View Full Version : Skin picking and trichotillomania


Shevey
04-13-12, 09:54 AM
I don't know where this fits, so I'm putting it here until the mods move it or whatever.

I read somewhere that these two problems are related to ADHD, but I can't find that information again. Anyway, do any of you have these issues and if so, how did you stop? I've found so far that my medication has increased these issues to the point that I'm not sure my eyebrows are going to survive the Adderall.

hardiesl
04-13-12, 11:12 AM
Yes! I have this same problem! I've always done this, but now that I'm on concerta it's gotten so much worse. I spoke with to my dr yesterday about it, he says it's always a risk with stimulants and he doesn't want to give me anything just yet because I'm still trying to get the dosing correct. I do understand this, however, my poor face can't handle much more...it looks like a pizza! I did actually stop pulling my eyebrow hair, now i just play with it....but then again I plucked them til I only had half of one left...eh sharpie time!

gracious_mama
04-13-12, 12:35 PM
Skin picking is a major problem for me. I have always done it to some extent. It worsened when I was on street meds. Now that I am off the illegal crap and taking adderall there are still some family members that are highly suspicious I am using again because I CANNOT stop picking at my face, arms, neck, chest etc...

It seems different from the street amphetamines though - when I was doing them I would sit in the mirror and pinch these little whiteheads (that no one noticed) which created a scab that I would keep picking at but for some odd reason I did have more control over it...like I was actively aware of what I was doing and when I would want to pinch I would tell myself "Don't do that because no one notices that little whithead but they will if you mess with it." and I would be able to leave it alone.

On the adderal it is more of an unconcious thing or I don't have as much control of it. I will be on here and then realize I have been picking at my face but then even after I notice it I can't stop myself.

known_guy
04-13-12, 05:46 PM
I suffer from dermatillomania.
Been a sufferer in varying degrees since I was in grade school. Got worse in college, I think probably due to my ADHD medication. Been working hard at stopping this terrible, embarrassing habit for some time now.

I work to stop this "habit" every day. Been difficult, with moments of relapses and such, but got to keep pushing on. :)

Drewbacca
04-13-12, 09:48 PM
I pick out a lot of my facial hair. The habit started my sophomore year of college (not on any medication at that time). I think it primary started due to a) not liking hair growing out of my face and b) the repetitive bordom of a thirty minute bus ride to my school. It eventually became a nervous habit that I can't stop. I don't think it got any worse on the adderall, but then, I'm not sure that it could get any worse.

What I hate most about it, is how angry I get when anyone who is aware of my habit tries to correct me, thinking that they are doing me a favor.

I figure, that the only way I'm ever going to quit the habit is to take an all of the above approach:
First off, I have to get rid of the initial problem... for me, that would be irritation caused by ingrown hairs.
If I manage that, I need to kill the nervous habit, the "good feeling" I get when I finally get that hair that has been avoiding my mighty tweezer-fingers. I take zoloft and it actually seemed to help with that good-tingling-sensation.
Even if both of those are treated, I still pick out of habit as I've been doing it for years and it has become second nature. I need to replace the habit with a new one, like a stress ball in the pocket. I've considered wearing gloves or something during the times I'm most likely to pick (watching tv, driving a car, in a class room, etc.).

It would probably be worth trying an SSRI. If your response is the same as mine, and the "reward" aspect of picking goes away, then it might be easier to get under control.

take_too
04-14-12, 05:34 AM
When I was first diagnosed with adult ADD I was given dexamphetamine, here in Australia (WA) that's the first line of treatment. Within a couple of weeks, I had symptoms of dermatillomania, which is very similar to trichotillomania and it just got worse and worse. I knew it was the dex doing it because I had the same problem a few years ago when I took the stimulant Duromine to lose weight.

I tried so many things to get my picking compulsion under control, but it was like my fingers belonged to someone else, I had no control at all over them if they weren't actively engaged in some other activity, like typing. At times it got so bad I would kind of go into a trance and just sit for over an hour, picking at one small irregularity in my skin until I 'got it right'. Which of course I never did, just made more of a mess.

I finally went back to my doctor and asked if I could try Ritalin (we don't have many choices here in Australia for medication). I didn't think it would make any difference, but it did. Within 3 days I had completely stopped picking. There isn't even the slightest urge to pick. I don't understand why this medication is different for me, because its also a stimulant, or so I thought, but there you go. Maybe try a different kind of medication. I hope you find a solution because compulsive behavior that you can't stop, comes with its own kind of hellish insanity.

