How To Tell If You Have Acne Excoriée

Acne comes in different shapes and forms. There is comedonal acne such as blackheads and whiteheads, which are non-inflammatory and thus easier to treat with over-the-counter treatments and monthly facials. However, inflammatory acne such as papules, pustules, and cysts might require longer and more advanced treatments. Another acne-related condition that might sound unheard of to many is acne excoriée. According to the Mayo Clinic, acne typically occurs when your hair follicles — tiny holes in the skin — become plugged by dead skin cells and sebum under the influence of hormone fluctuations or lack of facial hygiene. But acne excoriée, on the other hand, is a different type of acne with an unusual cause.

According to DermNet, acne excoriée — or excoriated acne — is caused by the act of repetitively picking on and squeezing acne lesions with fingers, pluckers, tweezers, or pins, resulting in scars and scratch marks that may become permanent. For this reason, acne excoriée is also known as picker's acne, meaning it develops as a result of habit rather than by natural causes. Since acne excoriée is caused by an uncontrolled desire to pop your pimples, it can also be seen as a behavioral disorder that exacerbates your skin condition. Here are ways to tell if you have acne excoriée and how to overcome the condition.

The American Osteopathic College of Dermatology (AOCD) looks at acne excoriée as an excoriation disorder, marked by patients' conscious and uncontrollable impulse to scratch, pop, and squeeze their acne lesions. Excoriation disorders fall under the umbrella of obsessive-compulsive (OCD) and related disorders. In other words, you know picking at your pimples is wrong but you can't help it. Patients with excoriation disorders make up around 1.5% of all dermatology sessions. This condition is most common among women aged 15 to 45 and has been said to be linked with underlying psychological disorders such as anxiety and depression.

Since most of us feel the temptation to touch our acne or scabs when they look all dried up and are safe to remove, it's hard to tell if the urge is a signal of a behavioral disorder. To differentiate excoriée from pimple popping, medical aesthetician Savanna Boda tells Women's Health, "It becomes excoriée when you cannot stop and it becomes an addiction. There is a difference between popping one or two pimples from time to time and spending hours in the mirror picking at your skin and every imperfection." People think they can get rid of acne lesions by popping them, but this habit can infect existing acne, furthering inflammation and triggering more breakouts. Eventually, repetitive picking at acne leads to bleeding, ulcerations, disfiguration of acne, fungal infection, and possibly permanent scarring with hyperpigmentation.

There is a close link between acne excoriée and regular acne, so you need to seek treatment for your excoriation disorder. As long as you continue picking at your acne, it will never heal. According to Oliva Clinic, excoriated acne has a lot to do with the behavioral aspect, so the treatment must include behavioral therapy to control the skin-picking urge in addition to dermatological intervention to keep your breakouts under control. Cognitive behavioral therapy, habit reversal therapy, and acceptance-enhanced behavior are techniques that have been successful in managing the disorder.

In your behavioral therapy, you might be asked about your underlying psychological and emotional issues, so your healthcare provider can identify the roots of your skin-picking habit and name your triggers. For instance, you habitually pick at your pimples when you feel stressed or you have a tendency to touch your face unconsciously. Once you've known your triggers, do your best to avoid them. According to the United Kingdom's NHS, keeping your hands busy can also distract you from skin-picking urges. For instance, wear gloves or squeeze a soft ball whenever you feel like touching your face. If you can't fight the urge to touch your skin, opt to care for it instead by slathering sunscreen or moisturizer over it. In case your condition has escalated to the point where you're causing damage to your skin and the habit is making your life more stressful, visit a specialist for accurate diagnosis and treatment.