As mentioned, the single most useful tool is an acne patch, or hydrocolloid dressing. You do not need to buy Hero Patches or Zit Sticka, as these are more about marketing, & packaging over medical therapy. You can purchase hydrocolloid dressings for less than one fifth the price of these brands. In the acute phase of wound management, it is about time & numbers over microdart technology with time released skin care actives. 

Get yourself some hydrocolloid acne patches from any pharmacy. Don’t pay more than 5-7 dollars for a box. Invest in a few boxes as most likely you will go through a sh*t load of desssings, especially if you are a prolific skin picker.

I really love the technology of microdarts. The best darts come out of South Korea. Darts are essentially time-released acne patches with skincare actives such as pigment correctors (vitamin C, arbutin, citric acid, kojic acid), as well as exfoliators (mostly BHA salicylic acid). Each patch contains 40 – 200 micro darts that penetrate the stratum corneum (top layer of skin). Over 4-8 hours, the darts release goodies as described into the epidermal layer of your skin.

The role of these darts can be considered when your acute picking wound or ulcer re-epithelialized. The best/fastest/ most effective/ cost effective way of healing an open wound is with hydrocolloid dressings, not with micro darts.

Skin picking will leave scars of some sort. Hyperpigmented scars are almost universally seen in Asian & ethnic patients. They occur when the superficial layers of skin are picked. Fortunately, most will fade within 6-18 months. Dig deeper & hypopigmented scars can result. This occurs because pigment cells are gouged out (they are supposed to reside in the epidermis & not under your fingernails).

PIH or pigment can be reduced with adequate sunscreen application. When the skin is completely healed, pigment inhibitors such as abrutin, kojic acid, vitamin C, niacinamide, liquorice root & botanicals can help.

I use lasers such as pico, nano & fractional to treat PIH. Treating the primary source of picking gives permanent results.

If you have this type of scarring, you have removed the pigment cells in the upper parts of skin. Hypopigmentation is much harder to treat compared to other skin scars. You can try sensible DIY microneedling at 0.2 mm. Add tacrolimus or bimatoprost topically. See the section on home treatments.

Failing that, my team at Cutis can employ other lasers & topicals, including phototherapy. I am the final step in scar revision as I use surgical methods of melanocyte transfer.

Simple mind exercises such as cognitive behaviour therapy, habit reversal therapy and acceptance & commitment therapy can help reduce your urge to pick. A clinical psychologist can help. You can also practice these techniques at home. There are heaps of informative videos on YouTube.

My suggestion is to get skin picking under absolute remission before the task of chronic wound management. Remission may take 2 to never (depending on your insight & your willingness to undertake therapy, either self-therapy or by a professional). The more insight you have, the faster the recovery.

Treating your scars will depend on the pattern of scarring you exhibit with skin picking. See below for more information.

This is challenging. You can try DIY microneedling with a derma stamper. Do not try to go deeper than 0.2 mm on your face, you may cause more harm than good.

If you compromise the skin’s barrier whilst you still have active picking, you may expose yourself to infection & scarring. 

Hypopigmented scars are usually from chronic skin picking wounds. Chances are you have gone deep. This pattern is also seen in cases of acne excoriee & drug induced skin picking, usually ice – methamphetamine.

Briefly, the use of microneedling & pigment stimulators such as tacrolimus or Latiesse are first line, followed by lasers then phototherapy & surgery.

For acute picking & infection prevention, a wound specialist can assist. A family physician is often the first health professional you should see.

Here is the catch- they may or may not know about skin picking disorder or dermatillomania. If they know how to manage (psychotherapy, SSRIs etc…), then you are in good hands. If they don’t, escalate your concerns. Your first port of call can either be a general dermatologist, a psychologist who specializes in OCD, or a psychiatrist who has an interest in treating this condition.

If you are in Brisbane, my colleagues at Cutis can help. We refer patients to the OCD Clinic in Bulimba.

Disclaimer: I am a procedural dermatologist. Skin picking disorder is a commonly treated skin condition that is seen by my medical colleagues, I intervene at the end to fix up scarring.

It’s complex. If you understand why you pick, it may give you better insight & seek professional help. Skin picking can be viewed as a combination of OCD as well as a self-gratifying condition. In many cases it is impossible to stop picking. Picking also makes you feel better (during the act), then you feel guilty, & the cycle continues.

I get it, but I am bad at counselling patients. You do need to see someone who has the skill sets & time to walk you through the healing process. If you are open to it, you will get better. If you deny that you have a problem, your condition will be chronic & have a major impact on your quality of life.

Not much. As reinforced, the best investment are hydrocolloid dressings. They start at 10 to 20 cents per patch. You do not need expensive brands.

A bottle of antibacterial wash is about 10 bucks, Tubigrip dressings are about 20-30 bucks. Melolin patches are about 3-5 bucks. Buy some Savlon or Bepanthen.

If you are serious about managing skin picking, get a referral to see a psychologist for CBT & HRT. Medicare & private health insurance subsidies visits. You need between 5 to 10 sessions to get it. Can’t afford it? Not motivated enough? Watch a few YouTube videos. In all seriousness, the sooner you get professional help, the better your life will be.