Shevey
04-14-12, 10:24 AM
when I was doing them I would sit in the mirror and pinch these little whiteheads (that no one noticed) which created a scab that I would keep picking at but for some odd reason I did have more control over it...like I was actively aware of what I was doing and when I would want to pinch I would tell myself "Don't do that because no one notices that little whithead but they will if you mess with it." and I would be able to leave it alone.

This, exactly this! Though in my case,most of the time it's blackheads on my nose or inner thighs (sorry if that's TMI) and then also whiteheads on my chest. Right now my chest is a mess of spots and scabs because it's gotten worse since I started Adderall.

I did actually stop pulling my eyebrow hair, now i just play with it....but then again I plucked them til I only had half of one left...eh sharpie time!

Yeah, right now my left eyebrow is a mess. I still have hair left, but there are scabs and sores because I will quite frankly dig open the skin to get at a barely grown in hair on a regular basis.

What I hate most about it, is how angry I get when anyone who is aware of my habit tries to correct me, thinking that they are doing me a favor.

I figure, that the only way I'm ever going to quit the habit is to take an all of the above approach:
First off, I have to get rid of the initial problem... for me, that would be irritation caused by ingrown hairs.
If I manage that, I need to kill the nervous habit, the "good feeling" I get when I finally get that hair that has been avoiding my mighty tweezer-fingers. I take zoloft and it actually seemed to help with that good-tingling-sensation.
Even if both of those are treated, I still pick out of habit as I've been doing it for years and it has become second nature. I need to replace the habit with a new one, like a stress ball in the pocket. I've considered wearing gloves or something during the times I'm most likely to pick (watching tv, driving a car, in a class room, etc.).

It would probably be worth trying an SSRI. If your response is the same as mine, and the "reward" aspect of picking goes away, then it might be easier to get under control.

This too! I get a "good feeling" when I finally get that hair that's been evading the tweezers too. I believe I am already on an SSRI (Effexor is one, right?) but while it helped intially with this, it seems to have been overriden by the addition of Adderall. I also find that I pick through my hair when I'm bored, but at least snipping off split ends isn't as destructive as picking my skin.

Also, I absolutely HATE it when my mother gets after me about my eyebrows. She knows I pick, but for crying out loud, I'm 35 years old, not a child.

At times it got so bad I would kind of go into a trance and just sit for over an hour, picking at one small irregularity in my skin until I 'got it right'. Which of course I never did, just made more of a mess.

And this! I'll go into the bathroom at work or school and be in there for 15 minutes at a pop because I'm entranced with picking. The worst time for me though is at night after my toddler goes to bed. I'll be in the bathroom for sometimes 30 minutes until my legs hurt from leaning over the bathroom counter to see my eyebrows in the damned mirror. :(

Anyhoo, thank you for sharing. I think I'll have to mention this all to my doctor when I see her next Wednesday. Initially I dismissed it as an acceptable side-effect, but the worse it gets, the less I find it so.

Fuzzy12
04-14-12, 01:17 PM
Shevey, I spent about 3-4 hours yesterday night scouring over every inch of healthy skin on my shoulders and arms (and finally moved up to the face) and picked at it till it was red and burning (still is :( ).

I tried so many things to get my picking compulsion under control, but it was like my fingers belonged to someone else, I had no control at all over them if they weren't actively engaged in some other activity, like typing. At times it got so bad I would kind of go into a trance and just sit for over an hour, picking at one small irregularity in my skin until I 'got it right'. Which of course I never did, just made more of a mess.

Sometimes, I'm not aware that I'm doing it but often I can't stop even when I realise that I'm ruining my skin for the next few weeks.

It gets worse when I'm stressed or tired. I wish I had some advice for you but I don't really know how to stop it.

Shevey
04-14-12, 01:28 PM
Shevey, I spent about 3-4 hours yesterday night scouring over every inch of healthy skin on my shoulders and arms (and finally moved up to the face) and picked at it till it was red and burning (still is :( )

It gets worse when I'm stressed or tired. I wish I had some advice for you but I don't really know how to stop it.

I can't stop myself either, so you're not alone in that. Last night I spent an hour or so in the bathroom picking and picking, and this was /after/ spending 30 minutes sitting on the couch doing it while my kiddo crawled all over me. I know what you mean about the redness and burning because I quite often work on my nose until it's swollen, red and my eyes are watering from the hurt.

I think originally it was a response to stress from my undiagnosed ADHD and has blossomed into a full-blown issue with the addition of Adderall. I was okay with it when it only meant maybe five minutes here, or five minutes there. The only positive thing about it is that when I paw through my hair in class to find split ends, I'm actually very focused on my professor's words, especially in my composition class right now for some reason.

