Picky, Picky

It’s been a while since I’ve done an advice post. So, inspired by a few inquiries from friends, I bring you the following public service post.

Are you a face picker? Are you obsessed with removing every little imperfection in your complexion? Do you spend a half hour at a time sequestered in the bathroom, up against the mirror, scanning every inch of your skin, imagining defects if you can’t actually see them? Do you inevitably make things worse, leaving yourself with an angry bleeding crater where there was nothing before but a slightly tender little bump? Do you promise yourself you’ll never do this again, only to be back at it the very next day?

I’m here to help.

I’ve known a lot of you. Under times of stress, I’ve joined your ranks. I’ve see many patients, almost always young women, with the telltale red marks fanning out across their cheeks. It’s never their reason for the doctor visit, and I know how painful it is for them when I bring it up, uncovering their shame. But there are things that can help you, if not stop, at least minimize the carnage.

Rules to Pick By

• Don’t think you’ll be able to stop through willpower alone. Habits like this—nail biting, hair twirling, face picking—are notoriously hard to break that way, at least in the long term. You need a strategy.
• The simplest trick of all, yet the one that is most resisted: Wherever it is that you’re doing it, switch the light bulb for one of exceedingly low wattage. When you can’t see the “problems,” one of the triggers is gone. Stop arguing about this one. Just try it. You can always switch the stupid bulbs back again.
• Get a face care regimen, and stick with it. It doesn’t really matter much which one. Most of them are based on one of four ingredients: benzoyl peroxide, retinoids, antibiotics, or salicylic acid. Some are over the counter, some are prescription. They all work ok, but none of them work overnight. You need to give a product at least a month to see if it agrees with you. (This is probably why the Pr0@ctiv system is successful. Although it’s just benzoyl peroxide, it gets you to buy into the regular use for a month thing. You can get similar “systems” for much less at the drugstore.)
• Consider investing in one of those electric pimple-zappers. These are pricey, but can be worth it. They ostensibly work by heating the blemish, and are meant to be used on the deep painful kind of blemish. This may or may not be effective at curing the pimple, but is definitely effective at hurting like hell. This is psychologically quite useful, because it gives you something serious to do. Take that! You can think as you hear the zap and feel the pain. If you can transfer your compulsion from picking—which is especially counterproductive with this kind of pimple—to zapping, you may be able to short-circuit the impulse to try and “fix” it by squeezing.
• When a pimple is healing—whether you picked at it or not—it usually flakes. Do NOT pick at these flakes with your filthy fingernails. Get a flat-tipped tweezer, and remove the dead skin with those. And don’t peel the skin back—pull forward, to pull off just the dead part. Scraping at the skin with your fingernails will grind bacteria in, and then you’ll get all sorts of nastiness.
• In fact, never scrape at your skin with your fingernails ever. If you end up with a blemish that MUST be manually removed—you know the ones I’m talking about, the kind that you avert your eyes from if you spot one on a stranger and wonder how on earth their loved one let them leave the house like that—do NOT pick at it with your fingernails. Use a washcloth, a cotton pad, almost anything but your fingernails.
• If you should end up with something on your face that is bleeding—which should only happen if you’ve ignored one or more of the instructions above, but whatever—I have a neat trick for stopping the bleeding in time for you to get to work. Remember how I said you should never use decongestant nasal spray for decongesting, but you can use it for a nosebleed? Well, you can also use it for other kinds of bleeding. A few drops on a bleeding wound constricts the blood vessels and stops the hemorrhage.
• Never use antibiotic ointments on any wound, but especially not on the face. About a third of folks who use these for any length of time develop a contact allergy to them, and the result looks just like an infection. So you keep putting the ointment on, and make the allergy worse, and put even more on, etc. … plain Vaseline is good for wounds, but use sparingly on your face, since if you spread it around, it’ll make you break out more. A tiny dab will help keep a lesion from looking quite so crusty.
• When you need camouflage, Dermablend is amazing stuff. Unfortunately it’s almost impossible to figure out which shade is best for you on line, which really sucks. If you can find a store that sells it, that’s probably the best way to find out, but I’ve never had the guts to approach one of those white-coated cosmetics ladies at the department stores myself. I’m not sure what I’m afraid of, but it has something to do with the thought of someone peering at my skin under bright lights and then gasping in horror. My skin is ok, but they’re paid to make you think your skin is only fit for a freak show.
• Try to remember that the vast majority of blemishes do not contain anything that has to come out. Yes, there is the odd whitehead or blackhead that can be easily removed, and very rarely an exceedingly ripe pustule that can be released, but most of the time, thinking that there’s something there that you can get out and thereby fix the problem is the path to madness, and to the wreck of a perfectly nice complexion.