production, fading dark spots and preventing new ones from forming. Topical vitamin C is another ingredient that has been shown to reduce discoloration and improve skin tone as well as fine lines and wrinkles.  The challenge with vitamin C is that most formulations are not compatible with niacinimide.  For this reason, I use niacinimide in the morning and vitamin C at night.  Lately, I’ve been applying an oil-based suspension of vitamin C (The Ordinary’s Ascorbyl Tetraisopalmitate Solution 20% in Vitamin F) at night, after alpha arbutin and before azleaic acid.  However, the best time to apply vitamin C is in the morning, especially partnered with alpha arbutin, because of the protection from sun damage these products provide. A common problem with serums is they can pill under makeup.  To minimize pilling, allow time for each serum to absorb into the skin before applying the next product or moisturizer.  Some pilling is unavoidable but generally fixable and outweighed by the benefits that serums provide. 

Moisturizer

During the daytime, I favor a moisturizer with added sunscreen to minimize the steps in my routine and the amount of product on my face.  I like Neutrogena’s Healthy Defense Daily Moisturizer (SPF 50), which I have found works well with The Ordinary products.  It’s not as powerful as sunscreens containing zinc oxide, but it does the job without being drying. At night, I’ve found I no longer need a moisturizer thanks to the combination of oil-based cleanser and serums outlined above.  However, when my skin needs added support, I’ll use The Ordinary Squalane Oil (Sephora, $7.90) or Aquaphor Healing Ointment.  CeraVe PM Facial Moisturizing Lotion (Target, $12.39) is another excellent and affordable option that contains ceramides, hyaluronic acid, and niacinimide. 

Exfoliation for Hyperpigmentation

I avoid products containing exfoliating ingredients and instead use a chemical peel once or twice a week to promote skin cell turnover, fade dark spots, and address textural irregularities.  I highly recommend The Ordinary’s AHA 30% + BHA 2% Peeling Solution, which provides a potent concentration of acids.  I believe this product has been the single most effective treatment in combatting hyperpigmentation and abnormal texture from years of picking.  I apply it to dry, cleansed skin twice weekly and leave it on for no more than 10 minutes, then follow with a serum.  (Be forewarned, it has the color of blood.)  You absolutely must not use this product on broken skin, as it can cause scarring.  It’s a good idea to introduce this product gradually (for example, by leaving it on for only two minutes or, better yet, doing a spot test on your arm) to see how your skin responds. If you are not yet far enough along in your recovery from skin picking to use a chemical exfoliant, I recommend Mario Badescu’s Exfoliating Scrub (Sephora, $26.00) or Clinique Pep-Start 2-in-1 Exfoliating Cleanser (Sephora, $19.50).  Both products contain granules that promote skin cell turnover without interfering in the healing process. 

Spot Treatments for Pimples

Although my blemishes have been greatly reduced by the forgoing skin care regimen, I still get the occasional pimple.  For these, I like Neutrogena’s On-the-Spot Acne Treatment, which contains 2.5% benzol peroxide.  I’ve found it’s gentle yet effective and clears most zits within 2-3 days. Another product I love is hydrocolloid patches.  These patches help draw pus and other impurities out of the pimple while keeping the skin moist and protected.  They are effective as a spot treatment as well as for promoting the healing of broken skin.  As an added benefit, they prevent you from touching the affected area and can provide an effective deterrent to skin picking.

Wow, thanks so much Martha! This is great. Like Martha emphasized, some of these treatments won't work if you are still damaging your skin by picking. If you need help, contact me to inquire about coaching.

Love and support,

Annette

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Anxiety and Skin Picking