Fuzzy12
04-14-12, 01:30 PM
I can't stop myself either, so you're not alone in that. Last night I spent an hour or so in the bathroom picking and picking, and this was /after/ spending 30 minutes sitting on the couch doing it while my kiddo crawled all over me. I know what you mean about the redness and burning because I quite often work on my nose until it's swollen, red and my eyes are watering from the hurt.

I think originally it was a response to stress from my undiagnosed ADHD and has blossomed into a full-blown issue with the addition of Adderall. I was okay with it when it only meant maybe five minutes here, or five minutes there. The only positive thing about it is that when I paw through my hair in class to find split ends, I'm actually very focused on my professor's words, especially in my composition class right now for some reason.

I think, it's quite soothing actually (at least while I'm doing it. Later I feel really bad about it). It's something I can focus my thoughts on to the exclusion of everything else. It drones out the noise in my head.

Flory
04-14-12, 01:33 PM
i don't know if its a similar thing but i get a crawling/tickling sensation in my skin like having a hair dragged across your face when im coming down from my meds >.<

Shevey
04-14-12, 01:39 PM
i don't know if its a similar thing but i get a crawling/tickling sensation in my skin like having a hair dragged across your face when im coming down from my meds >.<

Nah, I'm pretty sure it's not the same thing but I do think that's a known side-effect? It even has a name... formication. For me, I just have the impulse/compulsive need to pick or pull. It even extends to the desire to pick at my son's skin or my boyfriend's. I can control those though.

Flory
04-14-12, 01:40 PM
ahh thats a tough one, could you do something like shredding paper its a similar kind of tension pretty staisfying too ...or those bubbles they use for shipping things safely, something to kep your hands busy ?

Fuzzy12
04-14-12, 01:44 PM
i don't know if its a similar thing but i get a crawling/tickling sensation in my skin like having a hair dragged across your face when im coming down from my meds >.<

Nah, I'm pretty sure it's not the same thing but I do think that's a known side-effect? It even has a name... formication. For me, I just have the impulse/compulsive need to pick or pull. It even extends to the desire to pick at my son's skin or my boyfriend's. I can control those though.

Thanks for the info Shevey. Florence, I just looked up formication. Apparently it commonly accompanies taking Ritalin or Adderal and can be a common amphetamine with drawal symptom. Maybe that's what's happening?

http://en.wikipedia.org/wiki/Formication

And I love bubble wrap. I could pop it all day long!! :D

Flory
04-14-12, 01:45 PM
eeek...withdrawal, is that a sign that i'm becoming dependent or does that literally just mean the meda are wearing off for the day ?

it also doesnt help because i have a massive phobia of spiders, it can sometimes present as a creepy crawly feeling like theyve described on that link >.<

Fuzzy12
04-14-12, 01:47 PM
eeek...withdrawal, is that a sign that i'm becoming dependent or does that literally just mean the meda are wearing off for the day ?

It doesn't have to be a withdrawal symptom, it's also just mentioned as a side effect of Ritalin and Adderal. You are taking concerta, isn't it? Isn't that methylphenidate (like Ritalin) as well?

Flory
04-14-12, 01:48 PM
yeah thats right concerta with pm ritalin..it could just be a side affect then , thanks for checking for me

Drewbacca
04-14-12, 03:30 PM
This too! I get a "good feeling" when I finally get that hair that's been evading the tweezers too. I believe I am already on an SSRI (Effexor is one, right?) but while it helped intially with this, it seems to have been overriden by the addition of Adderall.

Effexor is an SNRI (Serotonin–norepinephrine reuptake inhibitor) as opposed to an SSRI (Selective serotonin reuptake inhibitor). I have no idea how they compare.

Drewbacca
04-14-12, 03:35 PM
It gets worse when I'm stressed or tired. I wish I had some advice for you but I don't really know how to stop it.

Initially, the picking actually went down in frequency when I started Adderall for exactly this reason; the frequency went way up when I was tired and down when I took the amphetamines. I guess we all react to them differently, since some people become anxious and therefor more likely to pick.

Medication definitely plays a role, but it isn't the only thing contributing (for good or for bad varies I guess).

Also, at the OP: Px: Adderall XR 20mg (2xDaily) is on the high end of the spectrum. I take 20-30mg a day. Have you tried a lower dosage?

talknerdytome
04-14-12, 04:48 PM
Florence...I have an intense phobia of spiders as well...this is just getting weird now...:-P

I obsessively pick my fingers until they bleed and pull out any hairs I think are 'course'. I'm on no meds, but I think it's something I started doing to occupy my mind and stop myself fidgeting when it was inappropriate and now I can't stop.

