Dermatillomania Fingers: The Silent Struggle
You're in a meeting, and your thumb finds the edge of a cuticle. By the time you look down, it's bleeding. Finger picking is one of the most common forms of dermatillomania, and one of the easiest to hide, which is why it can go on for years.
By Nathan Peterson, LCSW, OCD and BFRB therapistDefinition of dermatillomania
Dermatillomania, also called excoriation disorder or skin picking disorder, is picking at your skin over and over, to the point of damage, and not being able to stop even when you try. It's a body-focused repetitive behavior (BFRB). The face is the most common spot, and the fingers are right behind it. For the full overview, see what dermatillomania is.
What dermatillomania on the fingers looks like
- Picking or peeling your cuticles
- Pulling at hangnails until they tear
- Picking the skin on the sides of your nails
- Peeling skin off your fingertips
- Using one finger or a nail to scrape at another
- Biting the skin around your nails
- Fingers that stay raw, split, or sore
Finger picking is often automatic. You don't decide to start. You notice after, when it stings.
Why fingers?
Your fingers are always with you, and they're always near each other. There's no mirror needed, it's quiet, and it's easy to do under a table or in your lap. A rough edge or dry patch can feel like it needs to be smoothed out right now.
Common triggers include boredom, stress, sitting still, screens, driving, and dry or cold weather that makes skin peel.
How does dermatillomania affect you?
Physically
Picking can leave fingers raw, bleeding, or scarred. Open skin around the nail can get infected, and picking near the nail over time can affect how the nail grows.
Emotionally and socially
You might hide your hands in your pockets or sleeves, skip manicures, or feel embarrassed shaking hands. It's easy to feel like you should be able to stop, and that frustration can turn into more picking.
How to stop picking your fingers
These come from habit reversal training, the main treatment for BFRBs. For the full version, see how to stop picking your skin.
1. Notice when you pick
For a few days, jot down when you catch yourself: where you were, what you were doing, and which fingers. Finger picking usually has a pattern.
2. Give your hands a job
When the urge shows up, do something that makes picking hard, like making a fist, holding a fidget, or pressing your palms together. Keep it up for about a minute, or until the urge drops. The urge is allowed to stay. Your hands go somewhere else while it does.
3. Take away the edges
- Keep cuticles moisturized so there's less to peel
- Carry nail clippers and trim hangnails instead of picking them
- Keep nails short and filed
- Wear bandages or finger covers on the fingers you pick most
- Wear gloves during the times you pick most, like TV or driving
- Try a manicure or nail wraps, if nice nails make you less likely to pick
I know, "use lotion" sounds way too simple for something you've been doing for years. The simple part is the point. The work is doing it every time.
Put nail clippers and a small lotion in the place you pick most, like your desk, car, or couch. Next time you find a hangnail, clip it instead. (Yes, your fingers will go looking for another one. That's the urge. Let it be there and keep your hands busy.)
If you want help building the whole plan, that's what the course below is for.
Common questions about finger picking
Is picking at your cuticles dermatillomania?
It can be. Picking a hangnail now and then is normal. If you pick your cuticles or the skin around your nails over and over, it causes damage, and you can't stop when you try, that could possibly be dermatillomania. A therapist who treats BFRBs can tell you for sure.
Can picking the skin around my nails cause an infection?
Yes. Open skin around the nail can get infected. If a finger gets red, swollen, hot, or has pus, see a doctor.
Does moisturizer help with finger picking?
It can. Dry, peeling skin gives your fingers more to find. Keeping cuticles moisturized and hangnails trimmed takes away some of the edges that set off picking. It works best alongside the other steps.
Is finger picking the same as nail biting?
They're close cousins. Both are BFRBs and they often go together. Some people pick the skin with their fingers, some bite it, and some do both. The same treatment skills help with all of them. See how to stop biting your nails.