Shevey
04-14-12, 07:05 PM
ahh thats a tough one, could you do something like shredding paper its a similar kind of tension pretty staisfying too ...or those bubbles they use for shipping things safely, something to kep your hands busy ?

Funny you should mention shredding paper because it used to be that I never got through a dinner without completely demolishing several paper napkins.


Effexor is an SNRI (Serotonin–norepinephrine reuptake inhibitor) as opposed to an SSRI (Selective serotonin reuptake inhibitor). I have no idea how they compare.

Well, I was on Zoloft after my pregnancy because I was breastfeeding. I had to be taken off of it because it caused me to gain all of my pregnancy weight back in a 1.5 month span. We're talking like 40 lbs in that short period. Nasty stuff!


Also, at the OP: Px: Adderall XR 20mg (2xDaily) is on the high end of the spectrum. I take 20-30mg a day. Have you tried a lower dosage?

20mg XR a day was what my doctor started me on, but I either metabolize it rapidly or something else is going on. It worked great the first week with just a bit of dizziness, but now it's not working very well. The doc added 10 mg XR onto the end of the 20 mg because I have very long days. That was upped to 20 mg not long after. Anyhoo, my doc told me 20 mg XR was normal for adults to start with and did not titrate me up on it.

I'm pretty lost at this point.

Drewbacca
04-14-12, 08:45 PM
I'm pretty lost at this point.

What is your caffeine consumption?

Shevey
04-14-12, 09:28 PM
What is your caffeine consumption?

Oh... I can easily go through 3-5 twenty-four oz. bottles (or 72-120 oz.) of Diet Mountain Dew a day and that equals approximately 324-540 mg of caffeine a day. Needless to say, before I had an official diagnosis of ADHD, I was already heavily self-medicating the issue. I'm currently working on paring down my habit, but without having achieved an optimal dosage for my ADHD medication, I'm loathe to give up my caffeine crutch.

At least with Adderall causing dehydration I'm forced to drink more water, so it's more toward the lower side of those measurements these days. I usually drink on a 1-for-1 basis. One bottle of soda, refill it with water, drink that, repeat.

Drewbacca
04-15-12, 09:50 PM
Just my experience, but I've found that if I consume caffeine while still under the influence of Adderall, things get ugly; my head spins, I scratch more... it's somewhat similar to that just about to fall asleep feeling that the adderall keeps me away from in the first place. I honestly expect you'll see improvement once you've cut it back, but I know how hard it can be to give up a crutch. Since I have been on Adderall before, years ago, I knew what to expect so I had already adjusted my habits (cut the caffeine, drink more water, increase fiber) before I started taking it again and it has made a world of difference. I hope the same is true for you. Good luck!

Nautilus
05-05-12, 04:13 PM
I really like to pick at pimples and tweeze unwanted hairs, I go into some kind of zoned out state where I can think about other things, usually highly creative things, very calmly and happily.

I don't generally consider this a problem, because I have gotten to know how much I can do before damaging my skin, and when I just have to leave it. My skin IS red afterwards, but that fades pretty quickly and there's no injury left - it looks better than before. Usually.

If I am REALLY tired (seriously sleep deprived), I can zone out for too long - and be late for whatever it is I got up so early for, or just pick for too long, if this happens at night. Then I can get some damage before I realize "Stooooop! We passed the point of 'done'!", but nothing too noticeable and never causing permanent scars.

I get compliments on my "good skin/clear skin," which used to surprise me because I can see all the little blemishes, but now I just realize people don't look that closely and if you look at my skin in "zoom out mode" it does look just fine.

As long as people consider my skin to be "good" or "clear," and as long as it doens't make me late for things, I think it's OK I do this - not a problem. But it obviously stems from the same issue that can cause some people to get much too carried away.

By the way I also like to "groom" other people this way, especially if they have something noticeable -- if they'll let me get away with it! It's not that I don't find it gross, I do, but it's so satisfying. Not to gross anyone out or anything, but when I remove a large solid pimple for example, I can see the offending mass conquered on my finger, and see that I've just left a neat, empty pore behind, I feel like I just removed a tumor or something! I'm all proud of my great job... heh.

Shevey
05-06-12, 10:59 PM
Effexor is an SNRI (Serotonin–norepinephrine reuptake inhibitor) as opposed to an SSRI (Selective serotonin reuptake inhibitor). I have no idea how they compare.

I was looking at information on this the other day and from what I understand Effexor functions as an SSRI until you go over a certain dosage and I'm well below that dosage... it's something like 200MG+.

Conman
06-01-12, 12:06 PM
ive always had hair-twirling or nail-biting problems. ive gotten way better at the nail-biting but the hair-twirling has come back for the first time in years (since it's summer i am NOT medicated).

i also have a Hyperhidrosis which consists of my pits and feet sweating randomly and uncontrollably on a day to day basis (my hands and nether regions do it when im outside on a nice hot day as well). im seeing a dermatologist about that soon enough

DeejayAng
08-05-12, 08:21 AM
I can't stop it :(
It just feels like such a relief when the hair comes out ....you feel like 100lbs lighter. At least I do. It sucks....I think I might get off adderall because I cant deal with it anymore.

CheekyMonkey
08-07-12, 03:00 AM
I can't stop it :(
It just feels like such a relief when the hair comes out ....you feel like 100lbs lighter. At least I do. It sucks....I think I might get off adderall because I cant deal with it anymore.

Yeah, I would look for a different med that doesn't make it so much worse!

Drewbacca
08-07-12, 07:46 PM
I was looking at information on this the other day and from what I understand Effexor functions as an SSRI until you go over a certain dosage and I'm well below that dosage... it's something like 200MG+.

Yeah, who knows. Sertraline is an SSRI, but it is known to increase dopamine (while other SSRIs don't). It's hard to say when companies don't provide/publish this info half the time.

known_guy
08-08-12, 03:29 AM
Ugh, my skin-picking started when I was a kid. Back then I picked my lips. This continued throughout my youth and such. In middle/high school my Dermatillomania worsened in that at times I literally wished I could scrape all the skin off my face. In college this escalated to tacking in picking and scratching at my back and occasionally my scalp.

Over time I was able to control the urge to peel my lips, just on my own. Now I am taking Lyrica for anxiety, and I believe it may indirectly be aiding my efforts to control my behavior but still, when I get über stressed and am on Adderall/Ritalin, skin-picking wins.

This skin-picking stuff is tough. It sucks.

TurquoiseWind
08-11-12, 10:49 PM
i don't know if my skin picking is related to my ADD but its annoying. i don't think i have Dermatillomania or anything like that, i think its more of a nervous/boredom habit with me. i will pick at the skin on the sides of my thumbs and my other fingers. i normally just clip the skin off and let it heal once it gets bad but before then i can't seem to stop especially if i am nervous or upset, but i do it at other times as well. also i used to chew on the insides of my cheeks but thankfully i don't do that anymore. maybe it is related to ADD.

BluRdgChk
08-26-12, 01:57 PM
I've had issues with picking at scabs since I was about 4 years old. Since I started the Adderall three years ago, it's gotten really bad on my face, especially my chin and forehead. I don't know if it's nerves or boredom or what, but it sure is upsetting. I pick, it gets red and scabs, and I hate the feeling of scabs on my face, so I pick the scab and it re-scabs, and...you get the idea. I somehow manage to keep from doing it while I'm at work, but once I get in my car to drive home, it's a free-for-all. Anyone ever have any success in quitting the picking?? Advice please!!

Melbot
08-25-13, 01:41 PM
Wow, I'm am amazed how many of you are dealing with the EXACT same thing as me. I actually found out I have Dermatillomania a few months ago, before I suspected I have ADD. This is a HUGE problem for me! I absolutely HATE it! I am destroying my skin and I don't know how to stop! I know I shouldn't, I know how bad it is and I know the consequences but when I'm in that moment nothing else seems to matter. I get a sick satisfaction while I'm doing it but after I look at what I've done and I'm full of shame and regret! It's like that part of your brain that tells you you shouldn't do it is just not there. I'm on Wellbutrin right now after trying Vyvanse and Celexa. My doc hasn't diagnosed me with anything yet, he's just trying out medications with me right now. He doesn't even know about this horrible problem. He did refer me to a psychologist so I'm just going to save it for him since my GP would not have the first clue on what to do. I'm actually looking forward to going to the psychologist, maybe I can get fixed after living with these things my whole life!

Nicksgonefishin
09-12-13, 03:43 PM
I always wondered why I picked at my skin. It seemed that I have times where I pick till its raw and others where my arms heal completely. Years and years ago in school it coincided with fall and mosquito season and I just figured they were mosquito bites and tell people that to cover. Perhaps it was the stress of starting a new school year. Over picking pimples... Maybe just boredom. I don't get angry and just start in to release stress I just do it sub conciously. I havn't noticed an increase of picking with amphetamines at all.